neck lumps

Question 1

salivary gland tumours:

• most common gland affected?
• most common type of tumour? (describe)
• age most affected?

Answer 1

• 80% parotid gland
• 80% pleomorphic adenoma

norm presents age 30-50

• slow growing tumour but has potential to turn malignant

Question 2

parotid tumours:

• symptoms?
• red flags for malignancy? 5
• investigation?
• treatment?

Answer 2

• painless, slow growing lump over parotid gland (normally nearer ear)

RED FLAGS

• facial nerve palsy (or any parasthesia)
• history of radiation to neck
• pain
• rapid increase in size
• ulceration of overlying skin (or underlying mucosa)
• USS with guided FNA
• surgery (occasionally with radiotherapy)

Question 3

differential diagnoses for salivary gland swelling:

• parotid gland? 5
• submandibular gland? 2
• minor salivary glands? 2

Answer 3

parotid:

• stone in salivary duct (most common)
• bacterial parotitis (norm unilateral)
• mumps (viral parotitis, both sided)
• benign + malignant tumours
• sjorgens syndrome (painless, bilateral)

nb also rare things like HIV-associated, wegeners granulomatosis, sarcoidosis

submandibular:
- stone in salivary duct
- benign + malignant tumours
(-sjorgens syndrome - less common)

minor:

• mucoceles
• benign + malignant tumours