抄録
Preoperative histological diagnosis of parotid carcinoma is more difficult than that of other head and neck carcinomas. Accurate tumor histological analysis is important in satisfactory management of cancer of the parotid gland. Therapy should be carried out according to each histological type because each has a different tumor activity level. We reviewed 45 cases of previously untreated carcinomas arising in the parotid gland that had been treated between 1989 and 2002 and investigated the accuracy of preoperative histological diagnosis and the initial surgery. Fine-needle aspiration biopsy (FNA) of the parotid gland tumors is an accepted, sensitive and specific technique in diagnosing tumors. FNA was performed for all patients with parotid carcinomas, and the FNA findings were compared with the final pathologic diagnosis of the surgical specimen. In 45 cases of parotid carcinomas, FNA correctly diagnoised 27 (13 histologically, and 14 as malignant only), but failed in 18. Because the accuracy of the FNA findings was poor, we performed open biopsy prior to surgery in 13 cases, and an accurate diagnosis of both histology and grading was obtained in 12 cases. The results of FNA findings in all cases and open biopsy in 13 cases showed correct disgnosis in 29 (22 histologically, and 7 were malignant only), but failed in 16. Seventeen of 22 patients accurately diagnosed histologically underwent an appropriate surgical procedure, while 3 of 16 patients diagnosed with benign tumors preoperatively underwent inappropriate procedures. About forty percent of the patients underwent an inappropriate procedure mainly because of the wrong preoperative histological diagnosis. An accurate diagnosis is necessary to schedule an appropriate surgery, which will improve the prognosis of parotid carcinoma.
