Purpose
Parotid gland tumors account for approximately 3% of all head and neck tumors and are most frequently benign [1].
The majority of cases,
however,
require surgical treatment - local excision or superficial parotidectomy in case of benign lesions and total parotidectomy with potential sacrifice of the facial nerve in malignant lesions [2].
Clinical findings are often of limited value with only a few symptoms indicating malignancy,
one of them being facial nerve palsy.
Typically,
the pathologic diagnosis is determined by the way of fine needle...
Methods and materials
Patient population:
117 patients with parotid gland tumors who had been admitted to the ENT Department in years 2013 - 2014 and subsequently,
after exclusion of contra-indications,
underwent MRI of parotid glands prior to surgical treatment were involved in the study.
With exclusion of examinations with heavy artifacts and patients with no prior biopsy,
100 subjects were selected for further analysis - 60 females (21-88 yo,
mean age 54,5) and 40 males (18-84 yo,
mean age 58,5).
All tumors were located in the parotid glands,...
Results
Diffusion restriction - low ADC - has been observed in Warthin tumors (94,7%) and malignant tumors (94,7%).
96,5% of pleomorphic adenomas presented with high ADC values.
ROC curve analysis allowed us to establish an ADC value of 1,3 x 10-3 mm2/s to be cut-off value in differentiation between pleomorphic adenomas and other lesions (with the area under the curve of 0,918).
Solid tumors and tumors with solid and cystic components with ADC values larger than 1,3 x 10-3 mm2/s are suggestive of benign lesions,
with...
Conclusion
Our study confirms the role of MRI as the optimal examination in the assessment of parotid gland masses and a promising method of verification of the diagnosis based on FNAC,
presenting with high level of accuracy in differentiating benign from malignant tumors.
We are aware that ADC values may overlap across various histologies,
particularly in case of Warthin tumors and malignancies,
however the added value of dynamic contrast-enhanced sequences with generated TICs may allow differentiation between those two entities.
Judging by the excellent interobserver agreement...
References
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MR imaging of parotid tumors: typical lesion characteristics in MR imaging improve discrimination between benign and malignant disease.
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