Who Is At Risk For Parotid Tumors & Is There A Blood Test For It?

There is a four-fold increase in the risk of salivary gland tumors in patients with Hodgkin’s lymphoma(1).

Blood tests are of little value in the diagnosis of salivary gland tumors(2).

Who Is At Risk For Parotid Tumors?

The etiology for salivary gland tumors is unclear. Generally, smoking and drinking are strongly implicated in most head and neck tumors, but this is not the case for salivary gland tumors and parotid tumors. People who may be at risk for parotid tumors include head and neck radiation for other head and neck cancers, occupational exposures (woodworking, rubber manufacturing and hairdressers or beauty salons), immunosuppression, history of previous cancers, association with Epstein-Barr virus and HIV infection. One study found a four-fold risk of salivary gland tumors in patients with Hodgkin’s lymphoma(1).

Lifestyle habits also affect the risk of salivary gland tumors. While increased intake of vitamin C has been associated with reduced risk of the parotid tumor, increased cholesterol diet and obesity are associated with increased risk of the tumor. People consuming greater amounts of processed meat are also at an increased risk of salivary gland tumors. Processed meats are rich in nitrates and nitrites (added for the preservation of meat), which produce N-nitroso compounds (NOCs) and NOC precursors that are known carcinogens. Processed meats increase the risk of other cancers too, especially colorectal cancer, in addition to cardiovascular diseases and all-cause mortality(1),(3).

The role of diet has also been studied in salivary gland tumors. Consumption of vegetables, especially spinach and squash has been implicated in reduced risk of salivary gland cancer progression. Spinach contains active compounds including antioxidants that suppress the formation of tumors. Vegetables are a rich source of several nutrients, including dietary fiber, vitamins, trace minerals, and other biologically active compounds such as phytochemicals. Phytochemicals have antioxidant and anticancer properties that help in the prevention of salivary glands and other tumors3.

Is There A Blood Test For Parotid Tumors?

The diagnosis of parotid tumors is made based on a complete history and physical examination. It is important to reach a conclusive diagnosis for the exclusion of a malignant tumor. On examination, the tumor mass is mostly non-tender, mobile, firm, and solitary. The intraoral examination may also give a clue regarding patency of Stensen duct and salivary flow, redness, bulge, soft palate, and tonsillar fossa characteristics that might assist to reach a proper diagnosis of the tumor(2).

Generally, no blood test or serological test helps in the diagnosis of parotid tumors and are usually not carried out. The most frequently employed investigations in the workup of parotid tumors are imaging studies (ultrasound, CT scan, MRI, PET scan) and biopsy (fine needle aspiration cytology). Ultrasound has no risk of radiation and is an excellent choice for superficial parotid lobe tumors. CT scan helps in the location, extent, and size of the tumor. MRI is considered superior to CT scan for benign tumors, malignant tumors, deep lobe extension of tumor, facial nerve involvement. PET scans are used in the assessment of malignancy, metastatic disease. FNAC is mostly used as a tool for pretreatment diagnostic tests and preparation of patients for the extent of the surgery, potential complications, need for neck dissection, and/or postoperative radiotherapy. Superficial parotidectomy can be used for both diagnostic and therapeutic purposes(1), (2).

Approximately 80% of all major salivary gland tumors are found in the parotid glands. Parotid tumors can be both benign and malignant in which malignant tumors comprise of around 20-25%, rest being benign tumors. Nearly 2500 new cases of salivary gland tumors are diagnosed every year. Women have a greater propensity for benign tumors, except for Warthin tumor. These tumors appear in the median age of 50 years, mostly in the Caucasians. Among all the benign tumors, pleomorphic adenoma is the most common one accounting for approximately 80% of all tumors followed by Warthin tumor that accounts for 5% of parotid tumors(1), (2).

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