Diagnostic difficulties in salivary gland tumors in children

Introduction. Tumors of major salivary glands, due to their low incidence and the wide spectrum of possible diagnoses, are a challenge for physicians. Imaging studies are the key elements of the diagnostic process, although their results often do not provide a definitive diagnosis. Aim. The aim of the study was to assess the usefulness of additional tests in the diagnosis of tumors of major salivary glands in children. Material and Methods. A retrospective analysis of medical data of children with tumors of parotid or submandibular salivary gland hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw from the years 2012-2017 was performed. Results. In 8 girls and 7 boys aged between 4 months and 17 years, the following diagnoses were established: 6 mixed tumors, 3 hemangiomas, 1 lymphangioma, 1 rhabdomyosarcoma, and 1 mucoepidermoid carcinoma. In all of the patients, ultrasound (US) of salivary gland, computed tomography (CT) and/or magnetic resonance imaging (MRI) of the head were performed. US examination enabled to diagnose the majority (66%) of mixed tumors. US and CT or MRI with contrast enabled to recognize angiomas in all 4 patients with this lesion. In 2 patients, malignant neoplasm was diagnosed based on the histological examination. Conclusions. US remains the primary diagnostic test in patients with tumors of major salivary gland. When necessary, it can be supplemented with CT or MRI. In some cases, imaging studies do not enable to establish a definite diagnosis. The definite diagnosis of salivary gland tumors is established based on the results of the pathological examination (except for angiomas). The most common salivary gland tumor in older children is mixed tumor, and in infants – angioma. It must be remembered that very rare salivary gland tumors, such as sarcomas and carcinomas, may also occur in children. Keywords