Dawaa Reference

chronic

Salivary gland cancer

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD28.04 - condition scope only, no dose · Malignant Salivary Gland Tumors - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK563022/ · No dose - referral pathway, no medicine given in primary care

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (5)

  • A palpable lump in a salivary gland area, sometimes painful, is the usual presenting complaint [skin nodule]
  • Difficulty swallowing and facial weakness may also feature in the history [difficulty swallowing · facial weakness]
  • Advanced disease can bring pain, palate or parapharyngeal fullness, trismus, skin ulceration, or a fistula [fistula · skin ulcer · trismus]
  • Tumours of the pharynx or larynx can cause painful swallowing, airway obstruction, a hoarse voice, and breathlessness on exertion [breathlessness · hoarseness · painful swallowing]
  • A mass growing rapidly, with pain, facial weakness, or neck node swelling, raises suspicion for malignancy [facial weakness · lymphadenopathy]

Signs — what you find (5)

  • Facial nerve palsy turns up in roughly 12 to 15 percent of parotid cancers, especially with adenoid cystic, mucoepidermoid, or salivary duct carcinoma [cranial nerve palsy]
  • Submandibular cancers tend to feel firm and lobulated and may be fixed to skin or deeper tissue
  • A large, fixed mass in front of the ear can come with metastatic neck nodes
  • Sublingual gland cancer often shows as a painless, non-ulcerated floor-of-mouth mass, though about half of cases are painful and numb
  • Salivary NHL can show one- or two-sided parotid swelling with neck node enlargement, splenomegaly, and skin vasculitis with purpura [parotid swelling · purpura · rash · splenomegaly]

Tests (9)

  • Ultrasound is the first non-invasive study, best for superficial parotid lesions and for guiding a needle biopsy
  • Uneven echo texture, blurred margins, local invasion, and enlarged nodes on ultrasound point to malignancy
  • MRI is favoured for assessing deep-lobe, sublingual, or minor gland tumours, including nerve involvement
  • MRI outperforms CT for detecting perineural spread, particularly with adenoid cystic carcinoma
  • PET cannot separate benign from malignant tumours, since benign ones like pleomorphic adenoma also take up glucose avidly
  • Fine-needle aspiration is preferred over incisional biopsy for parotid lesions and separates benign from malignant with about 80 percent sensitivity and 97 percent specificity
  • FNA can struggle to pin down the exact malignant subtype and tumour grade
  • Core needle biopsy carries more pain and a higher risk of facial nerve injury and haematoma than FNA
  • An intraoperative frozen section tells benign from malignant with about 90 percent sensitivity and 99 percent specificity

If not this — what else fits (6)

  • A range of benign salivary tumours, such as pleomorphic adenoma or Warthin tumour, top the differential
  • Benign cysts, sialadenitis, and sialoliths are also considered
  • Reactive node swelling from infection or inflammation is on the list, including tuberculosis and mononucleosis
  • Chronic sclerosing sialadenitis, or Kuttner tumour, is more often seen in the submandibular gland
  • First branchial cleft cysts and lymphoepithelial cysts are considered, the latter especially in HIV-positive patients
  • Metastases from cancers elsewhere in the body can also mimic a primary salivary tumour

SourceStatPearls "Malignant Salivary Gland Tumors" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (RECOGNITION & REFERRAL)

1st line
Adult dose and duration

A firm, growing, or fixed salivary gland mass (usually parotid) is suspicious for malignancy and needs urgent ENT/head-and-neck surgical referral for biopsy and staging; there is no primary-care drug treatment. - Refer

Paediatric dose

Children follow the same pathway: recognise and refer. No primary-care medicine is implied.

Dose source

No dose - referral pathway, no medicine given in primary care

Why

A firm, growing, or fixed salivary gland mass (usually parotid) is suspicious for malignancy and needs urgent ENT/head-and-neck surgical referral for biopsy and staging; there is no primary-care drug treatment.

Cautions
  • Rare in Egyptian primary care.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.
  • RED FLAG - Concerning signs of malignancy beyond a firm, growing or immobile mass are rapid growth, pain, facial nerve paresis, and cervical lymphadenopathy.
  • RED FLAG - Fixation to skin or deep tissue, hard cervical lymphadenopathy, or pain, which is uncommon in benign salivary tumours.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.