This PDQ cancer information summary has current information about the treatment of childhood salivary gland tumors. It is meant to inform and help patients, families, and caregivers. It does not give formal guidelines or recommendations for making decisions about health care.

Editorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer. The summaries are reviewed regularly and changes are made when there is new information. The date on each summary ("Date Last Modified") is the date of the most recent change. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Pediatric Treatment Editorial Board.

What are salivary gland tumors?

Salivary gland tumors are abnormal growths that can form in the salivary glands. They can be benign (not cancer) or malignant (cancerous). Although benign tumors do not spread to other parts of the body, they may require treatment to stop them from continuing to grow and press on nearby tissue. Cancerous tumors can spread to other areas of the body and will be treated to kill the cancer cells. Salivary gland tumors rarely occur in children.

The salivary glands make saliva and release it into the mouth. Saliva has enzymes that help digest food and antibodies that help protect against mouth and throat infections. There are three pairs of major salivary glands:

• Parotid glands are the largest glands and are found in front of and just below each ear. Most salivary gland tumors begin in this gland.
• Sublingual glands are found under the tongue in the floor of the mouth.
• Submandibular glands are found below the jawbone.

Anatomy of the salivary glands. The three main pairs of salivary glands are the parotid glands, the sublingual glands, and the submandibular glands.

Causes and risk factors for childhood salivary gland tumors

Salivary gland tumors in children are caused by certain changes to the way salivary gland cells function, especially how they grow and divide into new cells. Often, the exact cause of these cell changes is unknown. Learn more about how cancer develops at What Is Cancer?

A risk factor is anything that increases the chance of getting a disease. Past treatment for cancer with chemotherapy or radiation therapy is a risk factor for childhood salivary gland tumors. Not every child with this risk factor will develop a salivary gland tumor. And it will develop in some children who don't have a known risk factor. Talk with your child's doctor if you think your child may be at risk.

Symptoms of childhood salivary gland tumors

Children may not have symptoms of a salivary gland tumor until the tumor has grown bigger. It's important to check with your child's doctor if your child has:

• a lump near the ear, cheek, jaw, lip, or inside the mouth that may be painless
• numbness or weakness in the face
• pain in the face that does not go away

These symptoms may be caused by problems other than a salivary gland tumor. The only way to know is to see your child's doctor.

Tests to diagnose childhood salivary gland tumors

If your child has symptoms that suggest a salivary gland tumor, the doctor will need to find out if these are due to a salivary gland tumor or another problem. The doctor will ask when the symptoms started and how often your child has been having them. They will also ask about your child's personal and family medical history and do a physical exam. Depending on these results, they may recommend other tests. If your child is diagnosed with a salivary gland tumor, the results of these tests will help you and your child's doctor plan treatment.

The tests used to diagnose salivary gland tumors in children may include:

Magnetic resonance imaging (MRI)

MRI uses a magnet, radio waves, and a computer to make a series of detailed pictures of areas of the body, such as the head and neck. This procedure is also called nuclear magnetic resonance imaging (NMRI).

Magnetic resonance imaging (MRI) scan. The child lies on a table that slides into the MRI machine, which takes a series of detailed pictures of areas inside the body. The positioning of the child on the table depends on the part of the body being imaged.

CT scan (CAT scan)

A CT scan uses a computer linked to an x-ray machine to make a series of detailed pictures of areas inside the body. The pictures are taken from different angles and are used to create 3-D views of tissues and organs. A dye may be injected into a vein or swallowed to help the organs or tissues show up more clearly. This procedure is also called computed tomography, computerized tomography, or computerized axial tomography. Learn more about Computed Tomography (CT) Scans and Cancer.

Computed tomography (CT) scan of the head and neck. The child lies on a table that slides through the CT scanner, which takes a series of detailed x-ray pictures of the inside of the head and neck.

Getting a second opinion

You may want to get a second opinion to confirm your child's diagnosis and treatment plan. If you seek a second opinion, you will need to get medical test results and reports from the first doctor to share with the second doctor. The second doctor will review the pathology report, slides, and scans. This doctor may agree with the first doctor, suggest changes to the treatment plan, or provide more information about your child's tumor.

To learn more about choosing a doctor and getting a second opinion, see Finding Cancer Care. You can contact NCI's Cancer Information Service via chat, email, or phone (both in English and Spanish) for help finding a doctor or hospital that can provide a second opinion. For questions you might want to ask at your child's appointments, see Questions to Ask Your Doctor about Cancer.

Who treats children with salivary gland tumors?

A pediatric oncologist, a doctor who specializes in treating children with cancer, oversees treatment of salivary gland tumors. The pediatric oncologist works with other health care providers who are experts in treating children with cancer and who specialize in certain areas of medicine. Other specialists may include:

• pediatrician
• pediatric surgeon
• radiation oncologist
• pathologist
• ear, nose, and throat specialist
• pediatric nurse specialist
• social worker
• rehabilitation specialist
• psychologist
• child-life specialist

Treatment of childhood salivary gland tumors

There are different types of treatment for children and adolescents with salivary gland tumors. You and your child's care team will work together to decide treatment. Many factors will be considered, such as your child's overall health and whether the tumor is newly diagnosed or has come back.

Your child's treatment plan will include information about the tumor, the goals of treatment, treatment options, and the possible side effects. It will be helpful to talk with your child’s care team before treatment begins about what to expect. For help every step of the way, see our booklet, Children with Cancer: A Guide for Parents.

Treatment of salivary gland tumors may include:

• Surgery to remove salivary gland tumors or salivary gland cancer is the most common treatment. If the parotid gland is removed during surgery, special care must be taken to avoid damage to the facial nerve. Learn more about Surgery to Treat Cancer.
• Radiation therapy may be given after surgery for salivary gland cancer. Radiation therapy uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Salivary gland cancer may be treated with external beam radiation therapy or internal radiation therapy if the cancer is likely to spread.

  • External beam radiation therapy uses a machine outside the body to send radiation toward the area of the body with cancer.
  • Internal radiation therapy, also called brachytherapy, uses a radioactive substance sealed in needles, seeds, wires, or catheters that are placed directly into or near the cancer.
  Learn more about Radiation Therapy to Treat Cancer and Radiation Therapy Side Effects.
• Targeted therapy (entrectinib or larotrectinib) may be used to treat recurrent childhood salivary gland cancer. Recurrent salivary gland cancer is cancer that has come back after it has been treated. Targeted therapy uses drugs or other substances to block the action of specific enzymes, proteins, or other molecules involved in the growth and spread of cancer cells. The doctor may suggest biomarker tests to help predict your child's response to certain targeted therapy drugs. Learn more about Biomarker Testing for Cancer Treatment and Targeted Therapy to Treat Cancer.

Clinical trials

For some children, joining a clinical trial may be an option. There are different types of clinical trials for childhood cancer. For example, a treatment trial tests new treatments or new ways of using current treatments. Supportive care and palliative care trials look at ways to improve quality of life, especially for those who have side effects from cancer and its treatment.

You can use the clinical trial search to find NCI-supported cancer clinical trials accepting participants. The search allows you to filter trials based on the type of cancer, your child's age, and where the trials are being done. Clinical trials supported by other organizations can be found on the ClinicalTrials.gov website.

Learn more about clinical trials, including how to find and join one, at Clinical Trials Information for Patients and Caregivers.

Prognosis and prognostic factors for childhood salivary gland tumors

If your child has been diagnosed with salivary gland cancer, you likely have questions about how serious the cancer is and your child's chances of survival. The likely outcome or course of a disease is called prognosis. The prognosis can be affected by whether the cancer has spread to lymph nodes or other parts of the body at the time of diagnosis and whether the cancer can be completely removed by surgery. The prognosis for salivary gland cancer in children is usually good.

No two people are alike, and responses to treatment can vary greatly. Your child's cancer care team is in the best position to talk with you about your child's prognosis.

Side effects and late effects of treatment

Cancer treatments can cause side effects. Which side effects your child might have depends on the type of treatment they receive, the dose, and how their body reacts. Talk with your child's treatment team about which side effects to look for and ways to manage them.

To learn more about side effects that begin during treatment for cancer, visit Side Effects.

Problems from cancer treatment that begin 6 months or later after treatment and continue for months or years are called late effects. Late effects of cancer treatment may include:

• physical problems, such as:

  • dry mouth
  • trouble seeing
  • numbness or weakness in the face
  • changes in the way the bones of the head and face grow
  • other changes in the child's appearance
• changes in mood, feelings, thinking, learning, or memory
• second cancers (new types of cancer)

Some late effects may be treated or controlled. It is important to talk with your child's doctors about the possible late effects caused by some treatments. Learn more about Late Effects of Treatment for Childhood Cancer.

Follow-up care

As your child goes through treatment, they will have follow-up tests or check-ups. Some of the tests that were done to diagnose the tumor may be repeated to see how well the treatment is working. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.

Some of the tests will continue to be done from time to time after treatment has ended. The results of these tests can show if your child's condition has changed or if the tumor has recurred (come back).

Coping with your child's cancer

When a child has a tumor, every member of the family needs support. Taking care of yourself during this difficult time is important. Reach out to your child’s treatment team and to people in your family and community for support. To learn more, see Support for Families: Childhood Cancer and the booklet Children with Cancer: A Guide for Parents.

Related resources

For more childhood cancer information and other general cancer resources, see:

• About Cancer
• Childhood Cancers
• CureSearch for Children's Cancer
• Adolescents and Young Adults with Cancer
• Cancer in Children and Adolescents
• For Survivors and Caregivers

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