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Background: Bilateral salivary gland tumors, both benign and malignant and synchronous or metachronous are very rare.

Case presentation: Here three cases of synchronous bilateral salivary gland tumors are described and discussed. Recognizing the entity is important for diagnostics and treatment planning. The first patient was a 56-year-old female with a bilateral parotid tumor, a malignant tumor, salivary duct carcinoma on the right side and a benign tumor, pleomorphic adenoma on the left side. The second patient was a 50-year old female with a bilateral benign parotid tumor, a pleomorphic adenoma. The third patient was a 51-year old female with a bilateral malignant tumor, an acinic cell carcinoma. Details on the diagnostic work-up, histopathology and treatment are described and discussed.

Conclusions: In the case of a unilateral salivary gland tumor, especially of the major glands, the contralateral gland is always included in the clinical and radiological (MRI) head and neck evaluation prior to surgery, to detect or exclude possible bilateral occurrence.