Salivary Gland Mass
A salivary gland mass is an abnormal growth or enlargement within one of the salivary glands, which produce saliva that helps with chewing, swallowing, digestion, and oral health. The major salivary glands include the parotid glands located in front of the ears, the submandibular glands beneath the jaw, and the sublingual glands under the tongue, along with hundreds of smaller minor salivary glands throughout the mouth and throat. Salivary gland masses may be benign or malignant and can result from tumors, inflammation, infection, stones, cysts, or autoimmune conditions. Most are discovered as a painless lump or swelling.
What is it?
The salivary glands produce saliva and release it into the mouth through a network of small ducts. The parotid glands are the largest and most commonly affected, followed by the submandibular and sublingual glands. Numerous smaller salivary glands are also present throughout the mouth, throat, and upper airway.
A salivary gland mass may arise from any of these glands and can have many possible causes.
Benign conditions are common and include pleomorphic adenoma, Warthin tumor, simple cysts, enlarged lymph nodes within the gland, inflammatory conditions such as sialadenitis, autoimmune disorders such as Sjögren syndrome, and salivary duct stones (sialolithiasis).
Malignant salivary gland tumors are less common, but the risk varies by gland location. Masses in the parotid gland are more likely to be benign, while masses involving the sublingual gland or minor salivary glands have a comparatively higher likelihood of malignancy.
Ultrasound is often the first imaging test used to evaluate salivary gland masses because it provides detailed assessment of lesion size, internal structure, vascularity, and location without radiation exposure.
MRI of the head and neck with contrast is the preferred imaging test for evaluating salivary gland tumors because it provides excellent soft tissue detail and helps determine whether a lesion is likely benign or malignant. MRI also evaluates the relationship of the mass to nearby structures such as the facial nerve, muscles, lymph nodes, and deep neck tissues.
CT imaging is often complementary and is particularly useful for evaluating salivary stones, calcifications, bony involvement, infection, or inflammatory changes.
Fine-needle aspiration biopsy is commonly performed when tissue diagnosis is needed.
Important to Know
Treatment depends on the underlying cause of the mass. Inflammatory and infectious conditions are usually treated with medication, hydration, massage, gland stimulation, or supportive care.
Salivary stones may sometimes be removed with minimally invasive techniques or surgery if symptoms persist.
Benign tumors are often surgically removed because they can enlarge over time and, in some cases, undergo malignant transformation.
When imaging or biopsy suggests a malignant salivary gland tumor, care is typically coordinated through a multidisciplinary head and neck oncology team and may involve surgery, radiation therapy, and occasionally chemotherapy.
Because the facial nerve passes through the parotid gland, careful imaging and surgical planning are especially important to preserve facial movement and function.
Follow-up imaging may be recommended to monitor treatment response, recurrence, or lesion stability.
Red flag symptoms include facial weakness or paralysis, rapid enlargement, persistent pain, numbness, skin changes over the gland, fixation to surrounding tissues, or enlarged neck lymph nodes. These findings require prompt medical evaluation.