Perioperative frozen section examination in parotid gland tumors

Abstract

We consider that frozen section examination for salivary gland tumors is not sufficient on its own for deciding on the best management. Their interpretation must be correlated with clinical and intraoperative findings, in association with the surgeon's experience.

Diagnostic value of ultrasound-guided core needle biopsy in patients with salivary gland masses

“…27 The accuracy and potential benefit of FS in salivary gland surgery is controversially discussed in the literature. 1,5,10,23,24,27,34 Its reported sensitivity for diagnosing malignancy ranges from 43% to 100%. Most authors have shown that FS provides sensitivity rates between 60% and 80% which is similar to FNAC, and many of them have concluded that FS examination is not sufficient on its own for deciding on the best management of salivary gland lesions.…”

“…Most authors have shown that FS provides sensitivity rates between 60% and 80% which is similar to FNAC, and many of them have concluded that FS examination is not sufficient on its own for deciding on the best management of salivary gland lesions. 5,10,24,27,34 The high rate of false-negative results may also be due to the following reason. When the pathologist is not sure about the diagnosis he may be inclined to give an inconclusive or benign diagnosis because he is afraid of the consequences of a malignant diagnosis for the patient at the time of surgery.…”

“…When the pathologist is not sure about the diagnosis he may be inclined to give an inconclusive or benign diagnosis because he is afraid of the consequences of a malignant diagnosis for the patient at the time of surgery. 10,27 With regard to tumour typing, most studies have shown that FS is superior to FNAC but BADOUAL et al 5 have shown that in a series of 721 patients the exact subtype of a salivary gland carcinoma could not be determined in half of the cases.…”

“…23,30 The histopathology and cytology of salivary gland tumours are extremely sophisticated, even for experienced pathologists, demonstrating a highly diverse mix of cell types and growth patterns and overlapping morphologic features. 10,27,30 The extent of surgery for salivary gland neoplasms (e.g. save or sacrifice the facial nerve) is not only dependent on the differentiation between benign and malignant disease but also on the exact entity and grading of the malignant tumours.…”

“…[1][2][3][4]6,18,23,27,30,34,35 Frozen section (FS) has been discussed as an alternative approach to guide treatment intraoperatively but has also been associated with a high rate of diagnostic errors and low sensitivity. 5,10,27,34 In recent years, percutaneous image-guided core needle biopsy (CNB) has gained widespread popularity for tissue sampling particularly of deep-seated masses throughout the body. 25 Despite the advantages of CNB only a few studies have discussed its application for diagnostic purpose in salivary gland lesions.…”