Submandibular Gland Tumour — ORE Part 1 MCQ

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ModerateOral PathologySubmandibular Gland TumourORE Part 1

A 52-year-old man presents with a firm, non-tender, fixed mass in the left submandibular triangle. It has been gradually enlarging over 6 months. There is no facial nerve weakness. An ultrasound-guided fine needle aspiration is reported as showing pleomorphic adenoma. Which gland is most likely affected?

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Correct answer: C — Submandibular gland

The correct answer is C (submandibular gland). Although pleomorphic adenoma arises in the parotid gland in approximately 80% of cases, the clinical context is decisive: the mass is located in the submandibular triangle, is firm and fixed, and shows no facial nerve weakness. The facial nerve (CN VII) passes through the parotid gland, so parotid tumours would typically cause at least mild facial nerve involvement as they enlarge. The absence of facial nerve weakness and the explicit submandibular location therefore exclude parotid origin. Sublingual and minor salivary gland tumours would present intraorally or in the soft palate. Lymph nodes do not yield pleomorphic adenoma on FNA. The submandibular gland is the second most common site for pleomorphic adenoma (8–10%) and is the correct answer.

Reference: PubMed Central. Khanal P. Pleomorphic Adenoma of the Submandibular Gland: A Case Report. 2019. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827573/