Being told that you have a salivary gland tumor can naturally raise many questions. Is the tumor cancerous? Will the whole gland need to be removed? What happens during surgery? And will the operation affect your facial movement, saliva production, or appearance?
The answers depend on the type of tumor, the salivary gland involved, its size and location, and whether it is benign or malignant. Many salivary gland tumors are benign, but they may still require surgery because they can continue to grow, cause symptoms, or need to be removed for a definite diagnosis. When cancer is present, surgery is often an important part of treatment.
If you are learning about the surgical options available for these conditions, our Salivary Gland Surgery page provides a broader overview of salivary gland conditions and their surgical treatment.
What Is a Salivary Gland Tumor?
Salivary gland tumors are abnormal growths that develop in one of the glands responsible for producing saliva. They can occur in the major salivary glands—the parotid, submandibular, or sublingual glands—or in the smaller minor salivary glands found throughout the mouth and throat.
More than half of salivary gland tumors are benign, meaning they are not cancerous. However, a benign tumor can still require treatment, particularly if it grows, causes discomfort, affects nearby structures, or cannot be safely observed.
Malignant salivary gland tumors are less common but require careful evaluation and treatment planning. The type and extent of surgery depend on the specific cancer and how far it has extended.
When Is Surgery Recommended?
Surgery may be recommended for a salivary gland tumor for several reasons. The decision is not based on the presence of a lump alone.
- The tumor is growing: A progressively enlarging mass may need to be removed even when it appears benign.
- The tumor is causing symptoms: Pain, pressure, difficulty opening the mouth, swallowing problems, or other local effects may influence treatment decisions.
- The tumor is suspicious for cancer: A suspicious mass requires appropriate evaluation and, when cancer is diagnosed or strongly suspected, surgical treatment may be part of the plan.
- The diagnosis remains uncertain: In selected cases, removing the mass may provide tissue needed to establish the final diagnosis.
- The tumor has a risk of continued growth or recurrence: Some benign tumors can become increasingly difficult to treat as they enlarge.
Which Salivary Gland Is Usually Involved?
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
The parotid glands, located on either side of the face near the ears, are the most common site of salivary gland tumors.
Tumors can also develop in the submandibular glands beneath the jaw, the sublingual glands beneath the tongue, and the minor salivary glands.
The location matters because each gland has different surrounding structures that the surgeon must consider during treatment.
What Happens Before Salivary Gland Tumor Surgery?
Surgery is usually planned after the tumor has been assessed carefully. Your doctor may begin with a physical examination of the head and neck and then recommend imaging to understand the size and location of the mass.
Depending on the situation, imaging may include ultrasound, CT, or MRI. MRI can be particularly useful for assessing soft tissues and the extent of a salivary gland tumor.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
A biopsy may also be performed. Fine-needle aspiration is commonly used to obtain cells from a salivary gland mass. The sample is examined by a pathologist to help determine whether the lesion appears benign or malignant and what type of tumor may be present.
In some situations, the exact diagnosis may only become clear after the tumor or a larger portion of tissue has been removed and examined.
What Types of Surgery Are Used?
There is no single operation for all salivary gland tumors. The procedure is selected according to the gland involved, tumor location, tumor size, and whether the tumor is benign or malignant.
Parotidectomy
A parotidectomy is surgery to remove part or all of the parotid gland. When a tumor is located in the superficial part of the gland, a portion of the gland may be removed while preserving the remaining healthy tissue when appropriate.
More extensive surgery may be required when the tumor is deeper, larger, malignant, or involves structures beyond the portion of the gland where it began.
One of the most important considerations during parotid surgery is the facial nerve. This nerve passes through the parotid gland and controls many facial movements. The surgeon carefully identifies and protects the nerve whenever it is not involved by the tumor.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
Submandibular Gland Surgery
When a tumor develops in the submandibular gland, surgery may involve removal of the affected gland. The approach depends on the tumor's characteristics and its relationship to nearby nerves, blood vessels, and other structures.
If the tumor is malignant, additional surgery involving nearby lymph nodes may sometimes be considered depending on the extent and characteristics of the cancer.
Surgery for Sublingual or Minor Salivary Gland Tumors
Tumors arising from the sublingual or minor salivary glands require an approach based on their exact anatomical location.
Because minor salivary glands are distributed throughout areas such as the palate and oral cavity, the surgical procedure can vary considerably from one patient to another.
The objective is to remove the tumor adequately while considering nearby structures and preserving important functions whenever possible.
What If the Tumor Is Cancerous?
When a salivary gland tumor is found to be malignant, surgery is often a central part of treatment when the tumor can be removed safely.
The operation may involve removal of the primary tumor and some surrounding tissue. If cancer has spread to nearby lymph nodes or there is a significant risk of lymph-node involvement, removal of selected lymph nodes in the neck may also be considered.
The need for additional treatment after surgery depends on factors such as the tumor type, grade, size, stage, surgical margins, lymph-node involvement, and whether the tumor has invaded nearby nerves or other structures.
Radiation therapy may be recommended after surgery in selected patients, particularly when the tumor has features associated with a higher risk of recurrence. Treatment is therefore individualized rather than determined by the word “cancer” alone.
What About the Facial Nerve?
This is one of the most common concerns for people undergoing parotid tumor surgery. The facial nerve travels through the parotid gland and controls muscles responsible for facial expression. When a tumor is not involving the nerve, the surgical team generally aims to identify and preserve it.
Temporary weakness of facial movement can occur after surgery because the nerve may be affected by manipulation during the operation. Permanent weakness is a more significant concern when the tumor directly involves the nerve and the nerve or one of its branches needs to be removed as part of cancer treatment.
If the facial nerve must be sacrificed because it is involved by cancer, reconstructive or nerve-repair procedures may sometimes be considered as part of the treatment plan.
What Are the Possible Side Effects of Salivary Gland Tumor Surgery?
The risks depend on the type and extent of surgery. Your surgeon should explain the complications that specifically apply to your procedure. Possible effects can include:
- Pain, swelling, or temporary discomfort around the surgical area
- Scarring
- Temporary or permanent facial weakness after parotid surgery
- Numbness around the ear, jaw, or surgical area
- Changes in saliva production
- Bleeding or infection
- Fluid collection or a salivary leak in some cases
- Frey syndrome after some parotid procedures
Frey syndrome can cause sweating or flushing in the skin near the operated area when eating. It occurs because nerve fibers involved in salivary function can reconnect with sweat glands during healing. Not everyone develops this complication, and treatment is available when it becomes troublesome.
*AI-generated image - for illustration only. Clinical accuracy is not guaranteed.
The Bottom Line
Salivary gland tumor surgery is not one standardized procedure. The operation may range from removing part of a gland to a more extensive procedure involving the entire gland and, when necessary, nearby lymph nodes or other affected tissues.
Many salivary gland tumors are benign, but they may still need treatment. When a tumor is malignant, surgery is often an important part of treatment, with the extent determined by the tumor's type, size, location, stage, and relationship to nearby structures.
For patients, understanding the diagnosis and the planned extent of surgery is just as important as understanding the operation itself. Discussing the expected benefits, possible nerve-related effects, recovery, pathology findings, and need for additional treatment can help you approach surgery with a clearer picture of what to expect.
