> Services

Sublingual Gland Tumors

Sublingual gland tumors are rare neoplasms that originate in the sublingual salivary glands, located beneath the tongue. Although these tumors are less common than those in other salivary glands, a significant proportion tend to be malignant. Early diagnosis and treatment are crucial for effective management.

Types of Sublingual Gland Tumors

1. Benign Tumors (uncommon):

   • Pleomorphic adenoma: The most common benign tumor in salivary glands but rare in the sublingual gland.

   • Adenomas (e.g., basal cell adenoma): Rare, slow-growing, and non-invasive.

2. Malignant Tumors (more common in sublingual glands):

   • Adenoid cystic carcinoma: The most frequent malignancy, known for perineural invasion and late metastasis.

   • Mucoepidermoid carcinoma: Varies in aggressiveness, can be low-grade or high-grade.

   • Adenocarcinoma: Aggressive and rare in sublingual glands.

   • Squamous cell carcinoma: Rare but aggressive.

   • Acinic cell carcinoma: Rare in sublingual glands.

Symptoms of Sublingual Gland Tumors

• Swelling or mass under the tongue (may cause asymmetry).

• Pain or discomfort in the mouth.

• Ulceration or changes in the mucosa (often seen in malignant tumors).

• Difficulty swallowing (dysphagia).

• Speech difficulties.

• Numbness or tingling in the tongue (if the tumor invades nerves).

• Swollen lymph nodes in the neck (indicative of malignancy).

Diagnosis

1. Clinical Examination:

   • Inspection and palpation of the floor of the mouth.

   • Assessment for mass consistency, fixation, and tenderness.

2. Imaging Studies:

   • Ultrasound: May help identify the size and nature of the mass.

   • CT or MRI: Provides detailed images of the tumor, its extent, and potential invasion into surrounding tissues.

   • PET-CT: Useful for identifying distant metastases in malignant cases.

3. Fine-Needle Aspiration Cytology (FNAC):

   • Helps differentiate between benign and malignant lesions.

4. Biopsy:

   • Often avoided pre-surgery to prevent tumor seeding but may be necessary for definitive diagnosis in some cases.

Treatment

1. Surgical Excision:

   • Sublingual gland excision (gland removal) is the primary treatment for both benign and malignant tumors.

   • Malignant tumors may require wide local excision, including adjacent tissues and sometimes part of the tongue.

   • In advanced malignant cases, neck dissection may be needed to remove involved lymph nodes.

2. Radiation Therapy:

   • Commonly used for malignant tumors, especially for high-grade or incompletely excised tumors.

3. Chemotherapy:

   • Rarely used as a standalone treatment but may be considered for advanced or metastatic disease in combination with radiation.

Prognosis

• Benign Tumors:

  • Excellent prognosis with complete excision.

• Malignant Tumors:

  • Varies depending on the type, grade, and stage of the tumor.

  • Adenoid cystic carcinoma has a tendency for late recurrence and metastasis, necessitating long-term follow-up.

  • Early-stage tumors with complete surgical removal have a better prognosis.

Follow-Up

• Regular follow-up for both benign and malignant cases is necessary to monitor for recurrence.

• Imaging and clinical exams are recommended for malignant tumors, especially for the first 5 years post-treatment.