OP149: Diagnostic accuracy of fine-needle aspiration cytology in parotid tumors

Abstract

Introduction Fine-needle aspiration cytology (FNAC) has gained widespread acceptance and popularity among head and neck surgeons in the assessment of neck masses. The use of FNAC in parotid gland masses is still controversial, regarding its sensitivity and specificity that vary between 41–100% and 86–100% respectively. The aim of this study To assess the sensitivity and specificity of FNAC in the diagnosis of parotid tumors compared with the final pathology, and tumor location on pre-operative computerized tomography. Methods FNAC, final pathology and CT data were retrospectively reviewed and compared for a total sum of 79 patients who underwent Parotidectomy between the years 2000 and 2010. Literature review was based on trials comparing FNAC with final histological evaluation of parotid tumors identified through an extensive Medline search of the English literature. Outcome measures analyzed included percentage of non-diagnostic samples, sensitivity, specificity, positive predictive value, negative predictive value and the accuracy of FNAC. Results Sensitivity of FNA in the present study (90%) was higher compared to previous series, Specificity of FNA in the present study (98%) was equally high as that calculated. Diagnostic accuracy of FNA was equally high (88%) in our study compared to previous series. Conclusions FNA should be interpreted as a complementary diagnostic tool and combined with clinical features, physical examination and imaging to increases the diagnostic yield. FNA can contribute to the diagnosis of parotid gland malignancy and should be performed in all patients especially those over 60.Ultrasound guidance is recommended in lesions smaller than 25 mm.