Medical Oncologist
CION Cancer Clinics
Benign or malignant salivary tumour: how the surgery differs | CION Cancer Clinics
Surgery for a benign salivary tumour usually removes the gland with the lump inside it. If the tumour is malignant, the operation may also take lymph nodes from the neck, occasionally a nerve, and radiotherapy often follows. Often you only know which it is once the whole tumour has been examined. This page sets out what changes, what the team weighs, and what the report words mean. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- What changes if a salivary tumour turns out to be cancer?
- How do the two operations compare?
- What does the team weigh when the tumour is cancer?
- Why might you not know until after the operation?
- What happens once the final report is back?
- What do the words on the report mean?
- Are these beliefs about salivary tumours true?
- Common questions about benign and malignant salivary tumours
The short answer
What changes if a salivary tumour turns out to be cancer?
Mostly, how much is removed and what follows. A benign (non-cancerous) tumour is usually removed with the whole gland and nothing more. A malignant (cancerous) tumour may also need lymph nodes taken from the neck, sometimes a nerve, and often radiotherapy afterwards.
Why the gland matters as much as the diagnosis
Salivary tumours grow in the large glands of the face and neck, or in the small glands that line the mouth. Tumours of the submandibular gland under the jaw, and of the small glands in the palate, are more often cancerous than those of the parotid gland in front of the ear. So a lump in these places is treated with more caution from the start.
Benign does not mean it can simply be left
The commonest benign tumour, the pleomorphic adenoma, keeps growing slowly. Over many years a small share can turn cancerous. If it is not fully removed, it can come back in several places at once. That is why removal is often advised. Whether it suits you is a decision to make with your team.
Side by side
How do the two operations compare?
Benign tumour
Malignant tumour
Usually the gland and the lump inside it
The gland, the lump and a wider rim of tissue around it
Lymph nodes in the neck left in place
Nodes may be removed, especially for larger or high-grade cancers
Nearby nerves kept whenever possible
Nerves kept unless the cancer is growing into them
The final report mainly confirms the type
The final report guides radiotherapy and follow-up
Wound checks, then usually discharged
Regular check-ups and scans, over years
Planning a cancer operation
What does the team weigh when the tumour is cancer?
No two malignant salivary tumours are planned the same way. These are the questions your team works through.
The type and the grade
There are many kinds of salivary gland cancer. Grade describes how abnormal the cells look. Low-grade cancers tend to grow slowly and stay local. High-grade ones are more likely to spread to the neck.
Size and spread into nearby tissue
A cancer that stays inside the gland needs less surgery than one growing into skin, muscle, the jawbone or the floor of the mouth. Scans before the operation help map this.
The nerves nearby
A nerve that works normally before surgery is usually kept. One the cancer has grown into may need to come out.
Nerves close to the gland
- Movement of the lower lip
- Movement of the tongue
- Feeling and taste in the tongue
The lymph nodes in the neck
If scans or examination show nodes are involved, a neck dissection (removing lymph nodes from the neck) is usually part of the plan. For some high-grade cancers, nodes are removed even when they look normal.
Not sure whether this applies to you?
Ask an oncologistThe uncertain part
Why might you not know until after the operation?
Often the answer is only certain once the whole tumour has been looked at under a microscope. Tests before surgery point in a direction, but they do not always settle it.
What the needle test can and cannot show
A fine needle test, written as FNAC on your report, takes a few cells from the lump. It is quick and useful. But salivary tumours are hard to read from a few cells, and some results come back as uncertain or change once the whole tumour is examined.
Checks during the operation
Some surgeons send a piece of tissue for a quick check while you are still asleep, called a frozen section. It can help decide whether to do more there and then. It is not always conclusive, and the final report still follows later.
When more treatment is needed
Occasionally the final report shows cancer in a tumour expected to be benign, or cells close to the edge of what was removed. Your team may then advise more surgery, radiotherapy or both. This does not mean the first operation was wrong. It is how these tumours sometimes behave.
Before surgery, ask what the surgeon will do if the check during the operation suggests cancer, so your family has agreed it in advance.Next steps
What happens once the final report is back?
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Waiting for the report
The removed tissue is studied in detail. Salivary tumours often need extra stains, so this report can take longer than a simple biopsy. Your team will tell you roughly when to expect it.
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The tumour board
For a cancer, surgeons, radiation oncologists and pathologists look at the report together. They weigh the type, grade, margins and nodes before advising what comes next.
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Your appointment
The surgeon explains what was found and what is recommended. Bring the family member who will help you decide, and write your questions down beforehand.
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What follows
For a benign tumour, this is usually wound checks and then discharge. For a cancer, it may be radiotherapy, followed by regular visits with examination and scans.
On your report
What do the words on the report mean?
- Pleomorphic adenoma
- The commonest benign salivary tumour. It is not cancer, but it can come back if not fully removed.
- Mucoepidermoid carcinoma
- One of the commoner salivary gland cancers. It can be low grade or high grade, and that changes the plan a great deal.
- Adenoid cystic carcinoma
- A slow-growing cancer that tends to creep along nerves. It is seen fairly often in the submandibular gland and the palate.
- Perineural invasion
- Cancer cells found along a nerve. It often leads the team to advise radiotherapy.
- Margin
- The rim of normal tissue around what was removed. A clear margin means no cancer cells were found at the edge.
Commonly believed
Are these beliefs about salivary tumours true?
"The needle test said benign, so there is nothing to worry about."
The needle test is helpful but not final. Salivary tumours can be hard to judge from a few cells. The report on the whole tumour after removal is the one that counts.
"A benign lump can be left alone for ever."
Some people are advised to watch a lump, often for good reasons such as other health problems. But common benign tumours keep growing, and a larger one means a bigger operation. Make this decision with your surgeon, not by waiting quietly.
"Cancer here always means losing a nerve."
Nerves that work normally before surgery are usually kept, even in cancer operations. A nerve is removed only when the cancer has grown into it. Ask which nerves are at risk in your case.
"Operating on it will make the cancer spread."
Removing a salivary tumour does not make cancer spread. Waiting lets the tumour grow, which can mean a bigger operation. Bring any worry like this to your team before you decide.
Questions we are asked
Common questions about benign and malignant salivary tumours
Is a submandibular gland lump more likely to be cancer?
Lumps in the submandibular gland are more often cancerous than lumps in the parotid gland, though many are still benign. Many lumps under the jaw are not tumours at all, but swollen lymph nodes or a blocked gland. A scan and a needle test help sort this out. Only the full report gives the final answer.
Will the operation be bigger if it is cancer?
Often, yes. The surgeon may remove more tissue around the gland and some lymph nodes from the neck. That takes longer and leaves a longer scar, and the hospital stay may be a little longer. Ask your surgeon to explain both plans before the day, so nothing comes as a shock.
Can a benign salivary tumour come back?
Yes, especially a pleomorphic adenoma that was not fully removed or was broken open during surgery. That is why surgeons take it out whole, with the gland. A tumour that returns can appear as several small lumps. Keep your follow-up visits and report any new lump near the scar.
Does malignant always mean radiotherapy?
No. Some low-grade cancers removed with clear margins need surgery alone. Radiotherapy is more often advised for high-grade cancers, close margins, spread to the nodes, or cancer along a nerve. The tumour board decides this on your final report, not before the operation.
How long does the final report take?
Longer than most people expect, because salivary tumours often need extra tests. Your team will give you an idea of the wait. If that date passes without news, call and ask. A delay usually means more tests are being done, not that something bad has been found.
Should we get a second opinion on the report?
It is reasonable, and common for rare tumours. Salivary tumours are uncommon and come in many types, so a second pathologist's view can be useful. Ask your team for the slides and tissue blocks. Arranged quickly, it rarely delays treatment by much.
Will a cancer operation affect speech or eating?
Most people speak and eat normally after submandibular surgery. If the nerve to the tongue is bruised or removed, tongue movement or feeling can change. Larger operations inside the mouth, such as on the palate, can affect speech and swallowing for a time. Ask what to expect in your case.
Can this page tell me whether my lump is cancer?
No. Only tests on the lump itself can do that. This page explains how the two paths differ, so you can follow what your team says. Take your scan and needle test reports to your surgeon, and ask what they show and what is still uncertain.
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Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
Medical Oncologist
Medical Oncologist
Surgical Oncologist
Dr. Muralidhar Muddusetty
MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
Surgical Oncologist
Surgical Oncologist
Surgical Oncologist
Dr. Vinay Mamidala
MBBS, MS(General Surgery), M.Ch(Surgical Oncology), FMAS, FARIS(Ongoing)
Surgical Oncologist
Radiation Oncologist
Radiation Oncologist
Radiation Oncologist
Hematologist
Surgical Oncologist
Dr. Vajja Sandeep Kumar
MBBS, MS (General Surgery), DrNB (Surgical Oncology), FALS Oncology
Surgical Oncologist
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Sources
- Cancer Research UK — Salivary gland cancer
- National Cancer Institute — Salivary Gland Cancer Treatment (PDQ) - Patient Version
- American Cancer Society — Salivary Gland Cancer
- Cancer.Net — Salivary gland cancer
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
Nerves at Risk in Submandibular SurgeryWhich nerves sit close to the gland and what happens if one is affectedRadiation After Salivary Gland SurgeryWhen the final report leads to radiotherapyThe Pathology Report After SurgeryReading margins, grade and nodes on your own reportMinor Salivary Gland Tumours of the PalateTumours of the small glands in the roof of the mouth
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