Salivary Gland Tumors: To Remove or Not? - Dentistry

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When it comes to salivary gland tumors, the decision to remove a tumor, especially one that is asymptomatic and small, can be complex and should be made with careful consideration of various factors. In your case, you have a small bump in the area of the salivary gland that has been diagnosed as a salivary gland tumor by two dental professionals. Here are some important points to consider regarding your situation.


Nature of Salivary Gland Tumors
Salivary gland tumors can be benign (non-cancerous) or malignant (cancerous). The most common benign tumors include pleomorphic adenomas, which are often referred to as "benign mixed tumors." These tumors can grow slowly and may not cause any symptoms initially. However, they can sometimes become larger or change in nature over time. Malignant tumors, while less common, can be more aggressive and require prompt treatment.


Symptoms and Diagnosis
You mentioned that the bump does not cause pain and that you occasionally bite it. This suggests that it may not be causing significant issues at this time. However, the fact that it is located in the salivary gland area and has been diagnosed as a tumor warrants further investigation. Imaging studies, such as ultrasound or MRI, may be recommended to assess the tumor's characteristics, including its size, shape, and whether it has invaded surrounding tissues.


Surgical Considerations
The recommendation for surgical removal often depends on several factors:
1. Size and Growth: If the tumor is growing or larger than a certain size, surgical removal is usually advised to prevent complications.

2. Histological Type: If the tumor is confirmed to be a pleomorphic adenoma or another benign type, removal is often recommended to prevent recurrence.

3. Potential for Malignancy: If there is any suspicion of malignancy, surgical intervention becomes more critical.

4. Symptoms: If the tumor causes discomfort, pain, or functional issues (like difficulty eating or speaking), surgery may be necessary.


Risks of Not Removing
If a benign tumor is left untreated, there is a risk that it could grow larger over time, potentially leading to complications such as obstruction of the salivary duct, infection, or even transformation into a malignant tumor in rare cases. Regular monitoring may be an option, but this typically requires periodic imaging and clinical evaluations.


Recurrence After Surgery
Regarding your concern about recurrence after removal, it is important to note that while benign salivary gland tumors can recur, the likelihood of this happening depends on the type of tumor and the completeness of the surgical excision. If the tumor is completely removed with clear margins, the chances of recurrence are significantly lower. However, if any tumor cells are left behind, there is a higher risk of recurrence.


Conclusion
In summary, while your tumor is currently asymptomatic, the recommendation for surgical removal by dental professionals is likely based on the potential risks associated with salivary gland tumors. It would be prudent to consult with an oral surgeon or an otolaryngologist (ENT specialist) who specializes in salivary gland disorders. They can provide a more comprehensive evaluation, including imaging studies, and help you weigh the benefits and risks of surgery versus observation. Ultimately, the decision should be made based on a thorough understanding of your specific situation, the characteristics of the tumor, and your personal preferences.