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Salivary Gland Mass Evaluation in Children

Purpose: To manage a child with a mass in the region of a salivary gland using the approach of Bentz et al.

Description

While most masses in the region of a salivary gland are benign, malignant tumors of the salivary gland or adjacent tissues may occur. In general the overall prognosis for patients is favorable. The authors are from Northwestern University Medical School and Children's Memorial Hospital in Chicago.


Masses in the region of salivary gland in children:

(1) Most masses are benign, with hemangiomas, pilomatrixoma, pleomorphic adenomas and reactive processes the most common.

(2) In the series reported, almost a quarter of solid masses were malignant (mucoepidermoid carcinoma, rhabdomyosarcoma, aggressive fibromatosis, malignant lymphoma or liposarcoma).

 

Initial evaluation:

(1) Does the lesion appear to be inflammatory? If so, treat with antibiotics and then re-evaluate when inflammation subsides.

(2) Is the lesion solid, vascular or cystic by physical examination and/or ultrasound? If the lesion is not solid, then follow it conservatively.

 

If the lesion is noninflammatory and solid, then perform an MRI or CT scan.

 

Location of Mass on Scan

Procedure

intraglandular

biopsy

extraglandular

wide local excision

 

 

Finding on Pathology

Management

benign (on biopsy)

wide local or superficial gland excision

carcinoma

superficial or total gland excision with or without neck dissection, chemotherapy and/or radiation therapy

sarcoma

superficial or total gland excision with chemotherapy and/or radiation therapy

 


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Specialty

Objective

ICD-10