Parotid Tumors: Fine-Needle Aspiration and/or Frozen Section

Abstract

Objective Assess the difficulties of preoperative and intraoperative tumor typing of parotid neoplasms. Know the advantages and pitfalls of fine-needle-aspiration cytology (FNAC) and frozen section (FS) analysis in primary parotid neoplasms. Methods In 113 parotid neoplasms (70 malignancies and 43 benign tumors) preoperative FNAC as well as intraoperative FS analysis were performed. FNAC and FS findings were analyzed and compared with the final histopathologic diagnosis. Results The FNAC smear was non-diagnostic in 6 tumors. In 2 FS specimens, it was not possible to determine the tumor dignity. FNAC findings and FS findings were both available in 105 neoplasMS The FNAC findings were true positive for malignancy in 54, true negative in 36, false positive in 4, and false negative in 11 tumors. The accuracy, sensitivity, and specificity were 86%, 83%, and 90% respectively. The FS findings were true positive in 60, true negative in 38, false positive in 2, and false negative in 5 tumors. The accuracy, sensitivity, and specificity were 93%, 92% and 95% respectively. The exact histologic tumor typing by FNAC was correct, false or not mentioned in 58%, 20% and 22% true positive or true negative evaluated tumors, and by FS in 83%, 5% and 12% true positive or true negative evaluated tumors. Conclusions The current analysis showed a superiority of FS compared with FNAC regarding the diagnosis of malignancy and especially of tumor typing. FNAC alone is not prone in many cases to determine the surgical management of primary parotid carcinomas.