Utility of fine-needle aspiration biopsy (FNAB) in parotid pleomorphic adenoma diagnosis and management

Abstract

Purpose. Pleomorphic adenoma (PA), the most common benign tumour of the parotid gland, requires accurate preoperative diagnosis owing to its capacity for malignant transformation. The aim of this study was to evaluate our experience with ultrasound-guided fine-needle aspiration biopsy (FNAB) in the diagnostic algorithm for patients with PA and to assess clinical outcomes for those with different surgical approaches. Material and Methods. We carried out a retrospective analysis of patients treated for parotid gland mass between 2010 and 2016. These had had preoperative FNAB and had undergone subsequent surgery. Results. 165 patients had FNAB with the result of PA and the definitive histology confirmed PA in 159 cases (96.4%). On the other hand, in 179 patients, the definitive histology showed PA and the preoperative FNAB result corresponded in 159 cases (88.9%). The measured sensitivity, specificity and accuracy of ultrasound-guided FNAB in the diagnosis of PA were, respectively, 88.83%, 96.23% and 92.31%. Most of the patients underwent superficial or partial superficial parotidectomy, followed by extracapsular dissection which was associated with statistically lower risk of facial nerve injury (P=0.04). Conclusion.Ultrasound-guided FNAB is simple, accurate and valuable in the diagnosis of PA and provides results that can lead to the choice of less invasive operative treatment.

Surgical management of a giant parotid gland pleomorphic adenoma in Northern Sri Lanka: A case report

“…PA is usually present as a unilateral, slow-growing, painless mass [ 7 , 8 ]. But if left untreated, it can present as a giant mass, like in this case.…”

“…It usually presents as hard, uneven nodular swelling in the parotid region and usually asymptomatic with slow growing tendency without facial nerve involvement. However, if left untreated, they can grow into extensive sizes [ 5 , 7 , 8 ]. Approximately 6 % of PA tends to malignant transformation into Carcinoma Ex-pleomorphic adenoma, an aggressive tumour.…”