Salivary Gland Malignancy Introduction

• SSx: malignancy suggested by the presence of a slow growing discrete mass (although may present as rapidly growing mass), facial nerve involvement, constant pain, cervical lymphadenopathy

• Evaluation: see Work-up of the Parotid Mass, pp. 66-68

• Dx: preoperative FNA is often utilized to counsel patient of risk of facial nerve involvement and malignancy, confirmation must be determined by a superficial parotidectomy (incisional biopsies are contraindicated due to the possibility of tumor seeding and violation of tumor margins)

• Poor Prognostic Indicators: submandibular gland involvement (parotid gland more favorable), parapharyngeal space involvement, high-grade tumors, larger size, facial nerve or skin involvement, painful tumors, recurrence, regional lymph nodes, distant metastasis (more common in adenoid cystic and undifferentiated tumors)

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