Submandibular And Sublingual Gland Tumors

Overview

These tumors arise in minor salivary glands beneath the jaw (submandibular) and floor of the mouth (sublingual). Submandibular cases show 40-45% malignancy, while sublingual exceed 90%, far higher than parotid's 20-25%. Common types include pleomorphic adenoma (benign) and adenoid cystic carcinoma (malignant, 42-49% in submandibular).

Clinical Features

Patients typically notice slow-growing, painless swelling in the neck or mouth floor. Malignancy signals include rapid growth, pain, fixation, facial nerve palsy, or lymphadenopathy. Neurotropic adenoid cystic variants may cause tongue nerve issues.

Diagnosis and Staging

Fine-needle aspiration, ultrasound, CT/MRI assess extent. Biopsy confirms histology; staging follows NCCN guidelines emphasizing margins and nodes.

Treatment Approach

Surgery is primary: complete gland resection for submandibular/sublingual tumors, preserving nerves if possible. Adjuvant radiation suits high-risk cases; neck dissection for nodes. Prognosis varies by grade—benign curable, malignant perineural spread worsens outlook.