Hello Doctor. I have an enlarged submandibular salivary gland with no tenderness, discomfort, fever or any other symptoms. Using ultrasound a doctor measured the swollen area at about 9x7x4mm and found it was quite hard. It seems infection and blockage have been ruled out. The doctor wanted to do a fine needle biopsy. I don t want that because of the risk of causing any cancer cells to spread. He says OK I respect that but then you have only two options. (1) Wait and see - measure again by ultrasound in 8 weeks and if it has grown bigger, take it out. (Pros: no unnecessary loss of gland; Cons: risk of complications/spreading if it is cancerous.) (2) Take it out right away. (Pros: certainty, and no further risk; Cons: possible unnecessary loss of gland.) I asked if there isn t some other type of test/imaging - eg PET scan - that could aid in trying to diagnose. He said no there isn t. This is unsuited to PET as the whole area shows hot. Please may I have your view. (Male aged 54, 5ft5in. 125lbs. Health issues: don t digest food very well; likely food intolerances; don t sleep well; wake feeling rough. Don t drink or smoke. Not stressed, but find it hard to fully relax.)