How is Salivary Gland Cancer Diagnosed?

Salivary gland cancer is an uncommon or rare head and neck tumor that grows in the salivary glands that produce saliva. Salivary glands produce most of the saliva in our mouths. Other sites producing a salivary component include the major glands: parotids, submandibular and sublingual, as well as several other smaller glands within oral mucosa (which produce relatively small amounts of saliva and minor salivary gland tumors). Since Salivary gland tumors can be non-malignant (benign) or malignant, a precise diagnostic strategy is vital.

In Tender Palm Hospital, Gomtinagar, Lucknow, a comprehensive approach utilizing a panel of experts is recommended to provide dedicated care for salivary gland Cancer. In the event of suspicion for salivary gland Cancer, the specialists will investigate the primary lesion using in-depth clinical evaluation and imaging services such as Ultrasound, CECT scans, and MRIs.

Tissue sample assessment by pathologists, Laboratory tests, and possibly other specialized imaging such as PET-CT scans have all made it possible for our oncologists and head-neck surgical oncologists and their expert team to evaluate every suspected Case and precisely diagnose.

Why is an accurate Diagnosis vital for Salivary Gland Cancer?

Many Salivary gland swellings are not cancerous; in fact, 50 % of Salivary tumors are benign, not cancerous. Some swellings in the salivary glands can also be caused by chronic infections, stones (Calculi), cysts, and inflammatory conditions. Hence, a thorough investigation is needed to ascertain the exact diagnosis before undertaking any investigation and treatment to identify the nature and extent of the disease.

By using this systematic diagnostic approach, specialists can help to ascertain whether swelling is benign or malignant; which glands it involves; the type of the tumor; extent of local invasion; and whether there is any involvement of regional lymph nodes or distant metastases.

All information is obtained by means of Physical examination, Imaging studies, fine-needle aspiration cytology & biopsy of primary lesions & affected lymph nodes, & other specialty-related tests for final diagnosis.

Which specialist would diagnose Salivary Gland Cancer?

Diagnosis requires a multi -specialty effort. Typically the relevant specialists include:

• Head & Neck Surgical Oncologist - this is the prime specialist who would coordinate investigation & would be responsible for diagnosis and treatment planning. He will decide whether to perform any investigations and may include biopsy.
• ENT (Ear, Nose & Throat) Specialist - the ENT specialist is often involved with swelling related to major salivary gland cancer and is also interested in any accompanying involvement of nearby head & neck regions. Regions.
• Surgical Oncologist - He provides comprehensive support in planning and specimen handling, coordinating various teams when required for the Case.
• Radiologist - He specializes in analyzing MRI and CECT scans of these areas. He has a vital role in staging the extent of a primary lesion or in identifying nodal or distant metastases.
• Pathologist - He examines the tissue and cellular specimen procured from the patient under a microscope to determine/set whether the Lesion is benign or malignant and its type.
• Cytopathologist - If an FNAC is done of a salivary gland mass, these specialists can comment on cell types from the aspirate.

What happens during an Initial Salivary Gland consultation?

The Initial Consultations by the oncologist begin with a detailed medical history regarding, such as:

• How long has the swelling been present?
• Has it been growing or been there unchanged?
• Are there any painful or uncomfortable sensations within the lesion or any facial pain?
• Is there any abnormality of facial movement (weakness/paralysis)?
• Any difficulty in opening the mouth or problems while swallowing?
• Have you ever had an infection in the salivary glands?
• What kind of work do you do?
• Do you consume tobacco (smoking or chewing)?
• Family history?
• Past irradiation in the head and neck area.
• Any previous surgeries?

During the physical examination, the Head & Neck oncology team undertakes a systematic physical examination of all salivary glands, mouth and face including:-

• Parotid Glands: Situated in Front of Each Ear
• The submandibular glands: located in front of the jaw below and slightly back of the chin and behind the submandibular duct.
• Minor Glands: hundreds of very small glands dispersed through the lining of the mouth and lips.
• The sublingual glands: located beneath the tongue.
• The mouth, to include the inner aspect of lips and cheeks and tongue.
• Palpable lymph nodes in neck and face.
• The examination of the face to identify and assess for facial nerve weakness of all branches of the facial nerve (eyelids droop, inability to close eyelids, cheek puffiness, drooling).

What imaging scans detect Salivary Gland Cancer?

Once there is any suspicion of Salivary Gland Cancer, a specialist may perform one or a combination of these examinations to size, assess local, or confirm the presence of involved adjacent structures:-

• Ultrasonography (US):

  A highly effective method for initial assessment of superficially located lesions. A specialized ultrasound technique is useful in evaluating lumps arising from different salivary glands. US has also been commonly used in guiding FNAC procedures.

• Computed Tomography (CT Scan) with Intravenous Contrast Material :

  CT SCAN WITH contrast medium is ideal for delineating the boundaries of the tumor and showing extension to regional lymphatics and nearby bones, facial nerve proximity, and deep lobe extensions in the parotid gland. CT SCAN is of great value when dealing with larger or deeper tumors, especially submandibular and parotid tumors, which can extend into the middle ear or brain.

• Magnetic Resonance Imaging (MRI) :

  This can provide better visualization of the soft tissue features of the tumor. In particular, it can evaluate the relationship with the facial Nerve and its nearby extensions, and it shows the spread of the tumor with surrounding muscle, etc.

• Positron Emission Tomography-CT (PET-CT) Scan :

  In very selected Cases, this specialized scan may be used to find any metastasis that has developed elsewhere in the body that can't be found with typical imaging studies.

• Fine Needle Aspiration Cytology (FNAC):

  For salivary gland swelling, you would generally require FNAC to evaluate a tissue sample and rule out cancer from other benign lesions. If FNAC is ambiguous, additional fine-needle aspiration cytology procedures help obtain more sample, or even Fine-needle biopsy may be advised. FNAC procedure itself rarely causes injury or spread of the Cancer. However, it must be carried out by an experienced radiologist or surgeon.

Biopsy

If FNAC suggests any abnormal cells, a tissue biopsy may be performed for an exact histological diagnosis. Depending on the particular needs, tissue can be obtained via needle biopsy or incisional/ excisional surgery. The tissue thus obtained can undergo a procedure called histology, where it is then processed, prepared, and examined by the pathologist under a microscope. Histology is one of the keys to establishing a proper diagnosis of Salivary Gland Cancer.

Histological examination of Biopsy Specimen

It IS THE “GOLD STANDARD” for diagnosis, as a pathologic sample of a salivary gland tumor examined by a pathologist defines whether the specimen is benign or malignant. Malignancy cannot usually be definitively determined by imaging alone, & Histology is crucial not only for diagnosis but also for distinguishing and confirming the exact subtype(s) of salivary cancers, the grade of the salivary gland cancer, the pattern of cellular growth, and the pattern of Invasion. Histopathological findings are important for differentiating different types of salivary gland cancer and for arriving at treatment based on classification of Salivary Gland Cancer by different world organizations.

Immunohistochemistry

For a few salivary cancers, classification of the tumor is easily determinable solely by viewing their appearance under the microscope; thus, immunohistochemistry (IHC), as a stain, is used in these instances to help pathologists and clinicians differentiate these special subtype salivary tumors. The technique exploits specific antigens to identify them accurately.

Laboratory tests: Other basic laboratory blood exams, such as a routine blood count, tests to monitor the function of the liver and kidneys, and blood sugar (which is part of the basic evaluation) before any investigative procedure, and also to follow up at the end of the diagnosis, are standard investigations. Blood tests help us gauge patients' health at the time of diagnosis.

Salivary Gland Lymph Nodes: As the cancer stage also depends on whether these glands have moved into any adjacent neck lymphatic system (lymph nodes), these glands would also be checked both physically and in imaging, and when they are involved, FNAC may be needed in particular enlarged lymph nodes.

How is Salivary Gland Cancer Staged ?

The diagnosis workups finally lead to “Staging” of your salivary gland cancer, which helps the doctor to make an appropriate treatment Plan based upon the spread. Staging uses a global standard.

• The T stage(Size and Local Extension)
• N stage(Regional Lymph Nodes status)
• M status (Metastases to distant organs)

These stages are based on results from the physical examination and any imaging tests (MRI, CT SCAN AND PET SCAN) that are done to find the presence of cancer elsewhere.

A definitive diagnosis is the cornerstone for any cancer, and a comprehensive and state-of-the-art approach is mandatory to diagnose salivary cancer at Tender Palm hospital, Lucknow, correctly. Our dedicated team of head and neck oncologists and specialists is readily equipped to handle Salivary gland cancerous cases with the highest level of accuracy and precision.

Which diagnostic procedures are available at Tender Palm Hospital?

The diagnostic approach for a patient who has salivary gland cancer at Tender Palm Hospital is as follows:

• Special consultation with surgical oncologists (head and neck) and ENT specialists
• Full clinical assessment
• Ultrasound
• Ultrasound-guided FNAC
• Core needle biopsy and biopsies where required
• Histopathology examination
• Immunohistochemistry (IHC)
• Laboratory investigations
• Digital X-Ray
• CECT (contrast-enhanced CT scans)
• MRI scans
• PET CT scans (this is available via the integrated diagnostic network of the hospital)
• Multidisciplinary diagnostic review

These integrated diagnostic services are in place to ensure speedy evaluation.

Why choose Tender Palm Super-Speciality Hospital for Salivary Gland Cancer Diagnosis in Lucknow, India?

Tender Palm Super-Speciality Hospital offers advanced Salivary Gland Cancer Diagnosis services in Lucknow, India at an affordable cost. We use high-quality imaging, ultrasound, and biopsy facilities to closely examine the salivary glands for accurate and early detection of cancerous changes. Our expert ENT and oncology team, known for providing the best diagnostic care, ensures a safe procedure, quick reporting, and reliable results to guide timely and effective treatment.

To seek an Expert Consultation for Salivary Gland Cancer Diagnosis in Lucknow, India:

Call us at +91-9076972161
Email at care@tenderpalm.com

Request a Call Back