Parotid tumors: what are they?

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Parotid tumors are growths in the largest salivary gland, typically benign. Symptoms include swelling and difficulty moving facial muscles. Treatment involves surgical removal and sometimes radiation therapy. Survival rates are high, even for malignant tumors.

Parotid tumors are abnormal growths of tissue in the parotid gland, the largest of the three main pairs of salivary glands in the mouth and throat. The parotid glands secrete saliva into the mouth, thus making it easier to chew, swallow and digest food. A gland is located under each ear, under the jaw. Gland tumors typically increase in size but tend to grow rather slowly. When parotid tumors are diagnosed as malignant, they can usually be treated successfully.

Salivary gland tumors are generally quite rare, typically occurring in just one in 33,000 people each year. When such tumors develop, however, they usually manifest as parotid tumors. About 80% of parotid tumors are usually diagnosed as benign or non-cancerous.

The first symptom of a parotid tumor is often swelling of the gland, noticed as a hard bump under the ear. The enlargement is typically accompanied by little or no pain. As the facial nerve passes through the parotid gland, pressure on the nerve may eventually result in an additional symptom: some degree of difficulty moving the facial muscles on the affected side of the gland.

Tests to see whether a tumor is benign or cancerous typically begin with a biopsy to examine the tissue, usually in the form of fine needle aspiration (FNA). If further tests are needed for the diagnosis, they usually consist of one or more imaging studies using X-rays, computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET). When cancer is found, additional imaging studies are sometimes done to determine whether the cancer cells have spread to the lymph nodes.

Whether parotid tumors are malignant or benign, the primary treatment option is usually surgical removal of the tumor. The surgery usually carries some risk of a hangover as the surgeon has to cut around the easily damaged facial nerve. Candidates for this surgery are generally advised to ask their surgeons for an assessment of possible damage to the facial nerve and its consequences.

For cases where a cancerous tumor appears to be particularly aggressive or has already spread to the lymph nodes, the surgeon may also remove the lymph nodes. Such surgeries are often complemented with radiation therapy. In rare cases where chemotherapy is used to treat malignant parotid tumors, its use is usually limited to shrinking the tumors to reduce pain.

Even when parotid tumors have been diagnosed as malignant and lymph nodes are involved, the cancer is usually curable. The curability of cancer is assessed in terms of five-year survival rates. Even for malignant parotid tumors in which the cancer has spread to the lymph nodes, survival rates of up to 85% can usually be expected after treatment.

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