Abstract
ABSTRACTObjective Fine-needle aspiration cytology is a valuable method for preoperative assessment of head and neck tumors. However, its accuracy in detection of salivary gland masses is controversial compared with other methods. The aim of this work was to evaluate the effectiveness and accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of parotid gland masses.Material and Methods Over a 10-year period, 126 parotid gland masses were resected. Retrospective chart reviews of 114 patients were performed. The results of FNAC and final histological diagnosis were compared and the accuracy of FNAC was determined.Results Final histological evaluation revealed 11 malignant tumors and 103 benign lesions. Pleomorphic adenoma was the most common neoplasm (63%), followed by Warthin’s tumor (17.5%). The sensitivity of FNAC in detecting malignant tumors was 73% and the specificity was 97%. Positive predictive value (PPV) was 73% and negative predictive value (NPV) was 97%. The overall accuracy of FNAC in detecting parotid masses was 95%. False-negative diagnosis was found in mucoepidermoid carcinoma, acinic cell carcinoma, and epithelial-myoepithelial carcinoma whereas there was false-positive diagnosis in cases of pleomorphic adenoma and normal parotid gland tissue.Conclusion FNAC is a reliable minimally invasive diagnostic method with a high sensitivity in diagnosis of lesions in parotid glands. The sensitivity of detection of malignant tumors in parotid glands was low due to the biopsy technique used, and depended on tumor location. Postoperative complications decreased after superficial parotidectomy.
Highlights
Salivary gland tumors are a morphologically and clinically diverse group of neoplasms, which may SUHVHQW VLJQL¿FDQW GLDJQRVWLF DQG PDQDJHPHQW challenges
Several imaging modalities have been used for diagnosis of parotid masses, including magnetic resonance imaging (MRI) and computed tomography (CT)16,28
Fine-needle aspiration cytology (FNAC) of the deep portion of parotid mass was conducted in 7 cases (6%), whereas in 20 cases (17.5%) this procedure was performed using ultrasound-guided biopsy
Summary
Salivary gland tumors are a morphologically and clinically diverse group of neoplasms, which may SUHVHQW VLJQL¿FDQW GLDJQRVWLF DQG PDQDJHPHQW challenges. Malignant salivary gland neoplasms account for more than 0.5% of all malignancies and approximately 35% of all head and neck cancers. In Sweden, the incidence of parotid gland tumors is 0.77 cases per 100,000 women and 1.16 cases per 100,000 men. The overall incidence of salivary gland tumors during the same year was 0.99 in women and 1.49 in men. Fine-needle aspiration cytology (FNAC) is a globally accepted method in the preoperative evaluation of head and neck tumors. This method provides excellent distinction between benign and malignant parotid tumors, and has other advantages: it is inexpensive, easy to perform, relatively painless, and well tolerated. The procedure is a cytodiagnostic method whereby a needle is used to acquire a sample of cells and
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