Preoperative evaluation and treatment consideration of parotid gland tumors

Abstract

Background The nature of parotid tumors often remains unknown preoperatively and final histopathology may reveal unexpected malignancy. Still, the use of fine‐needle aspiration cytology (FNAC) and imaging varies in the management of these tumors. Methods We evaluated the preoperative examinations and management of all 195 parotid gland tumors diagnosed within our catchment area of 1.6 million people during 2015. Results Altogether 171 (88%) tumors were classified as true salivary gland neoplasms. FNAC showed no false malignant findings, but it was false benign in 5 (2.6%) cases. Preoperative MRI was utilized in 48 patients (25%). Twenty (10%) malignancies included 16 salivary gland carcinomas. Pleomorphic adenomas accounted for 52% of all adenomas. For 24 (40%) Warthin tumors, surgery was omitted. Conclusion The proportion of malignancies was lower than generally presented. Our proposed guidelines include ultrasound‐guided FNAC with certain limitations. MRI is warranted in selected cases, but seems unnecessary routinely.

The Usefulness of Ultrasound-Guided Core Needle Biopsy Compared to Fine Needle Aspiration in Pre-Operative Diagnosis of Cystic-Predominant Parotid Tumors

“…이하선 종양은 전체 타액선 종양 중 약 70%로 가장 많은 비중을 차지하며, 이 중 악성종양으로 진단되는 비율은 14%-25%로 보고되고 있다. 1,2) 이하선 종양의 표준치료는 수술적 적출이며, 종양의 위치와 크기 및 수술 전 평가에서의 악성 진단여부에 따라 종양을 포함한 이하선 절제 범위를 설정한 다. 3,4) 이하선의 절제 범위가 넓어질수록 안면신경 손상 가능 성이 높고, 술전 안면마비가 있는 악성종양의 경우 종양이 침 윤된 안면신경 분지의 희생이 필요할 수 있다.…”

Clinical decision making when cytology indicates a Warthin tumor

“…Warthin tumor (WT) is the second most common parotid gland tumor, and it constitutes up to 36% (range, 3–36%) of tumors at this location, which is its predilection site 1 – 6 . WT more often affects men over 50 years of age, and those who are smokers 1 , 2 , 7 , 8 .…”

Minimally invasive retroauricular approach parotidectomy: A pictorial essay

“…On average, 20 000 parotid neoplasms are diagnosed annually in the United States and the incidence is increasing 1 . Approximately 70% of salivary tumors arise in the parotid gland, though, overall, they comprise of less than 3% of head and neck neoplasms 2,3 . Surgery remains the primary treatment and success regarding retroauricular resection of parotid gland masses in the posterior and inferior portions has been previously demonstrated as feasible 3 .…”

“…1 Approximately 70% of salivary tumors arise in the parotid gland, though, overall, they comprise of less than 3% of head and neck neoplasms. 2,3 Surgery remains the primary treatment and success regarding retroauricular resection of parotid gland masses in the posterior and inferior portions has been previously demonstrated as feasible. 3 The most frequently used operative approaches for parotidectomy include the modified-Blair incision (MBI), facelift incision (FI), and the retroauricular hairline incision (RAHI) first described in 2009.…”