6.3.3: 3. Evaluation of Parotid Mass- Key Points
- Page ID
- 18309
\( \newcommand{\vecs}[1]{\overset { \scriptstyle \rightharpoonup} {\mathbf{#1}} } \) \( \newcommand{\vecd}[1]{\overset{-\!-\!\rightharpoonup}{\vphantom{a}\smash {#1}}} \)\(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\) \(\newcommand{\id}{\mathrm{id}}\) \( \newcommand{\Span}{\mathrm{span}}\) \( \newcommand{\kernel}{\mathrm{null}\,}\) \( \newcommand{\range}{\mathrm{range}\,}\) \( \newcommand{\RealPart}{\mathrm{Re}}\) \( \newcommand{\ImaginaryPart}{\mathrm{Im}}\) \( \newcommand{\Argument}{\mathrm{Arg}}\) \( \newcommand{\norm}[1]{\| #1 \|}\) \( \newcommand{\inner}[2]{\langle #1, #2 \rangle}\) \( \newcommand{\Span}{\mathrm{span}}\)\(\newcommand{\AA}{\unicode[.8,0]{x212B}}\)
- 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