Skip to main content

Advertisement

SpringerLink
Log in

Challenges with preoperative diagnosis of low/intermediate-grade carcinoma of the parotid gland: single-center study of 112 patients

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Background

The malignancy of parotid carcinoma varies, and accurate preoperative assessment of malignancy is important for selecting the appropriate treatment. However, the preoperative diagnosis of low/intermediate-grade carcinoma is difficult, and surgery may sometimes be performed without any prior knowledge of malignancy.

Methods

The results of fine-needle aspiration cytology (FNA), imaging studies (MRI and US), physical examination, and frozen section biopsy (FSB) were evaluated in 112 patients with low/intermediate-grade parotid carcinoma.

Results

The result of FNA was benign/inadequate specimen in 44.6% of the patients. In addition, the tumor was diagnosed as benign by MRI/US in 21.4% of the patients and 37.5% had no symptoms/signs of malignancy on physical examination. The rate of misdiagnosis as benign decreased when FNA was combined with imaging and physical findings. However, malignancy could not be diagnosed by FNA and FSB in 12.5% of the patients who were only found to have malignant tumors by the final pathological examination.

Conclusion

FNA shows a high misdiagnosis rate of malignancy in patients with low/intermediate-grade cancer. Therefore, it is necessary to carefully evaluate the findings of imaging studies and physical examination, and FSB should be conducted if such findings suggest the possibility of malignancy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Cederblad L, Johansson S, Enblad G, Engström M, Blomquist E (2009) Cancer of the parotid gland; long-term follow-up. A single centre experience on recurrence and survival. Acta Oncol 148:549–555

    Article  Google Scholar 

  2. El-Naggar AK, Chan JK, Grandis JR, Takata T, Slootweg PJ (2017) world health organization classification of tumours. Chapter 7 Tumours of salivary glands. IARC Press, Lyon, pp 160–202

    Google Scholar 

  3. Garrett SL, Trott K, Sebastiano C, Wolf MJ, Rao NK, Curry JM (2019) Sensitivity of fine-needle aspiration and imaging modalities in the diagnosis of low-grade mucoepidermoid carcinoma of the parotid gland. Ann Otol Rhinol Laryngol. https://doi.org/10.1177/0003489419842582

    Article  PubMed  Google Scholar 

  4. Nishikado A, Kawata R, Haginomori SI, Terada T, Higashino M, Kurisu Y et al (2018) A clinicopathological study of parotid carcinoma: 18-year review of 171 patients at a single institution. Int J Clin Oncol 23:615–624

    Article  Google Scholar 

  5. Stodulski D, Mikaszewski B, Majewska H, Wiśniewski P, Stankiewicz C (2017) Close surgical margin after conservative parotidectomy in early stage low-/intermediate-grade parotid carcinoma: outcome of watch and wait policy. Oral Oncol 68:1–4

    Article  Google Scholar 

  6. Mantsopoulos K, Koch M, Iro H (2017) Extracapsular dissection as sole therapy for small low-grade malignant tumors of the parotid gland. Laryngoscope 127:1804–1807

    Article  CAS  Google Scholar 

  7. Richter SM, Friedmann P, Mourad WF, Hu KS, Persky MS, Harrison LB (2012) Postoperative radiation therapy for small, low-/intermediate-grade parotid tumors with close and/or positive surgical margins. Head Neck 34:953–955

    Article  Google Scholar 

  8. Nishikawa S, Kawata R, Higashino M, Lee K, Terada T, Kurisu Y et al (2015) Assessing the histological type and grade of primary parotid carcinoma by fine-needle aspiration and frozen section. Auris Nasus Larynx 42:463–468

    Article  Google Scholar 

  9. Okahara M, Kiyosue H, Hori Y, Matsumoto A, Mori H, Yokoyama S (2003) Parotid tumors: MR imaging with pathological correlation. Eur Radiol 13(Suppl 4):L25–33

    Article  Google Scholar 

  10. Christe A, Waldherr C, Hallett R, Zbaeren P, Thoeny H (2011) MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease. AJNR Am J Neuroradiol 32:1202–1207

    Article  CAS  Google Scholar 

  11. Burke CJ, Thomas RH, Howlett D (2011) Imaging the major salivary glands. Br J Oral Maxillofac Surg 49:261–269

    Article  CAS  Google Scholar 

  12. Renehan AG, Gleave EN, Slevin NJ, McGurk M (1999) Clinico-pathological and treatment-related factors influencing survival in parotid cancer. Br J Cancer 80:1296–1300

    Article  CAS  Google Scholar 

  13. Chen MM, Roman SA, Sosa JA, Judson BL (2014) Histologic grade as prognostic indicator for mucoepidermoid carcinoma: a population-level analysis of 2400 patients. Head Neck 36:158–163

    Article  CAS  Google Scholar 

  14. Rajasekaran K, Stubbs V, Chen J, Yalamanchi P, Cannady S, Brant J et al (2018) Mucoepidermoid carcinoma of the parotid gland: a national cancer database study. Am J Otolaryngol 39:321–326

    Article  Google Scholar 

  15. Zbären P, Nuyens M, Loosli H, Stauffer E (2004) Diagnostic accuracy of fine-needle aspiration cytology and frozen section in primary parotid carcinoma. Cancer 100:1876–1883

    Article  Google Scholar 

  16. Suzuki M, Kawata R, Higashino M, Nishikawa S, Terada T, Haginomori SI et al (2019) Values of fine-needle aspiration cytology of parotid gland tumors: a review of 996 cases at a single institution. Head&Neck 41:358–365

    Google Scholar 

  17. Stodulski D, Mikaszewski B, Stankiewicz C (2012) Signs and symptoms of parotid gland carcinoma and their prognostic value. Int J Oral Maxillofac Surg 41:801–806

    Article  CAS  Google Scholar 

  18. Tao L, Zhang D, Zhang M, Zhou L (2019) Clinical behaviours and prognoses of high- and low-risk parotid malignancies based on histology. Eur Arch Otorhinolaryngol 276:497–503

    Article  Google Scholar 

  19. Koide C, Imai A, Nagaba A, Takahashi T (1994) Pathological findings of the facial nerve in a case of facial nerve palsy associated with benign parotid tumor. Arch Otolaryngol Head Neck Surg 120:410–412

    Article  CAS  Google Scholar 

  20. Poorten VV, Hart A, Vauterin T, Jeunen G, Schoenaers J, Hamoir M et al (2009) Prognostic index for patients with parotid carcinoma: international external validation in a Belgian–German database. Cancer 115:540–550

    Article  Google Scholar 

  21. Terhaard C, Lubsen H, Tan B, Merkx T, van der Laan B, Baatenburg Jong R et al (2006) Facial nerve function in carcinoma of the parotid gland. Eur J Cancer 42:2744–2750

    Article  Google Scholar 

  22. Zbären P, Triantafyllou A, Devaney KO, Poorten VV, Hellquist H, Rinaldo A et al (2018) Preoperative diagnostic of parotid gland neoplasms: fine-needle aspiration cytology or core needle biopsy? Eur Arch Otorhinolaryngol 275:2609–2613

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan

    Shuji Omura, Ryo Kawata, Masaaki Higashino, Shuji Nishikawa, Tetsuya Terada & Shin-Ichi Haginomori

  2. Department of Pathology, Osaka Medical College, Takatsuki, Osaka, Japan

    Yoshitaka Kurisu & Yoshinobu Hirose

Authors
  1. Shuji Omura
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ryo Kawata
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Masaaki Higashino
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Shuji Nishikawa
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Tetsuya Terada
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shin-Ichi Haginomori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Yoshitaka Kurisu
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Yoshinobu Hirose
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ryo Kawata.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The protocol of this study was approved by the Ethics Committee of Osaka Medical College (#765).

Informed consent

Informed consent was obtained from all individual participants included in the study, including those from parents of minors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Omura, S., Kawata, R., Higashino, M. et al. Challenges with preoperative diagnosis of low/intermediate-grade carcinoma of the parotid gland: single-center study of 112 patients. Eur Arch Otorhinolaryngol 277, 2031–2039 (2020). https://doi.org/10.1007/s00405-020-05871-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-020-05871-6

Keywords

Search

Navigation