Salivary gland lumps

• Causes:

  • Tumours - benign or malignant
  • Stones/calculi
  • Infection
• Salivary gland tumours:

  • Nearly 80% are benign and arise in the parotid gland
  • Typically present as a well defined, painless, slow growing mobile mass
  • Malignant tumours are rare - present as a mass with pain, rapid growth, skin fixation, paraesthesia and facial nerve involvement if parotid gland affected
  • Management - persistent/unexplained swelling = 2WW ENT referral
• Salivary gland calculi (sialolithiasis)

  • Stones form in a salivary gland ducts - most commonly submandibular gland
  • Swelling and tenderness worsen when person is eating due to increased saliva production
  • Symptoms last a few minutes to hours before settling
  • If symptoms lasting for a few days suspect secondary infection
  • On bi-manual palpation - swelling or stone felt along course of the duct
  • Management = refer to ENT (urgency depends on clinical judgement)
• Salivary gland infection (sialadenitis)

  • Can be viral e.g. mumps or bacteria e.g. staphylococcus aureus
  • Pain, swelling, erythema, oedema, hardened mass (induration) and localised tenderness
  • Bimanual compression towards duct opening may cause purulent discharge into oral cavity
  • Mumps = bilateral parotid swelling, may be tender, possible otalgia and trismus
  • Management: bacterial - antibiotics and if due to stones refer to ENT, viral - supportive