Initial Telemedicine Encounter Initial Telemedicine Encounter
Identify patients with: palpable or visually identifiable mass in the area of major salivary gland symptoms concerning for neoplasm Inquire about cancer history: skin cancers of the head and neck area history of lymphoma history of other cancers Inquire about symptoms or history of inflammatory salivary gland disease: salivary gland stones infectious sialadenitis auto-immune conditions (Sjögren’s, IgG4 disease, Granulomatous disease, etc.) metabolic sialadenitis (radioactive iodine, iodine contrast, head and neck radiation) Ask about signs/symptoms concerning for neoplasm facial muscle weakness paresthesia progressive gland swelling and pain
Diagnostic Workup of Patients with Suspected Salivary Gland Neoplasm Diagnostic Workup of Patients with Suspected Salivary Gland Neoplasm
Screen for COVID-19 Salivary gland ultrasound FNA biopsy of neoplastic lesions Additional imaging if needed for surgical intervention (MRI) Confirm presence of salivary gland lesion Screen for signs or symptoms of non-neoplastic disease: salivary gland stones salivary gland inflammation
Patient Counselling and Treatment Recommendations Patient Counselling and Treatment Recommendations
Discuss FNA biopsy results Review treatment and prognosis COVID-19 testing if surgery is anticipated Referrals to Radiation Oncology and Hematology/Oncology if needed Consider patient’s age and co-morbidities Take into account pandemic status in the area/hospital Discuss patient’s home situation, support system and resources available