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6.3.3: 3. Evaluation of Parotid Mass- Key Points

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    • Most parotid neoplasms are benign
    • Clinical evaluation, cytology and imaging do not conclusively exclude malignancy….hence the need for complete resection of the tumour and histological examination, or if surgery is not to be done, a core needle biopsy
    • Objectives of preoperative evaluation
      • To avoid unnecessary surgery for e.g. infective or non-neoplastic masses, lymphoma, unresectable tumour
      • To do appropriate surgery
      • To avoid embarking on surgery that is beyond the scope of a surgeon e.g. deep lobe tumour, tumour extending to parapharyngeal space, tumour requiring neck dissection, or tumour requiring facial nerve reconstruction
    • History and examination are important means to identify infective causes (e.g. HIV, TB) , benign and malignant primary tumours and metastases to the parotid
    • FNAC is helpful in selected cases
    • Imaging is rarely beneficial for clinically benign, mobile parotid tumours as it uncommonly alters surgical management, but may be helpful in other selected cases
    • Histological classification of primary salivary neoplasms is difficult and complex. Cytological and histological diagnoses should always be treated with caution and viewed in a clinical context, especially if reported from outside centers of excellence