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Diseases of the salivary glands

Last updated: August 20, 2021

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The parotid, submandibular, and sublingual glands are the largest salivary glands. These glands may swell repeatedly and often bilaterally (sialadenosis), but are also subject to acute inflammation that is predominantly unilateral (sialadenitis). Diseases that commonly cause sialadenitis include: Sjögren syndrome (chronic immunologic sialadenitis), Heerfordt syndrome, and mumps (epidemic parotitis). Sialadenosis and sialadenitis primarily affect the parotid gland. However, stones in the salivary ducts (sialolithiasis) mainly form in the submandibular gland because of its ascending salivary duct.

Salivary gland tumors manifest mainly in the parotid. Painless and progressive swelling of the gland is the cardinal symptom of benign as well as malignant tumors, while facial palsy is considered a criterion for malignancy. Generally, the smaller the gland, the greater the chance that the tumor is malignant. Clinical examination and ultrasound play the biggest role in diagnosis. For all parotid tumors, the preferred treatment is parotidectomy with retention of the facial nerve. A resection of the facial nerve is indicated only if it is infiltrated by the tumor. Postoperative radiation therapy may benefit patients with malignant tumors.


  • Definition: formation of stones in the salivary ducts
  • Etiology
  • Location: may occur in any of the larger salivary glands
  • Clinical features
    • Recurrent, significant pain before and while eating
    • Partial swelling of the glands
  • Diagnostics
  • Complications: acute or chronic sialadenitis
  • Treatment
    • Mainly conservative
      • NSAIDs for pain relief
      • Stimulation of salivary flow by sucking sour candies, massaging the gland, and applying warm compresses
    • Invasive (only in severe cases): dilatation of the salivary duct or ultrasonic lithotripsy


Most salivary gland tumors are benign.

Pleomorphic adenoma (benign mixed tumor)

Other types of benign salivary gland tumors (monomorphic adenomas)

These benign salivary gland tumors fall under the umbrella term "monomorphic adenoma" because they usually originate in only one type of cell – as opposed to the pleomorphic adenomas, which consist of both epithelial and myoepithelial cells.

Warthin tumor (papillary cystadenoma lymphomatosum)

WARning! Smoking makes GERMs more resilient.

Rare histologic subtypes

Malignant salivary gland tumors are referred to collectively because of their many etiological, epidemiological, and pathological similarities.

Submandibular gland tumors are less common but more frequently malignant than parotid tumors. Generally, the smaller the gland, the higher the risk a tumor is malignant!


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