Three imaginary overlapping circles may be useful to relate site to pathology. Either submandibular salivary gland swelling or a submandibular lymph node. The commonest clinical condition relates to stone formation. The patient complains of intermittent pain and swelling in the submandibular region usually related to meals. A tiny stone can impact at the papilla which then looks red and swollen.
Benign tumours are hard and painless and much less common than in the parotid gland.
Malignant tumours are rare. The mean age at presentation is 45 years but can occur in young people. The tumour is implantable if the capsule is breached at operation. One of the most tragic complications of parotid surgery is multifocal recurrent disease. In the long term, the tumour may transform to its malignant variant which is usually of high grade.