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Preoperative fine needle cytology and imaging facilitates the management of submandibular salivary gland lesions
Author(s) -
Taylor Martyn J.,
Serpell Jonathan W.,
Thomson Peter
Publication year - 2011
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2010.05347.x
Subject(s) - medicine , adenoid cystic carcinoma , cytology , submandibular gland , malignancy , salivary gland , histology , histopathology , pleomorphic adenoma , pathology , fine needle aspiration , radiology , carcinoma , biopsy
Background: Lesions of the submandibular gland represent a pleomorphically diverse group in which benign and malignant pathologies are difficult to differentiate from each other. Accurate diagnosis and surgical intervention relies upon clinical presentation, examination and investigations to guide appropriate management. The current series aimed to identify the roles of preoperative cytology and imaging with subsequent histopathology in the management of these lesions. Methods: Between 1998 and 2008, 54 patients of median age 54 years (range 25–94), with a male : female ratio of 1:3.5 were identified, of which, 50 patients underwent 52 excisions of the submandibular gland. Demographic data were recorded. The utility of imaging and cytology were analysed, and the accuracy of cytology correlated with histology. Results: Pathologies of resected specimens were sialadenitis 17 (32%), pleomorphic adenomas nine (17%), calculi eight (15%), lymphoma five (10%), squamous cell carcinoma two (4%), adenoid cystic carcinoma one (2%) and other 10 (20%). Twenty‐eight patients (52%) underwent fine‐needle aspiration cytology/core biopsies, of which 25 (89%) were correlated with histology. The accuracy, sensitivity and specificity of the fine‐needle aspiration cytology correlation with histology were 88.0%, 71.4% and 94.4%, respectively. Overall, the complication rate was 9.6%; involving five temporary nerve palsies of the marginal mandibular branch of the facial nerve, including one temporary lingual nerve palsy. Conclusion: This series demonstrates histological outcomes in patients specific to the submandibular salivary gland. The malignancy rate was low compared to current published literature. The transcervical surgical approach to submandibular gland pathology is a safe and effective method with minimal morbidity when performed by experienced surgeons. No single investigative modality can be solely aligned with diagnosing a specific lesion of the submandibular gland.