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Background: The aim of the present study was to review the pathology found following parotid surgery at three Western Australian tertiary public hospitals over an 11-year period.  Method: Retrospective data was extracted on all patients who underwent parotid surgery from 2003 to 2013. Prospectively maintained electronic hospital-based Information systems were interrogated for patient demographics and surgical specimen histology.  Results: Parotid surgery was performed on 706 patients, of which 65% were male. The mean age was 61.0 (SD =16.8, range 8–98). Malignancy was more common (52%), than benign neoplasia (44%), with inflammatory/infective conditions uncommon (4%). Metastatic cutaneous squamous cell carcinoma (34%) was the most prevalent pathology followed by benign pleomorphic adenoma (28%). Primary salivary gland malignancy accounted for only 9% of parotid pathology. Advancing age (>50 years) and male gender increased the risk of a malignant parotid pathology.  Conclusions: Western Australians undergoing parotid surgery demonstrated concerning rates of metastatic cutaneous malignancy, particular older males. A high degree of suspicion and timely investigation of any parotid mass in this cohort is warranted. Given the poor prognosis seen in advanced disease, primary prevention strategies are paramount.

An 11-year tertiary level audit of surgical pathology of the parotid in Western Australia