A PROSPECTIVE STUDY ON CLINICOPATHOLOGICAL & RADIOLOGICAL EVALUATION OF PAROTID TUMOURS IN A TERTIARY CARE CENTRE

Abstract

Background: Salivary gland tumours are relatively rare clinical entities encountered in the frequent day-to-day clinical practice. They exhibit a wide variety of behaviour and widely diversified histology. Proper management of these tumours require an accurate diagnosis by the pathologist, correct clinical correlation by the surgeon. With this background, we have conducted a study on the incidence, age, gender, clinical features of parotid swellings, histological distribution, the efficacy of FNAC as a diagnostic modality, the role of ultrasound and MRI in the diagnosis and various treatment modalities in the management of parotid swellings and their outcome in our institute. Methods: Our study was a prospective study conducted on 60 patients over a period of 20 months from August 2018 to March 2020. All patients were evaluated by taking proper history, thorough clinical examination, routine laboratory investigations and specific investigations like FNAC, MRI, USG and biopsy. Results: The mean age of presentation in our study was 35.73 years. Seventy percent of tumours were pleomorphic adenoma, malignant mixed tumours constituted 13%, Warthin's neoplasm constituted 7.01%, Basal cell adenoma, Oncocytoma and Acinic cell carcinoma each of these tumours constituted 3.33%. All the patients presented with swelling (100%) in the parotid region, 46.67% patients presented with pain in swelling, out of which majority were benign. Pain occurred in 100% of the patients with malignant tumours and only in 36% of the patients with benign tumours. No patient presented with features of facial nerve paralysis, fungating mass or cervical lymphadenopathy. On FNAC, 56 were reported as benign (50 cases were reported as benign and remain six were reported as malignant on HPE) remaining 4 cases were reported as malignant. Similar results were obtained on ultrasound. Fifty-one cases were reported as benign and remaining 9 cases were reported as malignant on MRI. Superficial parotidectomy was done in 83.33% of cases, the remaining were treated with conservative total parotidectomy. No radical parotidectomy and radical neck dissection (RND) were done. Conclusion: Parotid tumours were commonly noticed in the 5th decade of life, males were predominantly affected. Pleomorphic adenoma is the most common tumour encountered. Malignant mixed tumours were most commonly observed malignant tumour followed by Acinic cell carcinoma. Parotid swelling is the most common presenting complaint followed by pain. Histopathological examination was more accurate when compared to FNAC. Superficial parotidectomy was the most commonly performed procedure.