Parotid tumours and cancers: History and examination

  • Objectives
    • Avoid unnecessary surgery for e.g. infective or non-neoplastic masses, lymphoma, unresectable tumour
    • Do appropriate surgery
    • Avoid embarking on surgery that is beyond the scope of a surgeon e.g. deep lobe tumour, tumour extending to the parapharyngeal space, tumour requiring neck dissection, or tumour requiring facial nerve reconstruction
  • Malignant parotid tumours may have clinically benign features
  • Consider lymphoma
    • Past lymphoma
    • HIV +ve
    • Cervical / generalised lymphadenopathy
  • Suspicious for malignancy
    • Pain
    • Rapid growth
    • Neurological deficits
    • Facial nerve: Facial twitching or weakness
    • Trigeminal nerve
    • Greater auricular nerve
    • Skin invasion
    • Muscle invasion….trismus
    • Cervical nodes
    • Prior skin/conjunctival cancer/melanoma
    • Previous salivary cancer
    • Previous radiation to salivary gland region

Return to Resource Appropriate Parotid Guideline Scenarios

Index: Clinical Practice Guidelines for Parotid