Role of fine needle aspiration in malignant parotid tumors at a single-center experience: A retrospective cohort study

Abstract

Background Parotid gland tumors are mostly benign with good prognosis. On the other hand, malignant tumors of the parotid gland often have poor prognosis and metastasize. Mucoepidermoid carcinoma is the most common cancer in the parotid gland accounting for nearly 40–50% of the cases. Therefore, it is important to define the role of fine needle aspiration in differentiating between different types of parotid malignancies. Method This is a retrospective chart review study that was done on 49 consecutive patients who underwent parotid surgeries in King Fahad Armed Forces Hospital in Jeddah, Saudi Arabia, between Jan 2003 and Feb 2020. The records of 49 patients were obtained, fine needle aspiration and pathology reports were reviewed to define the role of fine needle aspiration in diagnosing malignant parotid tumors by calculating the sensitivity, specificity, positive predictive value, and negative predictive value. Results Retrospective analysis of 39 cases revealed that there was one case which was diagnosed for cancer was missed by fine needle aspiration. Meanwhile, six cases were diagnosed as malignant lesions using both fine needle aspiration and histopathology. Furthermore, 30 cases were determined benign based on fine needle aspiration and histopathology. The sensitivity of fine needle aspiration for detecting malignancy was 85.7%, specificity was 93.8%. positive predictive value of 75% and negative predictive value of 96.7%. Conclusion Fine needle aspiration is highly sensitive and specific for parotid tumors. We support the role of pre-operative FNA for all parotid tumors as its accurate in differentiating between benign and malignant lesions.

Efficiency of Fine-Needle Aspiration (FNA) in Relation to Tru-Cut Biopsy of Lateral Neck Swellings

“…Diagnostic accuracy, specificity, and sensitivity were 90.6%, 94.3%, and 73.6%, respectively. Consistent with our results were accuracy, specificity, and sensitivity in the studies of Wan Y, Akhavan-Moghadam J, and Alwagdani A [ 3 - 5 ]. Other studies showed different accuracy, specificity, and sensitivity results.…”

“…Also, since FNA is a cheap and non-invasive procedure, we highly recommend that an FNA is performed before any neck mass surgical intervention [ 5 ]. FNAC cytology puts forward the advantage of being cost-effective and less invasive when done but the drawback of such a procedure is that the cytological smear cannot differentiate between cells due to the limited amount of cells being examined.…”

“…Akhavan-Moghadam et al studied FNA results for head and neck masses and reported accuracy, sensitivity, and specificity to be 92.3%, 95%, and 85%, respectively [ 4 ]. Alwagdani et al investigated the role of FNA in detecting malignant tumors and found the accuracy/sensitivity to be 85.7%, and specificity 93.8% with a positive predictive value of 75% [ 5 ]. A study conducted by Marzouki et al investigated 43 salivary gland cases that underwent parotidectomies, of which 38 FNA results were conclusive [ 7 ].…”

Salivary gland pathologies: evolution in classification and association with unique genetic alterations

“…Although it is a well-known examination that has been used for years [ 67 ], only with the introduction of an international standardized FNA assessment system—the Milan system [ 68 ]—there has been a return to the widespread use of this test in routine diagnosis of salivary gland lesions. Recently there have been an increasing number of reports of the very high sensitivity and specificity of FNA examination assessed by the Milan system [ 69 , 70 ]. FNA has the advantage of safety, simplicity of technique and low cost.…”