Parotid tumors are growths of cells that start in the parotid glands. The parotid glands are two salivary glands that sit just in front of the ears. There is one on each side of the face. Salivary glands make saliva to help with chewing and digesting food.
There are many salivary glands in the lips, cheeks, mouth and throat. Growths of cells, which are called tumors, can happen in any of these glands. The parotid glands are the most common place that salivary gland tumors happen.
Most parotid tumors aren't cancerous. These are called noncancerous or benign parotid tumors. Sometimes the tumors are cancers. These are called malignant parotid tumors or parotid gland cancers.
Parotid tumors often cause swelling in the face or jaw. Other symptoms include problems swallowing or a loss of facial movement.
Diagnosis and treatment for parotid tumors is often done by doctors who specialize in problems that affect the ear, nose and throat. These doctors are called ENT specialists or otolaryngologists.
Signs and symptoms of parotid tumors include:
Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.
It's not clear what causes parotid tumors. These tumors start as a growth of cells in the parotid glands. The parotid glands are two salivary glands that sit just in front of the ears. There is one on each side of the face. Salivary glands make saliva to help with chewing and digesting food.
Parotid tumors happen when cells in the parotid glands develop changes in their DNA. A cell's DNA holds the instructions that tell the cell what to do. In healthy cells, the DNA gives instructions to grow and multiply at a set rate. The instructions tell the cells to die at a set time. In tumor cells, the DNA changes give different instructions. The changes tell the tumor cells to grow and multiply quickly. Tumor cells can keep living when healthy cells would die. This causes too many cells.
Sometimes the changes in the DNA turn the cells into cancer cells. Cancer cells can invade and destroy healthy body tissue. In time, cancer cells can break away and spread to other parts of the body. When cancer spreads, it's called metastatic cancer.
Factors that increase the risk of parotid tumors include:
Tests and procedures used to diagnose a parotid tumor may include:
Collecting a sample of tissue for testing. A biopsy is a procedure to collect a sample of tissue for testing. It typically involves using a needle to collect fluid or tissue from the parotid gland. The needle may be inserted through the skin on the face and into the parotid gland.
In the lab, tests can show what types of cells are involved and tell if they're cancerous. This information helps your healthcare team understand your prognosis and which treatments are best for you.
Results from a needle biopsy aren't always correct. Sometimes the results say a tumor isn't cancerous when it is. For this reason, some healthcare professionals don't do a biopsy before surgery. Instead, they may take a sample of tissue for testing during surgery.
Parotid tumor treatment often involves surgery to remove the tumor. If the tumor is cancerous, you might need more treatment. This could be with radiation therapy and chemotherapy.
Operations used to remove parotid tumors include:
To get to the parotid gland, surgeons make a cut in the skin near the ear. The cut is often hidden in a crease of skin or behind the ear.
Sometimes a sample of tumor tissue is tested during surgery to see if it's cancer. A doctor who uses blood and body tissue to diagnose diseases, who is called a pathologist, looks at the sample right away. The pathologist tells the surgeon if the tumor is cancerous. This helps the surgeon decide how much of the parotid gland to remove. The pathologist also might test nearby lymph nodes and other tissue for signs of cancer.
The parotid gland surrounds the nerve that moves the muscles of the face. This nerve is called the facial nerve. Surgeons take special care to avoid hurting it. They might use electrical devices to check on the nerve and make sure it works as expected after surgery.
Sometimes the facial nerve gets stretched during surgery. This can cause loss of movement in the face muscles. Muscle movement often gets better over time. Rarely, the facial nerve must be cut in order to get all of the tumor. Surgeons can repair the facial nerve using nerves from other areas of the body or from artificial nerves.
Parotid tumor surgery can be complex. It requires well-trained surgeons and specialists for the best outcome. If you're facing surgery for a parotid tumor, meet with your surgeon before your operation to ask questions. Learning more about the procedure can help you feel more comfortable about your treatment plan. You might consider asking:
Radiation therapy uses powerful energy beams to kill cancer cells. The energy can come from sources such as X-rays and protons.
Radiation therapy is used to treat parotid gland cancers. Radiation therapy might be recommended after surgery. The radiation can kill any cancer cells that remain. If surgery isn't possible, radiation therapy might be the first treatment for parotid cancers.
Chemotherapy uses strong medicines to kill cancer cells. Chemotherapy is sometimes used to treat parotid gland cancers. It might be needed if there's a risk that the cancer might spread or if surgery isn't an option. In these situations, chemotherapy might be done at the same time as radiation therapy.
Chemotherapy is sometimes used on its own for advanced cancer, such as cancer that has spread to other parts of the body. Chemotherapy may help relieve pain and other symptoms caused by the cancer.
Targeted therapy uses medicines that attack specific chemicals in the cancer cells. By blocking these chemicals, targeted treatments can cause cancer cells to die.
Targeted therapy might be an option for treating parotid gland cancers when other treatments haven't helped.
Make an appointment with a doctor or other healthcare professional if you have any symptoms that worry you.
If your healthcare professional thinks that you might have a parotid tumor, you may be referred to a doctor who specializes in diseases of the ears, nose and throat. This doctor is called an ENT specialist or an otolaryngologist. If a cancer diagnosis is made, you also may be referred to a doctor who specializes in treating cancer, called an oncologist.
Because appointments can be brief, it's a good idea to be prepared. Here's some information to help you get ready.
Your time with your healthcare team is limited, so preparing a list of questions can help you make the most of your time together. List your questions from most important to least important in case time runs out. For parotid tumors, some basic questions to ask include:
Don't hesitate to ask other questions.
Be prepared to answer questions, such as:
