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Hamour AF, O'Connell D, Biron VL, Allegretto M, Seemann R, Harris JR, Seikaly H, Côté DWJ. Clinical diagnostic utility of ultrasound-guided fine needle aspiration biopsy in parotid masses. EAR, NOSE & THROAT JOURNAL 2024; 103:NP340-NP344. [PMID: 34818946 DOI: 10.1177/01455613211058922] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Fine needle aspiration (FNA) is a common diagnostic tool used in the initial evaluation of parotid masses. In the literature, variable diagnostic accuracy of FNA is reported. Therefore, when considering clinical management of these patients, the utility of FNA is unclear. The aim of this study was to determine the capability of ultrasound-guided FNA to differentiate between benign and malignant neoplasms. Further, the way in which FNA results affect clinical decision-making was assessed. METHODS Retrospective data were collected for all patients who underwent parotidectomy at a large Canadian tertiary care center between 2011 and 2016. Patient demographics, preoperative imaging reports, preoperative FNA results, and final pathological diagnosis were analyzed. RESULTS Of the 199 patients who underwent parotidectomy, 184 had preoperative ultrasound-guided FNA. There were a total of 13 non-diagnostic FNAs. In diagnosing malignancy, FNA had a sensitivity and specificity of 71.4% and 98.7%, respectively. The positive predictive value (PPV) was 83.3%. The negative predictive value was 97.5%. Of the non-diagnostic FNAs, 2 out of 13 (15.4%) were deemed malignant neoplasms on final pathology. CONCLUSION FNA is a useful adjunct in the work-up of parotid masses, but it should be used with caution. Due to limited sensitivity, it should not be relied upon as the sole determinant of a surgeon's management plan.
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Affiliation(s)
- Amr F Hamour
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Dan O'Connell
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Vincent L Biron
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Michael Allegretto
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Robert Seemann
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Jeffrey R Harris
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Hadi Seikaly
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - David W J Côté
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, University of Alberta, Edmonton, AB, Canada
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2
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Ali HM, Sankar GB, Stickney EA, Johns HL, Whaley RD, Rivera M, Lohse CM, Tasche KK, Price DL, Van Abel KM, Yin LX, Moore EJ. Ability for fine needle aspiration and frozen section to predict extent of parotidectomy. Head Neck 2023; 45:3006-3014. [PMID: 37752736 DOI: 10.1002/hed.27527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 09/11/2023] [Accepted: 09/15/2023] [Indexed: 09/28/2023] Open
Abstract
INTRODUCTION Several diagnostic modalities with various sensitivity and specificities can be used to evaluate a parotid mass. The aims of this project were to compare the diagnostic actionability, accuracy, and ability to accurately predict extent of surgery for FNA and frozen section during the evaluation of a parotid mass. METHODS A retrospective chart review of patients who underwent parotidectomy for a parotid mass from January 1, 2015 to January 30, 2022 was conducted. Actionability was defined as a pathology diagnosis or the histologic grade of a lesion, as this provided clear and useful information for the surgeon to act upon. Diagnostic accuracy was determined by comparing FNA and frozen section results to final pathology. Accuracy of extent of surgery was determined by comparing predicted extent of surgery from the FNA or frozen section result to the extent of surgery predicted by the final pathology. RESULTS A total of 626 patients were included in this study. FNA was obtained in 396 (63%) patients, while all neoplasms were evaluated by frozen section analysis. FNA diagnosis was actionable in 318 (80%), while frozen section diagnosis was actionable in 616 (98%) patients. Exactly 294 (92.5%) FNA diagnoses were accurate compared with 600 (98%) frozen section diagnoses. The FNA diagnosis predicted appropriate extent of surgery in 294 (74%) while the frozen section diagnosis predicted appropriate extent of surgery in 600 (96%). Among the 396 patients with FNA, frozen section was significantly more likely to accurately predict appropriate extent of surgery compared with FNA (p < 0.001). CONCLUSION Frozen section is more likely to yield actionable and accurate results compared with FNA. Additionally, frozen section is better than FNA in predicting the appropriate extent of surgery.
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Affiliation(s)
- Hawa M Ali
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - George B Sankar
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | | | - Heather L Johns
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Rumeal D Whaley
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Michael Rivera
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
| | - Christine M Lohse
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Kendall K Tasche
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Daniel L Price
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kathryn M Van Abel
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Linda X Yin
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
| | - Eric J Moore
- Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, USA
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Walsh E, Allan K, Brennan PA, Tullett M, Gomez RS, Rahimi S. Diagnostic accuracy of ultrasonography-guided core needle biopsy of parotid gland neoplasms: A large, single-institution experience in United Kingdom. J Oral Pathol Med 2021; 51:1-4. [PMID: 34784059 DOI: 10.1111/jop.13260] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Salivary gland tumours present a pleomorphic and complex morphology and, apart from the most common neoplasms with well-established histopathological criteria, may create diagnostic difficulty for histopathologists. The majority of salivary gland tumours occur in the parotid gland and the use of ultrasound guided parotid biopsy (US-PB) has increased. US-PB in contrast with fine needle aspiration (FNA), which is an easy and relatively painless technique, is performed under local anaesthesia, usually by radiologists. US-PB offers some advantages over the FNA such as tumour grading and the possibility of performing immunohistochemistry. We report our experience of the diagnostic value of US-PB in a large, referral centre in the United Kingdom.
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Affiliation(s)
- Elizabeth Walsh
- Department of Pathology, Brighton and Sussex University Hospitals NHS Trust, Eastern Road Brighton, UK
| | - Kimberly Allan
- Department of Pathology, Brighton and Sussex University Hospitals NHS Trust, Eastern Road Brighton, UK
| | - Peter A Brennan
- Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Southwick Hill Road, UK
| | - Mark Tullett
- Department of Pathology, St. Richard's Hospital Spitalfield Lane, Chichester, UK
| | - Ricardo Santiago Gomez
- Department of Oral Surgery and Pathology, Universidade Federal de Minas Gerais, Pampulha, Brasil
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Geiger JL, Ismaila N, Beadle B, Caudell JJ, Chau N, Deschler D, Glastonbury C, Kaufman M, Lamarre E, Lau HY, Licitra L, Moore MG, Rodriguez C, Roshal A, Seethala R, Swiecicki P, Ha P. Management of Salivary Gland Malignancy: ASCO Guideline. J Clin Oncol 2021; 39:1909-1941. [PMID: 33900808 DOI: 10.1200/jco.21.00449] [Citation(s) in RCA: 154] [Impact Index Per Article: 51.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
PURPOSE To provide evidence-based recommendations for practicing physicians and other healthcare providers on the management of salivary gland malignancy. METHODS ASCO convened an Expert Panel of medical oncology, surgical oncology, radiation oncology, neuroradiology, pathology, and patient advocacy experts to conduct a literature search, which included systematic reviews, meta-analyses, randomized controlled trials, and prospective and retrospective comparative observational studies published from 2000 through 2020. Outcomes of interest included survival, diagnostic accuracy, disease recurrence, and quality of life. Expert Panel members used available evidence and informal consensus to develop evidence-based guideline recommendations. RESULTS The literature search identified 293 relevant studies to inform the evidence base for this guideline. Six main clinical questions were addressed, which included subquestions on preoperative evaluations, surgical diagnostic and therapeutic procedures, appropriate radiotherapy techniques, the role of systemic therapy, and follow-up evaluations. RECOMMENDATIONS When possible, evidence-based recommendations were developed to address the diagnosis and appropriate preoperative evaluations for patients with a salivary gland malignancy, therapeutic procedures, and appropriate treatment options in various salivary gland histologies.Additional information is available at www.asco.org/head-neck-cancer-guidelines.
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Affiliation(s)
| | | | | | | | | | | | | | - Marnie Kaufman
- Adenoid Cystic Carcinoma Research Foundation, Needham, MA
| | | | | | - Lisa Licitra
- Istituto Nazionale Tumori, Milan, Italy.,University of Milan, Milan, Italy
| | | | | | | | | | | | - Patrick Ha
- University of California San Francisco, San Francisco, CA
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Tretiakow D, Przewozny T, Skorek A, Mikaszewski B. Regarding to "Minimaly invasive benign parotid surgery in selected patients: An adaptation example to compensate for COVID19 backlog or new era?". Oral Oncol 2021; 119:105227. [PMID: 33627225 DOI: 10.1016/j.oraloncology.2021.105227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Dmitry Tretiakow
- Department of Otolaryngology, Medical University of Gdansk, Poland.
| | - Tomasz Przewozny
- Department of Otolaryngology, Medical University of Gdansk, Poland
| | - Andrzej Skorek
- Department of Otolaryngology, Medical University of Gdansk, Poland
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Tretiakow D, Mikaszewski B, Skorek A. The role of fine‑needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls. Eur Arch Otorhinolaryngol 2020; 277:2939-2940. [PMID: 32215740 DOI: 10.1007/s00405-020-05923-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 03/16/2020] [Indexed: 11/26/2022]
Affiliation(s)
- Dmitry Tretiakow
- Department of Otolaryngology, Medical University of Gdansk, Smoluchowskiego str. 17, 80-214, Gdansk, Poland.
| | - Boguslaw Mikaszewski
- Department of Otolaryngology, Medical University of Gdansk, Smoluchowskiego str. 17, 80-214, Gdansk, Poland
| | - Andrzej Skorek
- Department of Otolaryngology, Medical University of Gdansk, Smoluchowskiego str. 17, 80-214, Gdansk, Poland
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Tretiakow D, Skorek A. Regarding the "Is Surgery an Inevitable Treatment for Advanced Salivary Lymphoepithelial Carcinoma? Three Case Reports". EAR, NOSE & THROAT JOURNAL 2020; 100:1015S-1016S. [PMID: 32538670 DOI: 10.1177/0145561320934929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Salivary lymphoepithelial carcinoma is a highly radiosensitive tumor that suggests the effectiveness of induction chemotherapy and induction concurrent chemoradiotherapy without previous surgery. However, the imperfection of diagnostic methods and the severe consequences of misdiagnosis of the tumor do not allow to resign from surgical treatment in patients with this type of salivary gland tumor.
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Affiliation(s)
- Dmitry Tretiakow
- Department of Otolaryngology, Medical University of Gdańsk, Poland
| | - Andrzej Skorek
- Department of Otolaryngology, Medical University of Gdańsk, Poland
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A Study of Clinicopathological Profile of Salivary Gland Swellings. Indian J Otolaryngol Head Neck Surg 2019; 71:253-257. [PMID: 31741969 DOI: 10.1007/s12070-018-1258-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Accepted: 01/30/2018] [Indexed: 10/18/2022] Open
Abstract
Salivary gland diseases usually present as a swelling of the affected gland. These lesions are commonly encountered in day to day practice. A salivary gland swelling can present in a variety of locations, depending on the salivary gland affected. The purpose of the study is to know the incidence of salivary gland swellings and the usefulness of FNAC in evaluating these swellings. The present study is a time bound prospective study of fifty consecutive cases of salivary gland swellings admitted in our hospital during the period November 2014-August 2016. Most of the patients underwent pre-operative work up with FNAC and patients indicated for surgery underwent surgery and HPE. Salivary gland swelling occurred more commonly in 3rd decade of life and equal number of cases were seen in both genders. Most of the patients presented with salivary gland swelling (98%). 21 (42%) were non neoplastic, 29 (58%) were neoplastic swellings, 18 (36%) were benign of which pleomorphic adenoma was the most common and 11 (22%) were malignant of which adenoid cystic carcinoma was the most common. Parotid gland was the most common gland involved. Fine needle aspiration cytology was highly sensitive for benign tumours and highly specific for malignant tumours. FNAC should be first choice of investigation in evaluating the salivary gland pathologies. Early diagnosis and subsequent appropriate management carries good prognosis.
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9
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Diagnostic accuracy and utility of fine-needle aspiration cytology in therapeutic management of parotid gland tumours. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019; 70:74-79. [DOI: 10.1016/j.otorri.2018.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/11/2018] [Accepted: 03/15/2018] [Indexed: 11/23/2022]
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10
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Lameiras AR, Estibeiro H, Montalvão P, Magalhães M. Diagnostic accuracy and utility of fine-needle aspiration cytology in therapeutic management of parotid gland tumours. ACTA OTORRINOLARINGOLOGICA ESPANOLA 2019. [DOI: 10.1016/j.otoeng.2018.03.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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11
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Bilateral Synchronous Mucoepidermoid Carcinoma of the Parotid Gland. MEDICAL BULLETIN OF SISLI ETFAL HOSPITAL 2018; 52:145-148. [PMID: 32595390 PMCID: PMC7315060 DOI: 10.14744/semb.2017.74936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Accepted: 04/17/2017] [Indexed: 11/20/2022]
Abstract
Mucoepidermoid carcinoma is the most common malignant tumor of the parotid; however, its synchronous occurrence in both of the parotid glands is extremely rare. Herein, we presented a case of 53-year-old man with bilateral synchronous mucoepidermoid carcinoma of the parotid gland treated with surgery. The patient mainly complained of a painless mass in the left parotid gland. A mass located in the right parotid gland was incidentally detected by imaging. Based on cytopathology, left total parotidectomy was performed while preserving the facial nerve with ipsilateral neck dissection, and 5 weeks later, right superficial parotidectomy was performed. At the 3-year follow-up, there was no recurrence in the parotid regions and the neck. A detailed examination for parotid masses is suggested for identifying possible occult synchronous tumors in the contralateral side or in other salivary glands. A close follow-up is also recommended for the risk of future occurrence of metachronous tumors.
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Comoglu S, Ozturk E, Celik M, Avci H, Sonmez S, Basaran B, Kiyak E. Comprehensive analysis of parotid mass: A retrospective study of 369 cases. Auris Nasus Larynx 2018; 45:320-327. [DOI: 10.1016/j.anl.2017.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Revised: 03/26/2017] [Accepted: 04/12/2017] [Indexed: 10/19/2022]
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Kilavuz AE, Songu M, İmre A, Arslanoğlu S, Özkul Y, Pinar E, Ateş D. Application of Sal classification to parotid gland fine-needle aspiration cytology: 10-year retrospective analysis of 312 patients. Head Neck 2018; 40:937-942. [PMID: 29385293 DOI: 10.1002/hed.25056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 09/10/2017] [Accepted: 11/22/2017] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The accuracy of fine-needle aspiration biopsy (FNAB) is controversial in parotid tumors. We aimed to compare FNAB results with the final histopathological diagnosis and to apply the "Sal classification" to our data and discuss its results and its place in parotid gland cytology. METHODS The FNAB cytological findings and final histological diagnosis were assessed retrospectively in 2 different scenarios based on the distribution of nondefinitive cytology, and we applied the Sal classification and determined malignancy rate, sensitivity, and specificity for each category. RESULTS In 2 different scenarios FNAB sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were found to be 81%, 87%, 54.7%, and 96.1%; and 65.3%, 100%, 100%, and 96.1%, respectively. The malignancy rates and sensitivity and specificity were also calculated and discussed for each Sal category. CONCLUSION We believe that the Sal classification has a great potential to be a useful tool in classification of parotid gland cytology.
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Affiliation(s)
- Ahmet Erdem Kilavuz
- Department of Otorhinolaryngology, Acibadem Healthcare Group Taksim Hospital, Istanbul, Turkey
| | - Murat Songu
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Abdulkadir İmre
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Secil Arslanoğlu
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Yilmaz Özkul
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Ercan Pinar
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
| | - Düzgün Ateş
- Department of Otorhinolaryngology, Izmir Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkey
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Pommier A, Lerat J, Orsel S, Bessede JP, Aubry K. [Cyto-histological correlation in the management of parotid gland tumors: A retrospective study of 160 cases]. Bull Cancer 2017; 104:850-857. [PMID: 29031506 DOI: 10.1016/j.bulcan.2017.09.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/09/2017] [Accepted: 09/06/2017] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The aim of this study was to correlate the cytological and histological results and evaluate the diagnostic performance of fine-needle aspiration cytology (FNAC) in the management of parotid gland tumors. METHODS This retrospective study included 160 patients with a parotid gland tumor who underwent fine-needle aspiration and parotidectomy surgery between January 2005 and August 2016 at the Limoges university hospital center. RESULTS On 160 fine-needle aspirations performed, fine-needle aspiration diagnoses were: 77 benign lesions, 35 malignant lesions and 48 non-diagnostic cases. Final histological diagnosis revealed there were 113 benign lesions and 47 malignant lesions. A hundred and one cytological diagnoses were accurate over 112 contributive fine-needle aspirations: seven false-negative cases and 4 false-positive cases were observed. The sensitivity, specificity, and accuracy were 82, 95 and 90% respectively for fine-needle aspiration, and 83, 95 and 92% respectively for association of fine-needle aspiration and magnetic resonance imaging. Diagnostic concordance between fine-needle aspiration and final histology for malignant lesions was 78%. A greater number of contributive fine-needle aspirations was observed among experimented operators. DISCUSSION Fine-needle aspiration is a reliable, safe and effective diagnostic tool that allows good differentiation between malignant and benign diagnosis in the preoperative management of parotid gland tumors. The association of fine-needle aspiration and magnetic resonance imaging (MRI) can improve diagnostic performance.
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Affiliation(s)
- Auriane Pommier
- CHU Dupuytren, service d'ORL et de chirurgie cervicofaciale, 2, avenue Martin-Luther-King, 87000 Limoges, France.
| | - Justine Lerat
- CHU Dupuytren, service d'ORL et de chirurgie cervicofaciale, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - Stéphane Orsel
- CHU Dupuytren, service d'ORL et de chirurgie cervicofaciale, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - Jean-Pierre Bessede
- CHU Dupuytren, service d'ORL et de chirurgie cervicofaciale, 2, avenue Martin-Luther-King, 87000 Limoges, France
| | - Karine Aubry
- CHU Dupuytren, service d'ORL et de chirurgie cervicofaciale, 2, avenue Martin-Luther-King, 87000 Limoges, France
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