Preoperative evaluation and treatment consideration of parotid gland tumors

BACKGROUND: The nature of parotid tumors often remains unknown preoperatively and final histopathology may reveal unexpected malignancy. Still, the use of fine‐needle aspiration cytology (FNAC) and imaging varies in the management of these tumors. METHODS: We evaluated the preoperative examinations and management of all 195 parotid gland tumors diagnosed within our catchment area of 1.6 million people during 2015. RESULTS: Altogether 171 (88%) tumors were classified as true salivary gland neoplasms. FNAC showed no false malignant findings, but it was false benign in 5 (2.6%) cases. Preoperative MRI was utilized in 48 patients (25%). Twenty (10%) malignancies included 16 salivary gland carcinomas. Pleomorphic adenomas accounted for 52% of all adenomas. For 24 (40%) Warthin tumors, surgery was omitted. CONCLUSION: The proportion of malignancies was lower than generally presented. Our proposed guidelines include ultrasound‐guided FNAC with certain limitations. MRI is warranted in selected cases, but seems unnecessary routinely.