GS36P PREOPERATIVE FINE NEEDLE CYTOLOGY AND IMAGING FACILITATES THE MANAGEMENT OF SUBMANDIBULAR SALIVARY GLAND LESIONS

Abstract

Purpose: Lesions of the submandibular gland represent a pleomorphically diverse group making benign and malignant lesions difficult to differentiate from each other. The current series aims to identify the roles of pre‐operative cytology and imaging with subsequent histopathology in the management of these lesions.Methods: Between 1998 and 2008 fifty‐four patients, of median age 54 years (range 25–94), were retrospectively identified. Fifty patients underwent fifty‐two surgical procedures involving the submandibular gland. The utility of imaging and cytology was analysed, and the accuracy of cytology correlated with histopathology.Results: Pathologies of resected specimens included: sialadenitis; 17 (32%), pleomorphic adenoma; 9 (17%), calculi; 8 (15%), lymphoma; 5 (10%) squamous cell carcinoma; 2 (4%), adenoid cystic carcinoma; 1 (2%) and other; 10 (20%). Twenty‐eight patients (52%) underwent fine needle aspiration cytology/core biopsies; of these 25 proceeded to surgery. Accuracy, sensitivity, and specificity of fine needle aspiration cytology correlation with histology were 88.0%, 71.4%, and 94.4% respectively. Overall, the complication rate was 9.6%.Conclusion: This series demonstrates histological outcomes in patients specific to the submandibular salivary gland for which there are few comparative series in the literature. The trans‐cervical surgical approach to submandibular gland pathology is a safe and effective method with minimal morbidity. Combining investigative modalities and cytology optimises the diagnosis and management of submandibular salivary gland lesions.