6.3.3: 3. Evaluation of Parotid Mass- Key Points
- Page ID
- 18309
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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