Salivary Gland Tumours
We have three pairs of main salivary glands which are the parotid glands, situated below the ear and behind the jawbone, the submandibular gland under the horizontal part of the jawbone and tongue, and lastly the sublingual gland which is in the floor of the mouth just below the mobile part of the tongue.
Tell-tale signs of malignancy include paralysis of the facial nerve which travels through the parotid gland and supplies the muscles of the face. Again, ultrasound and needle biopsy are mainstays of diagnostic tests to assess nature of the problem. Occasionally, the parotid and submandibular glands can increase in size itself due to the presence of a stone in the duct giving rise to a backlog of saliva and swelling with meals.
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The salivary glands can be affected by growths which are in the main benign but can also be malignant in nature.
Patient with large swelling of the right side of her neck due to a benign tumour.
The thyroid gland is situated at the lower part of the neck and its purpose is to produce thyroxine and parathormone, which are essential hormones that regulate various activities of the body. They can be both benign and malignant tumours involving the thyroid gland. This can usually present as a firm lump in the neck which may or may not cause any particular symptoms. Occasionally, when the tumour is very large, it can cause a compression feeling but this is uncommon. The thyroid gland can become diffusely enlarged as part of a multicystic disorder. In some cases, thyroid disease is part of an autoimmune condition where the body attacks its own tissues. Any lumps in the thyroid gland can be easily determined by ultrasound examination and this allows the radiologist to perform a needle biopsy. This can give rise to an accurate diagnosis in most cases and can help the attending surgeon plan the best treatment.
During the development of the foetus, the thyroid gland starts at the base of the tongue and makes its way down the neck during the first few weeks of development. Sometimes, this developmental process can be affected and result in the presence of a cyst in the midline of the neck which can lie dormant until adulthood. It then presents with a swelling in the midline which can be completely asymptomatic. However, it can also develop into an infection. This is called a thyroglossal cyst. Treatment is usually by excision of the cyst and associated tract including the middle third of the hyoid bone (Sistrunk’s operation).
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