Diagnosis & staging
Saliva enters your mouth through small openings called ducts. It has minerals needed to keep your teeth healthy.
There are three major pairs of salivary glands in and around your mouth:
- Parotid glands are the largest pair of glands. They are located in your cheeks, in front of each ear.
- Submandibular (or submaxillary) glands are just below the angle of the jaw bones, at the back of your mouth.
- Sublingual glands are under your tongue.
There are many other minor salivary glands in the tissues of your mouth and throat.
Image of salivary glands
Salivary gland cancer may also be called parotid tumour, Warthin tumour, mucoepidermoid carcinoma, and adenocarcinoma.
Salivary gland cancer is rare.
- A lump in your mouth, cheek, ear or jaw.
- Weakness or numbness in your face.
- Pain in your face or mouth that does not seem to be caused by anything.
- Problems swallowing.
- Swelling of your face or neck.
If you have any of the above symptoms for more than two weeks, see your doctor or nurse practitioner.
If you have any signs or symptoms that you are worried about, please talk to your family doctor or nurse practitioner.
These are tests that may be used to diagnose salivary gland cancer:
Exam by a doctor, nurse practitioner or dentist.
Biopsy: This is when a doctor takes a sample of your tissue. A specialty doctor (pathologist) then examines the tissue for cancer.
CT (Computed Tomography) scan: to see the tumour and if the cancer has spread.
For more information on tests used to diagnose cancer, see BC Cancer Library screening and diagnosis pathfinder.
Most salivary gland tumours are benign (not cancer). These are hardly ever life-threatening and not likely to spread. Benign tumours may be present for years with very little change.
Pleomorphic adenoma or mixed tumour: the most common salivary gland tumour. Often comes back (recurrence).
Warthin tumour: the second most common salivary gland tumour. Usually starts in the parotid glands.
Basal cell adenomas: rare and usually do not come back.
Malignant tumours are cancer. The most common type of malignant tumour of the salivary glands is mucoepidermoid carcinoma.
Staging describes the cancer. Staging is based on how much cancer is in the body, where it was first diagnosed, if the cancer has spread and where it has spread to.
The stage of the cancer can help your health care team plan your treatment. It can also tell them how your cancer might respond to treatment and the chance that your cancer may come back (recur).
Stage 1: The tumour is smaller than 2 cm (0.75 inches)
Stage 2: The tumour is larger than 2 cm but less than 4 cm (1.5 inches).
Stage 3: The tumour is larger than 4 cm and/or is spreading into nearby soft tissues.
Stage 4: The tumour is any size and is growing into nearby structures such as the base of the skull, or other nearby bones, or it is growing around the carotid artery (large blood vessel your neck).
For more information about staging, see About Cancer.
The grade of the cancer describes how different the cancer cells look from normal cells and how fast the cancer cells are growing.
A pathologist will give the cancer a grade after looking at the cells under a microscope. Salivary gland cancer is either low grade or high grade. They may also give the grade a number from 1 to 3. The lower the number, the lower the grade.
Malignant tumours are either low grade (low risk) or high grade (high risk). The grade depends on the type of cell that makes up the tumour.
Low grade: cells are abnormal but look a lot like normal cells. Low grade cancers usually grow slowly and are less likely to spread.
High grade: cells are abnormal and do not look like normal cells. High grade cancers usually grow more quickly and are more likely to spread.
- Some mucoepidermoid carcinomas
- Adenoid cystic carcinomas: the most common cancer of the minor salivary glands
- Salivary duct carcinoma: one of the most aggressive salivary tumours. This type often comes back or spreads to other parts of the body (metastasis).
- Oncocytic carcinoma: frequently comes back or spreads to other parts of the body.
- Large cell carcinomas: very rare, aggressive tumours
- Malignant mixed tumours: carcinomas that come from a benign pleomorphic adenoma.
- Most mucoepidermoid carcinomas.
- Acinic cell carcinomas: usually start in the parotid glands.
- Clear cell carcinomas: rarely spread beyond the salivary glands.
The grade of the cancer can help your health care team plan your treatment.