• Does fine needle aspiration and cytology really help in the management of Parotid tumours?

      Selbong, Uthaya; Pereira, Isabel; Syed, Nazar; Laugharne, David; Jones, Keith (2016-12)
      Introduction: Fine needle aspiration (FNA) and cytology routinely performed when assessing parotid mass. In our unit, FNA is performed by our radiologist under ultrasound guidance. We would like to determine how accurate FNA is in the investigation of parotid tumours.Methods: We retrospectively audited all consecutive FNAs done for patients presenting with parotid tumour to maxillofacial clinic Royal Derby Hospital for the period of April 2010 to March 2015. FNA results, definitive management and final histology results were analysed.Results: 103 patients who had FNA performed for parotid mass were identified for this audit. 38 patients had FNA reported as pleomorphic salivary adenoma (PSA), 27 patients had FNA reported as Warthin's tumour, 13 patients had various type of malignancy detected and 25 patients had non- specific diagnosis. We compared the FNA with final histology result of all those patients who underwent surgery (n = 79). We calculated the sensitivity of FNA in detecting pleomorphic salivary adenoma was 94.2% and specificity was 95.5%. For Warthin's tumour, the sensitivity and specificity was 92.3% and 98.6% respectively. However, the sensitivity of FNA in detecting malignant parotid tumour was only 54.5% in our audit and the specificity was 92%. We would also like to highlight that 3 patients had FNA suggestive of benign disease however the final histology were malignant tumours.Discussion: This audit clearly showed the limitation of FNAs especially when it comes to malignant tumours. Patient could possibly have malignancy undiagnosed or in the other hand can be over treated for common benign diagnosis.