Submandibular Salivary Gland tumours and cancers: History and examination

Objectives

Avoid unnecessary surgery
Do appropriate surgery
Avoid embarking on surgery that is beyond the scope of a surgeon e.g. tumour requiring neck dissection
Distinguish between submandibular lymph node and salivary mass

Distinguishing lymph node from SMG mass

Unlike the parotid, there are no intraglandular lymph nodes
Lymph nodes are lateral/superficial to the SMG
Palpate the mass between a finger placed on the floor of mouth and another on the neck: lymph nodes are generally palpable only with the finger on the neck, as opposed to a SMG mass that is palpable between both fingers
If still uncertain, proceed to U/S or FNAC

Suspicious for malignancy