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Official Journal of the Italian Society of Maxillofacial Surgery
Frequency: 3 issues
Online ISSN 1827-1901
Pia F., Policarpo M., Brovelli, Taranto F. F., Aluffi P.
Department of Otorinolaringology University of Piemonte Orientale “A. Avogadro” Novara, Italy
Aim. Primary epithelial tumors are the most commonly observed malignant neoplasms of the parotid gland, while metastatic tumors are less common. The diagnostic work-up comprises clinical examination with accurate history taking and imaging studies. Diagnostic errors arise when the clinical approach is hastily executed and methodologically incorrect.
Methods. This article underlines the pitfalls that can be encountered in the diagnosis of parotid cancer.
Results. From 1990 to August 2003, 379 parotidectomies for parotid neoplasms were performed at our unit. This retrospective study examines the modalities of onset, the clinical features, the cytology, the intraoperative and final histology of parotid neoplasms. In this case series 13.7% of tumors were malignant. The rapid growth of the neoplasms was strongly indicative of malignancy. Fine-needle aspiration cytology was rarely diagnostic for the parotid tumors (47.5% sensitivity) as was intraoperative frozen section histology.
Conclusion. In neoplastic diseases of the major salivary glands, a correct clinical approach is essential; the possibility of a parotid tumor should be suspected whenever rapid growth and pain are present without inflammation. A judicious choice of diagnostic studies significantly curbs medical costs, without compromising accurate and timely clinical diagnosis.