Materiały źródłowe

• #1 Diagnostics of parotid gland tumors

  https://otorhinolaryngologypl.com/seo/article/01.3001.0000.6014/en?language=pl

  Diagnostics of parotid gland tumors should provide the surgeon with the information regarding the location of the tumor relative to the facial nerve, whether the tumor is benign or malignant, and its relation to the adjacent structures. […] This article reviews the role of different diagnostic tools in the management of tumors of the parotid gland. […] The benefis and limitations of these modalities are discussed.

• #2 Clinical Diagnosis of Extended Parotid Tumors | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-319-26545-2_10

  The clinical examination forms the fundament for decision making in a patient with an extended parotid tumor. The examination starts with an elaborate interview of the patients looking for clinical hints for a malignant disease. The clinical examination comprises a complete head and neck examination including an investigation of all major salivary glands. Thereafter, ultrasound is the first-choice imaging technique for an immediate assessment of the parotid tumor. If available, fine-needle aspiration cytology (FNAC) continues the diagnostic workup. FNAC will determine whether the parotid tumor process is malignant. Core-needle biopsy or an open biopsy may offer an additional effective diagnostic tool in cases in which FNAC has failed to provide a definitive diagnosis. […] In extended parotid tumors, often the situation will occur that ultrasound does not allow visualizing the parotid tumor completely, due to its location in the deep lobe. In such a situation, or if FNAC or a biopsy argue for a malignant disease, further imaging with computed tomography (CT) or magnetic resonance imaging (MRI) are indicated. MRI is the first choice. If a malignant parotid tumor is suspected, MRI and CT scanning are important for the tumor staging of the primary tumor and the neck.

• #3 Parotid Gland Tumors: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/parotid-tumor

  A parotid gland tumor is a rare tumor on one of your salivary glands. […] Most parotid tumors are benign (noncancerous), but they can be cancerous. […] Both tumor types are rare. Each year, cancerous parotid gland tumors affect 1 in 100,000 people worldwide. […] Experts dont know the exact number of people who have noncancerous parotid gland tumors but estimate the condition may affect 1 to 6 in 100,000 people worldwide. […] Providers will do a physical examination focused on your head and neck. […] They may order the following tests: […] Fine needle aspiration: This test can confirm that a parotid gland tumor is cancerous. […] Providers use test results to develop treatment plans and a prognosis, which is what you can expect to happen after treatment. […] Treatment typically involves surgery to remove the tumor.

• #4 Salivary Gland Tumors – Ear, Nose, and Throat Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/ear-nose-and-throat-disorders/tumors-of-the-head-and-neck/salivary-gland-tumors

  Most salivary gland tumors are benign and occur in the parotid glands. A painless salivary mass is the most common sign and is evaluated by fine-needle aspiration biopsy. Imaging with CT and MRI can be helpful. […] Fine-needle aspiration biopsy of the mass confirms the cell type. A search for spread to regional nodes or distant metastases in the lungs, liver, bone, or brain is often indicated before treatment is selected. […] Only about 20 to 25% of salivary gland tumors are malignant; the parotid gland is most commonly affected. […] Cancers are firm, nodular, and can be fixed to adjacent tissue; pain and nerve involvement (causing numbness and/or weakness) are common. […] Perform biopsy and CT and MRI if cancer is confirmed. […] Treat using surgery, sometimes plus radiation therapy for certain cancers.

• #5 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Tests and procedures used to diagnose a parotid tumor may include: […] A healthcare professional feels the jaw, neck and throat for lumps or swelling. […] A biopsy is a procedure to collect a sample of tissue for testing. It typically involves using a needle to collect fluid or tissue from the parotid gland. The needle may be inserted through the skin on the face and into the parotid gland. […] In the lab, tests can show what types of cells are involved and tell if they’re cancerous. This information helps your healthcare team understand your prognosis and which treatments are best for you. […] Results from a needle biopsy aren’t always correct. Sometimes the results say a tumor isn’t cancerous when it is. For this reason, some healthcare professionals don’t do a biopsy before surgery. Instead, they may take a sample of tissue for testing during surgery.

• #6 Parotid Gland Tumors: Symptoms, Causes & Treatment

  https://my.clevelandclinic.org/health/diseases/parotid-tumor

  A parotid gland tumor is a rare tumor on one of your salivary glands. […] Most parotid tumors are benign (noncancerous), but they can be cancerous. […] Both tumor types are rare. Each year, cancerous parotid gland tumors affect 1 in 100,000 people worldwide. […] Experts dont know the exact number of people who have noncancerous parotid gland tumors but estimate the condition may affect 1 to 6 in 100,000 people worldwide. […] Providers will do a physical examination focused on your head and neck. […] They may order the following tests: […] Fine needle aspiration: This test can confirm that a parotid gland tumor is cancerous. […] Providers use test results to develop treatment plans and a prognosis, which is what you can expect to happen after treatment. […] Treatment typically involves surgery to remove the tumor.

• #7 Clinical Diagnosis of Extended Parotid Tumors | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-319-26545-2_10

  The clinical examination forms the fundament for decision making in a patient with an extended parotid tumor. The examination starts with an elaborate interview of the patients looking for clinical hints for a malignant disease. The clinical examination comprises a complete head and neck examination including an investigation of all major salivary glands. Thereafter, ultrasound is the first-choice imaging technique for an immediate assessment of the parotid tumor. If available, fine-needle aspiration cytology (FNAC) continues the diagnostic workup. FNAC will determine whether the parotid tumor process is malignant. Core-needle biopsy or an open biopsy may offer an additional effective diagnostic tool in cases in which FNAC has failed to provide a definitive diagnosis. […] In extended parotid tumors, often the situation will occur that ultrasound does not allow visualizing the parotid tumor completely, due to its location in the deep lobe. In such a situation, or if FNAC or a biopsy argue for a malignant disease, further imaging with computed tomography (CT) or magnetic resonance imaging (MRI) are indicated. MRI is the first choice. If a malignant parotid tumor is suspected, MRI and CT scanning are important for the tumor staging of the primary tumor and the neck.

• #8 Malignant Parotid Tumors: Practice Essentials, Anatomy, Diagnosis

  https://emedicine.medscape.com/article/1289616-overview

  The most common presentation is a painless, asymptomatic mass; over 80% of patients present because of a mass in the posterior cheek region. […] Approximately 30% of patients describe pain associated with the mass, though most parotid malignancies are painless. Pain most likely indicates perineural invasion, which greatly increases the likelihood of malignancy in a patient with a parotid mass. […] Of patients with malignant parotid tumors, 7-20% present with facial nerve weakness or paralysis, which almost never accompanies benign lesions and indicates a poor prognosis. Approximately 80% of patients with facial nerve paralysis have nodal metastasis at the time of diagnosis. These patients have an average survival of 2.7 years and a 10-year survival of 14-26%. […] Fine needle aspiration of the mass or an enlarged lymph node may be performed to obtain a tissue diagnosis.

• #9 Malignant Parotid Tumors: Practice Essentials, Anatomy, Diagnosis

  https://emedicine.medscape.com/article/1289616-overview

  The most common presentation is a painless, asymptomatic mass; over 80% of patients present because of a mass in the posterior cheek region. […] Approximately 30% of patients describe pain associated with the mass, though most parotid malignancies are painless. Pain most likely indicates perineural invasion, which greatly increases the likelihood of malignancy in a patient with a parotid mass. […] Of patients with malignant parotid tumors, 7-20% present with facial nerve weakness or paralysis, which almost never accompanies benign lesions and indicates a poor prognosis. Approximately 80% of patients with facial nerve paralysis have nodal metastasis at the time of diagnosis. These patients have an average survival of 2.7 years and a 10-year survival of 14-26%. […] Fine needle aspiration of the mass or an enlarged lymph node may be performed to obtain a tissue diagnosis.

• #10 Malignant Parotid Tumors: Practice Essentials, Anatomy, Diagnosis

  https://emedicine.medscape.com/article/1289616-overview

  The most common presentation is a painless, asymptomatic mass; over 80% of patients present because of a mass in the posterior cheek region. […] Approximately 30% of patients describe pain associated with the mass, though most parotid malignancies are painless. Pain most likely indicates perineural invasion, which greatly increases the likelihood of malignancy in a patient with a parotid mass. […] Of patients with malignant parotid tumors, 7-20% present with facial nerve weakness or paralysis, which almost never accompanies benign lesions and indicates a poor prognosis. Approximately 80% of patients with facial nerve paralysis have nodal metastasis at the time of diagnosis. These patients have an average survival of 2.7 years and a 10-year survival of 14-26%. […] Fine needle aspiration of the mass or an enlarged lymph node may be performed to obtain a tissue diagnosis.

• #11 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Imaging tests help your healthcare team understand the size and location of your tumor. If your parotid tumor is cancerous, imaging tests help look for signs that the cancer has spread. Tests may include ultrasound, MRI and CT. […] If your healthcare professional thinks that you might have a parotid tumor, you may be referred to a doctor who specializes in diseases of the ears, nose and throat. This doctor is called an ENT specialist or an otolaryngologist. If a cancer diagnosis is made, you also may be referred to a doctor who specializes in treating cancer, called an oncologist. […] Do I have a parotid tumor? […] Is my parotid tumor cancerous? […] What is the stage of my parotid tumor? […] Has my parotid tumor spread to other parts of my body? […] Will I need more tests? […] What are the treatment options?

• #12 Salivary gland tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/salivary-gland-cancer/diagnosis-treatment/drc-20354155

  Salivary gland tumor diagnosis often begins with a physical exam of the area by a healthcare professional. Imaging tests and a biopsy may be used to find the location of the tumor and determine what type of cells are involved. […] Imaging tests make pictures of the body. They can show the location and size of a salivary gland tumor. Tests might include MRI, CT and positron emission tomography, which is also called a PET scan. […] A biopsy is a procedure to remove a sample of tissue for testing in a lab. To collect a sample of tissue, a fine-needle aspiration or a core needle biopsy may be used. During the biopsy, a thin needle is inserted into the salivary gland to draw out a sample of suspicious cells. The sample is sent to a lab for testing. Tests can show what types of cells are involved and whether the cells are cancerous.

• #13 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  Ultrasound scan (USS) provides invaluable information about the site, size, and nature of salivary gland tumors and the presence of any significant cervical lymphadenopathy. The position of a tumor in the superficial or deep aspect of the parotid gland is established by the identification of its relation to the retromandibular vein. It is usually combined with FNA (USSgFNAB), which improves the adequacy rate. In experienced hands, this can distinguish malignant from benign disease in 80% to 90% of cases. Cross-sectional imaging is not essential in straightforward benign tumors, but MRI scanning of a parotid tumor is useful in the assessment and delineation of anatomical structures, extension into the deep lobe, and relation to the facial nerve.

• #14 Diagnosis | Center for Advanced Parotid Surgery in Beverly Hills, CA

  https://www.parotidsurgerymd.com/conditions/diagnosis/

  There are 3 main categories of diseases that happen in the salivary glands: Tumors (benign or cancers), inflammatory (infection or autoimmune), and obstructive (stones). […] We have a variety of excellent tools that can help the doctors at the CENTER diagnose the source of your parotid disease. Scans can show the anatomy of the parotid gland and if there is a tumor or stone in the glands, or if the gland is simply enlarged. Blood tests can tell us if there is inflammation, infection or an autoimmune reaction. Needle biopsy can tell us the exact type of tumor that is present in the gland. […] There are 4 main modalities used for parotid cancer imaging. They are ultrasound, CT scan, MRI & PET scan. Each has its own particular indication and utility. […] Ultrasound, specially when done in the office by the parotid surgeon can be very helpful because it can immediately give you very important detail about the tumor. It can show the exact size and shape of the tumor; also wether the borders of the tumor are clearly visible, and is it invading any of the surrounding structures.

• #15 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  Ultrasound scan (USS) provides invaluable information about the site, size, and nature of salivary gland tumors and the presence of any significant cervical lymphadenopathy. The position of a tumor in the superficial or deep aspect of the parotid gland is established by the identification of its relation to the retromandibular vein. It is usually combined with FNA (USSgFNAB), which improves the adequacy rate. In experienced hands, this can distinguish malignant from benign disease in 80% to 90% of cases. Cross-sectional imaging is not essential in straightforward benign tumors, but MRI scanning of a parotid tumor is useful in the assessment and delineation of anatomical structures, extension into the deep lobe, and relation to the facial nerve.

• #16

  https://link.springer.com/article/10.1007/s00405-017-4636-2

  The aim of the study is to define the utility of ultrasound (US) in differentiating benign from malignant parotid tumors as well as pleomorphic adenomas (PA) from monomorphic adenoma (MA). […] The sensitivity, specificity, and accuracy of US in differentiation of malignant from benign lesions in the parotid gland were 60, 95.2, and 90.3%, respectively. […] Differentiating diagnoses between PA and MA with US resulted in a sensitivity of 61.5%, specificity of 81.5%, and accuracy of 73.1%. […] For distinguishing malignant from benign tumors, the highest AUC values noted were for heterogeneity and vascularization (0.8 and 0.743, respectively). […] The echogenicity (slightly hypoechoic, highly hypoechoic) and homogeneity (homogeneous, slightly heterogenous, highly heterogenous) of the tumor were established.

• #17 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  Ultrasound scan (USS) provides invaluable information about the site, size, and nature of salivary gland tumors and the presence of any significant cervical lymphadenopathy. The position of a tumor in the superficial or deep aspect of the parotid gland is established by the identification of its relation to the retromandibular vein. It is usually combined with FNA (USSgFNAB), which improves the adequacy rate. In experienced hands, this can distinguish malignant from benign disease in 80% to 90% of cases. Cross-sectional imaging is not essential in straightforward benign tumors, but MRI scanning of a parotid tumor is useful in the assessment and delineation of anatomical structures, extension into the deep lobe, and relation to the facial nerve.

• #18

  https://link.springer.com/article/10.1007/s00405-017-4636-2

  The aim of the study is to define the utility of ultrasound (US) in differentiating benign from malignant parotid tumors as well as pleomorphic adenomas (PA) from monomorphic adenoma (MA). […] The sensitivity, specificity, and accuracy of US in differentiation of malignant from benign lesions in the parotid gland were 60, 95.2, and 90.3%, respectively. […] Differentiating diagnoses between PA and MA with US resulted in a sensitivity of 61.5%, specificity of 81.5%, and accuracy of 73.1%. […] For distinguishing malignant from benign tumors, the highest AUC values noted were for heterogeneity and vascularization (0.8 and 0.743, respectively). […] The echogenicity (slightly hypoechoic, highly hypoechoic) and homogeneity (homogeneous, slightly heterogenous, highly heterogenous) of the tumor were established.

• #19

  https://link.springer.com/article/10.1007/s00405-017-4636-2

  The criteria of irregular shape, poor defined margins, heterogenous echogenicity, and increased vascular pattern were considered predictors of a malignant tumor. […] We identified hypoechogenicity, vascularization, and enlargement of intraparotid lymph nodes as the most specific features in ultrasound differentiation of PA from MA. […] The sensitivity, specificity, and accuracy of US in differentiation of malignant versus benign lesion of the parotid gland were 60, 95.2, and 90.3%, respectively. […] The resulting predictive values were: PPV 50% and NPV 68.8%. […] The analysis of ROC curves showed that area under the curve for heterogeneity is 0.8 for patients with benign and malignant tumor while only 0.507 for PA and MA.

• #20

  https://link.springer.com/article/10.1007/s00405-017-4636-2

  The criteria of irregular shape, poor defined margins, heterogenous echogenicity, and increased vascular pattern were considered predictors of a malignant tumor. […] We identified hypoechogenicity, vascularization, and enlargement of intraparotid lymph nodes as the most specific features in ultrasound differentiation of PA from MA. […] The sensitivity, specificity, and accuracy of US in differentiation of malignant versus benign lesion of the parotid gland were 60, 95.2, and 90.3%, respectively. […] The resulting predictive values were: PPV 50% and NPV 68.8%. […] The analysis of ROC curves showed that area under the curve for heterogeneity is 0.8 for patients with benign and malignant tumor while only 0.507 for PA and MA.

• #21 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://www.mdpi.com/1422-0067/25/13/7350

  This is a scoping review that will help future diagnostic and research efforts to focus on specific molecular biology testing for differential diagnosis of parotid tumors. […] Ultrasonography is a useful tool for preoperative imaging of parotid gland tumors. […] CT scans with contrast media seem the most accessible imaging studies regarding parotid gland pathology. […] MRI with diffusion weighted imaging (DWI) is a widely used technique for evaluating the rate of microscopic water diffusion in parotid gland tissue. […] This is the central tool for the management of parotid gland tumors. FNA can obtain the necessary biopsy material for performing further molecular biology testing. […] In spite of all the diagnostic procedures available for the managing surgeon, there are numerous situations of diagnostic uncertainty.

• #22 Diagnosis | Center for Advanced Parotid Surgery in Beverly Hills, CA

  https://www.parotidsurgerymd.com/conditions/diagnosis/

  CT scans are quick and can give a fair amount of information. Some tumors are very visible as seen in the images to the right; the parotid glands on each side are outlined in blue, the jawbone in yellow, the throat in orange and the tumor in green. […] CT scans can show stones in the salivary glands & their ducts very well. Salivary stones or sialoliths are made up to a large part from calcium which on a CT scan shows as a light (white) colored object. […] MRI is a very sophisticated scan that shows the parotid gland itself in detail, along with the dimensions and shape of a tumor. It also shows other soft tissue structures such as muscles, fat, blood vessels, lymph nodes, and the spinal cord in great detail. […] Needle biopsy of parotid tumors is a very accurate way of identifying the type of tumor you are dealing with. At the CENTER we perform ultrasound guided needle biopsy of almost all parotid tumors, and for our patients that live in other cities we help you arrange for a biopsy.

• #23 Salivary Gland Neoplasms Workup: Imaging Studies, Diagnostic Procedures, Histologic Findings

  https://emedicine.medscape.com/article/852373-workup

  Imaging studies of the salivary glands are usually unnecessary for the assessment of small tumors within the parotid or submandibular gland. Computed tomography (CT) scanning or magnetic resonance imaging (MRI) is useful for determining the extent of large tumors, for evaluating extraglandular extension, for determining the actual depth of parotid tumors, and for discovering other tumors in one gland or in the contralateral gland. Additionally, CT scanning and MRI are helpful in distinguishing an intraparotid deep-lobe tumor from a parapharyngeal space tumor and for evaluation of cervical lymph nodes for metastasis. […] CT scanning and MRI can be used to predict possible malignancy based on observation of poorly defined tumor margins; MRI is the better of the 2 for this purpose. Indeed, a study by Mamlouk et al of pediatric patients with parotid neoplasms indicated that on MRI scans, the presence not only of poorly defined borders but also of a hypointense T2 signal, restricted diffusion, and focal necrosis are suggestive of malignancy, although not specific for it.

• #24 Parotid gland tumors | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/parotid-gland-tumors-1?lang=us

  Although approximately 70% of all parotid tumors are benign, given the overall higher frequency of tumors of the parotid gland compared to other salivary glands, 70% of all malignant salivary gland cancers arise in the parotid. […] From a diagnostic and staging point of view, CT and MRI are the primary modalities, having complementary strengths. CT is readily available and excellent at imaging bony involvement. MRI is better at perineural spread. […] Although PET lacks specificity, it is useful in assessing for distant nodal spread.

• #25 Salivary Gland Neoplasms Workup: Imaging Studies, Diagnostic Procedures, Histologic Findings

  https://emedicine.medscape.com/article/852373-workup

  Minor salivary gland neoplasms are often difficult to assess on examination, and the use of preoperative CT scanning or MRI is important for determining the extent of tumor, which is otherwise not clinically appreciable. This imaging is particularly valuable for salivary gland neoplasms in the paranasal sinus, where skull-base or intracranial extension may alter the resectability of the tumors. […] For most small parotid neoplasms without clinical evidence of facial nerve involvement, no pretreatment imaging studies are required. […] Gadolinium-enhanced dynamic MRI can be used to possibly differentiate pleomorphic adenomas from malignant salivary gland tumors using peak time of enhancement at 120 seconds and to differentiate between malignancies and Warthin tumors using washout ratios of 30% with a sensitivity of 100% and specificity of 80%. However, MRI can only suggest a diagnosis; definitive diagnosis requires pathologic examination.

• #26 Magnetic resonance imaging of parotid gland tumors: a pictorial essay | BMC Medical Imaging | Full Text

  https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12880-022-00924-0

  Imaging of parotid gland tumors is challenging due to the wide variety of differential diagnoses. […] Correct characterization of parotid tumors (i.e., benign or malignant) determines preoperative treatment planning and is important in optimizing the individualized surgical plan. Magnetic resonance imaging (MRI) is the imaging modality of choice for evaluation of suspected parotid gland lesions and differentiation between benign and malignant lesions. […] MRI is useful for detection and localization of the lesion(s), and associated findings like perineural spread of tumor, lymph node involvement and infiltrative changes of the surrounding tissues. […] Preoperative characterization of parotid gland tumors using dedicated imaging is crucial for appropriate treatment planning, as the surgical approach is different for benign and malignant lesions and depends also on the localization of the tumor.

• #27 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  Ultrasound scan (USS) provides invaluable information about the site, size, and nature of salivary gland tumors and the presence of any significant cervical lymphadenopathy. The position of a tumor in the superficial or deep aspect of the parotid gland is established by the identification of its relation to the retromandibular vein. It is usually combined with FNA (USSgFNAB), which improves the adequacy rate. In experienced hands, this can distinguish malignant from benign disease in 80% to 90% of cases. Cross-sectional imaging is not essential in straightforward benign tumors, but MRI scanning of a parotid tumor is useful in the assessment and delineation of anatomical structures, extension into the deep lobe, and relation to the facial nerve.

• #28 Parotid gland tumors | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/parotid-gland-tumors-1?lang=us

  Although approximately 70% of all parotid tumors are benign, given the overall higher frequency of tumors of the parotid gland compared to other salivary glands, 70% of all malignant salivary gland cancers arise in the parotid. […] From a diagnostic and staging point of view, CT and MRI are the primary modalities, having complementary strengths. CT is readily available and excellent at imaging bony involvement. MRI is better at perineural spread. […] Although PET lacks specificity, it is useful in assessing for distant nodal spread.

• #29 Advanced MRI Sequences (Diffusion and Perfusion): Its Value in Parotid Tumors

  https://www.clinmedjournals.org/articles/iaoms/international-archives-of-oral-and-maxillofacial-surgery-iaoms-2-010.php?jid=iaoms

  Tumors of salivary glands constitute 3% of neoplasms of the body. Clinical signs and symptoms usually occur in tumors at advance stages. Dynamic-contrast-enhanced and diffusion-weighted MR sequences have been described as useful diagnostic tools in other locations. Our goal is to evaluate the utility of these techniques for parotid tumors. […] Advanced MRI techniques contribute to the differential diagnosis of parotid tumors. Perfusion is useful in diagnosis of Warthin tumors and Pleomorphic adenomas. There is greater overlap in other tumors, for which diffusion-weighted MR sequences can help in discriminating malignancies. Both malignancies and Warthins show low Apparent Diffusion Coefficient values. […] Diagnosis of salivary gland tumors is critical in their treatment plan. […] Secondary to its high contrast enhance, its great resolution and possibility of stablishing the relationship of the facial nerve with the nearest structures, MRI is the best radiologic technique in salivary glands diagnosis.

• #30 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://www.mdpi.com/1422-0067/25/13/7350

  This is a scoping review that will help future diagnostic and research efforts to focus on specific molecular biology testing for differential diagnosis of parotid tumors. […] Ultrasonography is a useful tool for preoperative imaging of parotid gland tumors. […] CT scans with contrast media seem the most accessible imaging studies regarding parotid gland pathology. […] MRI with diffusion weighted imaging (DWI) is a widely used technique for evaluating the rate of microscopic water diffusion in parotid gland tissue. […] This is the central tool for the management of parotid gland tumors. FNA can obtain the necessary biopsy material for performing further molecular biology testing. […] In spite of all the diagnostic procedures available for the managing surgeon, there are numerous situations of diagnostic uncertainty.

• #31 Advanced MRI Sequences (Diffusion and Perfusion): Its Value in Parotid Tumors

  https://www.clinmedjournals.org/articles/iaoms/international-archives-of-oral-and-maxillofacial-surgery-iaoms-2-010.php?jid=iaoms

  Several MRI findings suggestive of malignancy in salivary gland tumors have been reported. These include ill-defined margins, infiltration into adjacent tissues and low signal intensity on T2 weighted images. […] In the last decades, the roles of functional MRI, such as DWI and DCE-MRI, have been assessed in head and neck neoplasms to improve this overlap between benign and malignant tumors. […] The ADC, a quantitative parameter measured from DW-MRI, combines the effects of capillary perfusion and water diffusion in the extracellular extravascular space. Precise measurement of ADC is of great importance because it has been used to differentiate malignant from benign tumors. […] DCE is a functional MRI sequence that may help the accuracy in diagnosis of parotid tumors. Dynamic MRI Studies such as DWI and DCE contribute to differential diagnosis of Parotid tumors.

• #32 Current Developments in Diagnosis of Salivary Gland Tumors: From Structure to Artificial Intelligence

  https://www.mdpi.com/2075-1729/14/6/727

  The combination between non-contrast MRI with diffusion-weighted imaging, arterial spin labelling and amide proton transfer weighted imaging was shown to be able to differentiate between benign and malignant salivary gland lesions. […] Several diagnostic methods are currently studied for establishing diagnosis and guiding the treatment strategy for salivary gland tumors. […] AI-assisted salivary biomarker models for oral cancer diagnosis are now being studied. […] AI algorithms can increase the effectiveness of the pre-surgical diagnosis. […] Diagnosing salivary gland tumors with histopathological examinations, studies represented by MRI, CT or ultrasonography rely on the experience of the medical staff handling the examination tools and clinical data.

• #33 Salivary Gland Neoplasms Workup: Imaging Studies, Diagnostic Procedures, Histologic Findings

  https://emedicine.medscape.com/article/852373-workup

  The following imaging characteristics indicate that a salivary gland tumor may be malignant and should be biopsied: Spiculated, irregular margins; MRI scans demonstrating T2 hypointensity; Perineural spread; Presence of necrosis; Capsule that is thick, irregular, and strongly enhancing and that does not completely surround the lesion. […] The following characteristics in association with a parotid lesion indicate that it should not be biopsied: Lymph node architecture is preserved (with the node having a reniform shape and a fatty hilum); The lesion is a simple parotid cyst, with the wall being thin or imperceptible, nodularity or enhancement being absent, and the internal contents being anechoic. […] FNAB is a valuable diagnostic adjunct in evaluation of head and neck masses. Its role in evaluation of salivary gland tumors is controversial. Overall sensitivity of FNAB in distinguishing between benign and malignant salivary gland tumors is approximately 95%. Its specificity is approximately 98%.

• #34 Magnetic resonance imaging of parotid gland tumors: a pictorial essay | BMC Medical Imaging | Full Text

  https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12880-022-00924-0

  Clinical assessments have limitations in diagnosing malignant parotid neoplasms and in most cases of palpable parotid masses, differentiation between benign and malignant lesions is not possible by clinical examination only. […] Although ultrasound is also very useful for evaluation of parotid lesions, the deep lobe is not adequately seen using this technique. Therefore, magnetic resonance imaging (MRI) has assumed a major role in assessing lesions of the parotid gland. […] On MRI, low-grade tumors are well circumscribed with a signal intensity similar to that of pleomorphic adenomas. High-grade tumors, on the other hand, have infiltrating margins with heterogeneous low to intermediate signal intensities on both T1-w and T2-w images. […] Signs suggesting high-grade malignancies include low to intermediate signal intensity on T2-w, which reflects high cellularity, ill-defined margins reflecting the invasive growth of tumor cells, and frequent nodal involvement reflecting the propensity for lymphatic involvement.

• #35 Magnetic resonance imaging of parotid gland tumors: a pictorial essay | BMC Medical Imaging | Full Text

  https://bmcmedimaging.biomedcentral.com/articles/10.1186/s12880-022-00924-0

  Clinical assessments have limitations in diagnosing malignant parotid neoplasms and in most cases of palpable parotid masses, differentiation between benign and malignant lesions is not possible by clinical examination only. […] Although ultrasound is also very useful for evaluation of parotid lesions, the deep lobe is not adequately seen using this technique. Therefore, magnetic resonance imaging (MRI) has assumed a major role in assessing lesions of the parotid gland. […] On MRI, low-grade tumors are well circumscribed with a signal intensity similar to that of pleomorphic adenomas. High-grade tumors, on the other hand, have infiltrating margins with heterogeneous low to intermediate signal intensities on both T1-w and T2-w images. […] Signs suggesting high-grade malignancies include low to intermediate signal intensity on T2-w, which reflects high cellularity, ill-defined margins reflecting the invasive growth of tumor cells, and frequent nodal involvement reflecting the propensity for lymphatic involvement.

• #36 Parotid gland tumors | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/parotid-gland-tumors-1?lang=us

  Although approximately 70% of all parotid tumors are benign, given the overall higher frequency of tumors of the parotid gland compared to other salivary glands, 70% of all malignant salivary gland cancers arise in the parotid. […] From a diagnostic and staging point of view, CT and MRI are the primary modalities, having complementary strengths. CT is readily available and excellent at imaging bony involvement. MRI is better at perineural spread. […] Although PET lacks specificity, it is useful in assessing for distant nodal spread.

• #37

  https://www.americanoncology.com/cancer-we-treat/diagnosis/salivary-gland-cancer

  Diagnosis of salivary gland tumor can be done through the following methods: […] Medical history and physical examination: The patients undergo a comprehensive physical examination to check for the signs associated with salivary gland cancer or other diseases causing symptoms. […] Magnetic resonance imaging: It is recommended to perform MRI for all tumors as there is a high risk of malignancy. […] Computed tomography: Patients may undergo computed tomography (CT) scan to diagnose salivary gland cancer. […] Positron emission tomography: PET scan provides vital information about the staging, histological grading, and response after treatment. […] X-rays: It is performed during the advanced stage of the salivary gland tumor to determine if the salivary gland cancer has spread to the lungs. […] Ultrasound: Ultrasound may also be performed to determine any swelling in the lymph nodes of the neck. […] Biopsy: Biopsy involves obtaining a sample of the abnormal tissue of the salivary gland or any organ and evaluating them in the laboratory to detect the presence of cancerous cells.

• #38 How is Salivary Gland Cancer Diagnosed?| Tests for Salivary Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/detection-diagnosis-staging/how-diagnosed.html

  A CT scan uses x-rays to make detailed cross-sectional images of your body. A CT scan can show the size, shape, and exact location of a tumor and can help find enlarged lymph nodes that might have cancer. […] MRI scans can help determine the exact location and extent of a tumor (for example, if it is growing into nearby tissues). […] For a PET scan, a slightly radioactive form of sugar (known as FDG) is injected into the blood and collects mainly in cancer cells. […] An ultrasound uses sound waves and their echoes to create images of the inside of the body. […] Other tests might be done as part of a work-up if a patient has been diagnosed with salivary gland cancer. […] No blood test can diagnose cancer in the salivary glands. Still, your doctor may order routine blood tests to get an idea of your overall health, especially before treatment.

• #39 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Tests and procedures used to diagnose a parotid tumor may include: […] A healthcare professional feels the jaw, neck and throat for lumps or swelling. […] A biopsy is a procedure to collect a sample of tissue for testing. It typically involves using a needle to collect fluid or tissue from the parotid gland. The needle may be inserted through the skin on the face and into the parotid gland. […] In the lab, tests can show what types of cells are involved and tell if they’re cancerous. This information helps your healthcare team understand your prognosis and which treatments are best for you. […] Results from a needle biopsy aren’t always correct. Sometimes the results say a tumor isn’t cancerous when it is. For this reason, some healthcare professionals don’t do a biopsy before surgery. Instead, they may take a sample of tissue for testing during surgery.

• #40 How is Salivary Gland Cancer Diagnosed?| Tests for Salivary Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/detection-diagnosis-staging/how-diagnosed.html

  Salivary gland cancer is most often diagnosed when a person goes to a doctor because of symptoms they are having. […] If you have signs or symptoms that might be caused by a salivary gland tumor, your doctor will examine you and order tests to find out if they’re being caused by cancer or some other condition. If cancer is found, more tests may be done. […] Symptoms and the results of exams or imaging tests may strongly suggest you have salivary gland cancer, but the actual diagnosis is made on a biopsy sample by a pathologist (a doctor who specializes in diagnosing and classifying cancer by testing and looking at cells in the lab). Different types of biopsies might be done, depending on the situation. […] An FNA biopsy takes a small amount of cells and fluid from a lump or tumor for testing. This type of biopsy can be done in a doctors office or clinic.

• #41 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  Salivary gland tumors are characterized by diverse histological appearances and variable biological behavior. The distinction between tumor types can be difficult, particularly based on material from fine-needle aspiration (FNA). […] Fine-needle aspiration biopsy (FNA) is the primary diagnostic tool for salivary gland lesions, but the role of FNA in the diagnosis of benign and malignant salivary gland disease still carries some controversy. It is a relatively painless procedure, has few complications (seeding of the tumor does not seem to occur), and may prevent an ill-advised and often ill-fated incisional or excisional biopsy of a parotid mass. However, it is far from straightforward with issues regarding aspiration technique, adequacy of the specimen, cytological expertise, and limitations of the interpretation. If the result of FNA is at variance with other findings, then clinical judgment should prevail. It is important to be aware that false-positive results can occur, leading to misdiagnosis of malignant lesions.

• #42 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://www.mdpi.com/1422-0067/25/13/7350

  This is a scoping review that will help future diagnostic and research efforts to focus on specific molecular biology testing for differential diagnosis of parotid tumors. […] Ultrasonography is a useful tool for preoperative imaging of parotid gland tumors. […] CT scans with contrast media seem the most accessible imaging studies regarding parotid gland pathology. […] MRI with diffusion weighted imaging (DWI) is a widely used technique for evaluating the rate of microscopic water diffusion in parotid gland tissue. […] This is the central tool for the management of parotid gland tumors. FNA can obtain the necessary biopsy material for performing further molecular biology testing. […] In spite of all the diagnostic procedures available for the managing surgeon, there are numerous situations of diagnostic uncertainty.

• #43 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  This is the central tool for the management of parotid gland tumors. FNA can obtain the necessary biopsy material for performing further molecular biology testing. […] The Milan System for Reporting Salivary Gland Cytopathology uses a diagnostic scheme including the following categories: (1) nondiagnostic, (2) nonneoplastic, (3) atypia of undetermined significance (AUS), (4) neoplasm (including benign neoplasms and salivary gland neoplasms of uncertain malignant potential [SUMPs]), (5) suspicious for malignancy (SM), and (6) malignant. […] In spite of all the diagnostic procedures available for the managing surgeon, there are numerous situations of diagnostic uncertainty. […] Molecular biology tests can also be used as predictors to the possible response to chemotherapy. […] The diagnosis of MEC is becoming more challenging nowadays due to the histopathological variants of MEC; thus, modern tests such as FISH (fluorescent in situ hybridization) and genomic sequencing (NGS) are mandatory in some cases.

• #44 Salivary gland cancer | Macmillan Cancer Support

  https://www.macmillan.org.uk/cancer-information-and-support/head-and-neck-cancer/salivary-gland-cancer

  You usually start by seeing your GP. Sometimes symptoms may be picked up by your dentist. If they think your symptoms could be linked to cancer, they will refer you to a specialist head and neck doctor. You will usually see a specialist within 2 weeks. You may see an ear, nose and throat (ENT) specialist. […] The specialist doctor will ask you about your symptoms and general health. They will check your mouth using a small mirror and light and examine the area where the lump is. If your only symptom is a lump in your neck, you may be referred to a hospital that has a neck lump clinic. […] You may have some of the following tests. […] Fine needle aspiration (FNA) To make a diagnosis your doctor needs to removes a small piece of tissue or some cells (biopsy) from the area that looks abnormal. An FNA is a type of biopsy using a very thin needle to remove a sample of cells.

• #45 Parotid Cancer – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK538340/

  Salivary gland tumors are characterized by diverse histological appearances and variable biological behavior. The distinction between tumor types can be difficult, particularly based on material from fine-needle aspiration (FNA). […] Fine-needle aspiration biopsy (FNA) is the primary diagnostic tool for salivary gland lesions, but the role of FNA in the diagnosis of benign and malignant salivary gland disease still carries some controversy. It is a relatively painless procedure, has few complications (seeding of the tumor does not seem to occur), and may prevent an ill-advised and often ill-fated incisional or excisional biopsy of a parotid mass. However, it is far from straightforward with issues regarding aspiration technique, adequacy of the specimen, cytological expertise, and limitations of the interpretation. If the result of FNA is at variance with other findings, then clinical judgment should prevail. It is important to be aware that false-positive results can occur, leading to misdiagnosis of malignant lesions.

• #46 Malignant Parotid Tumors: Practice Essentials, Anatomy, Diagnosis

  https://emedicine.medscape.com/article/1289616-overview

  The sensitivity of this procedure is greater than 95% in experienced hands. However, only a positive diagnosis should be accepted; negative results indicate the need for further attempts at obtaining a histologic diagnosis, including repeat fine needle aspiration. […] Imaging studies may be helpful in staging and for surgical planning. […] CT scanning provides better detail of the surrounding tissues, whereas MRI demonstrates the mass in greater contrast than a CT scan. […] A study by Park et al indicated that in patients with parotid gland tumors, a finding of malignancy via the Milan System for Reporting Salivary Gland Cytopathology, in combination with the presence of nodal metastasis, suggests that high-grade malignancy is being manifested.

• #47 Salivary Gland Neoplasms Workup: Imaging Studies, Diagnostic Procedures, Histologic Findings

  https://emedicine.medscape.com/article/852373-workup

  The following imaging characteristics indicate that a salivary gland tumor may be malignant and should be biopsied: Spiculated, irregular margins; MRI scans demonstrating T2 hypointensity; Perineural spread; Presence of necrosis; Capsule that is thick, irregular, and strongly enhancing and that does not completely surround the lesion. […] The following characteristics in association with a parotid lesion indicate that it should not be biopsied: Lymph node architecture is preserved (with the node having a reniform shape and a fatty hilum); The lesion is a simple parotid cyst, with the wall being thin or imperceptible, nodularity or enhancement being absent, and the internal contents being anechoic. […] FNAB is a valuable diagnostic adjunct in evaluation of head and neck masses. Its role in evaluation of salivary gland tumors is controversial. Overall sensitivity of FNAB in distinguishing between benign and malignant salivary gland tumors is approximately 95%. Its specificity is approximately 98%.

• #48 Accuracy of preoperative fine needle aspiration in diagnosis of malignant parotid tumors | Saudi Medical Journal

  https://smj.org.sa/content/38/10/1000

  Objectives: To determine the diagnostic accuracy of fine needle aspiration (FNA) for detecting malignant parotid tumors. […] The sensitivity of FNA for detecting malignancy was 50%, and the specificity was 100%; with a positive predictive value of 100% and negative predictive value of 91.4%. […] Fine needle aspiration is a highly specific, but only moderately sensitive test. We support the use of this method as an initial tool for diagnosing parotid gland malignancies, as it is a safe, rapid, and painless procedure, compared to histopathology. […] The main purpose of performing FNA prior to parotid surgery is to differentiate benign from malignant disease. […] Similar studies have reported the accuracy of FNA ranging from 69% to 98%, and specificities ranging from 88% to 100%. […] In the present study, 3 of 6 malignant lesions detected using histopathology were missed by FNA, which could be attributed to problems with the sampling technique.

• #49 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  This is the central tool for the management of parotid gland tumors. FNA can obtain the necessary biopsy material for performing further molecular biology testing. […] The Milan System for Reporting Salivary Gland Cytopathology uses a diagnostic scheme including the following categories: (1) nondiagnostic, (2) nonneoplastic, (3) atypia of undetermined significance (AUS), (4) neoplasm (including benign neoplasms and salivary gland neoplasms of uncertain malignant potential [SUMPs]), (5) suspicious for malignancy (SM), and (6) malignant. […] In spite of all the diagnostic procedures available for the managing surgeon, there are numerous situations of diagnostic uncertainty. […] Molecular biology tests can also be used as predictors to the possible response to chemotherapy. […] The diagnosis of MEC is becoming more challenging nowadays due to the histopathological variants of MEC; thus, modern tests such as FISH (fluorescent in situ hybridization) and genomic sequencing (NGS) are mandatory in some cases.

• #50 Diagnosis | Center for Advanced Parotid Surgery in Beverly Hills, CA

  https://www.parotidsurgerymd.com/conditions/diagnosis/

  Needle biopsy most often will give a clear answer and tell us what type of tumor is present. The reporting protocol is called the Milan System, which not only tells you the category of diagnosis but also the risk of the diagnosis not being accurate and a cancer instead. […] The blood tests have a limited role in helping diagnose parotid disease. They can help tell you if you have autoimmune salivary gland disease or Sjögren’s syndrome.

• #51 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  This is the central tool for the management of parotid gland tumors. FNA can obtain the necessary biopsy material for performing further molecular biology testing. […] The Milan System for Reporting Salivary Gland Cytopathology uses a diagnostic scheme including the following categories: (1) nondiagnostic, (2) nonneoplastic, (3) atypia of undetermined significance (AUS), (4) neoplasm (including benign neoplasms and salivary gland neoplasms of uncertain malignant potential [SUMPs]), (5) suspicious for malignancy (SM), and (6) malignant. […] In spite of all the diagnostic procedures available for the managing surgeon, there are numerous situations of diagnostic uncertainty. […] Molecular biology tests can also be used as predictors to the possible response to chemotherapy. […] The diagnosis of MEC is becoming more challenging nowadays due to the histopathological variants of MEC; thus, modern tests such as FISH (fluorescent in situ hybridization) and genomic sequencing (NGS) are mandatory in some cases.

• #52 Parotid tumors – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/parotid-tumor/diagnosis-treatment/drc-20579012

  Tests and procedures used to diagnose a parotid tumor may include: […] A healthcare professional feels the jaw, neck and throat for lumps or swelling. […] A biopsy is a procedure to collect a sample of tissue for testing. It typically involves using a needle to collect fluid or tissue from the parotid gland. The needle may be inserted through the skin on the face and into the parotid gland. […] In the lab, tests can show what types of cells are involved and tell if they’re cancerous. This information helps your healthcare team understand your prognosis and which treatments are best for you. […] Results from a needle biopsy aren’t always correct. Sometimes the results say a tumor isn’t cancerous when it is. For this reason, some healthcare professionals don’t do a biopsy before surgery. Instead, they may take a sample of tissue for testing during surgery.

• #53 Salivary Gland Malignancies: Diagnosis and Treatment of a Rare and Challenging Cancer – ENTtoday

  https://www.enttoday.org/article/salivary-gland-malignancies-diagnosis-and-treatment-of-a-rare-and-challenging-cancer/

  Some, like Dr. Medina, recommend doing a fine-needle aspiration (FNA) biopsy instead. […] If you have a doubt, stick a needle in it, he said. Don’t open it; don’t march in to do an open biopsy. […] Patients with salivary gland tumors often seek medical attention when they have a palpable, painless mass in either the parotid or submandibular region. […] The clinician might suspect malignancy if the patient has facial numbness; new muscle weakness on one side of the face; pain in the face, neck, or mouth; skin fixation; or enlarged lymph nodes, indicating metastasis.

• #54 How is Salivary Gland Cancer Diagnosed?| Tests for Salivary Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/detection-diagnosis-staging/how-diagnosed.html

  Sometimes, if the FNA biopsy is not able to get enough cells to test, the doctor might do a core needle biopsy that uses a hollow needle to take out pieces of tissue from a suspicious area. […] This type of biopsy may sometimes be done if the FNA biopsy didn’t get a large enough sample. […] As mentioned above, FNA biopsy of a suspected salivary gland cancer may not always provide a clear answer. If this is the case but the physical exam and imaging tests suggest that it is cancer, the doctor may advise surgery to remove the tumor completely. […] All biopsy samples are sent to a lab to be checked by a pathologist, a doctor who is specially trained to diagnose cancer from a biopsy. […] Imaging tests use x-rays, magnetic fields, or radioactive particles to create pictures of the inside of your body. Imaging tests might be done for a number of reasons, before and after a cancer diagnosis, including: To help find a suspicious area that might be cancer.

• #55 Clinical Diagnosis of Extended Parotid Tumors | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-319-26545-2_10

  The clinical examination forms the fundament for decision making in a patient with an extended parotid tumor. The examination starts with an elaborate interview of the patients looking for clinical hints for a malignant disease. The clinical examination comprises a complete head and neck examination including an investigation of all major salivary glands. Thereafter, ultrasound is the first-choice imaging technique for an immediate assessment of the parotid tumor. If available, fine-needle aspiration cytology (FNAC) continues the diagnostic workup. FNAC will determine whether the parotid tumor process is malignant. Core-needle biopsy or an open biopsy may offer an additional effective diagnostic tool in cases in which FNAC has failed to provide a definitive diagnosis. […] In extended parotid tumors, often the situation will occur that ultrasound does not allow visualizing the parotid tumor completely, due to its location in the deep lobe. In such a situation, or if FNAC or a biopsy argue for a malignant disease, further imaging with computed tomography (CT) or magnetic resonance imaging (MRI) are indicated. MRI is the first choice. If a malignant parotid tumor is suspected, MRI and CT scanning are important for the tumor staging of the primary tumor and the neck.

• #56 Salivary Gland Tumors | Palmdale Regional Medical Center

  https://www.swhpalmdaleregional.com/services/otolaryngology/head-and-neck-tumors/salivary-gland-tumors

  Two tests that are useful in determining the nature of the mass are fine needle aspiration biopsy and radiologic imaging, which is often a CT scan. During a fine needle biopsy, an experienced head and neck surgeon inserts a needle, coupled to a syringe, into the mass directly through the skin. The sample of the tumor cells is then sent to a lab for analysis. […] Scans are typically not used to provide a diagnosis but are used to help the surgeon to confirm the exact location of the mass, its size, the solid or cystic nature of the lesion, as well as the extent of the lesion. This is useful information for both diagnosis and treatment planning.

• #57 How is Salivary Gland Cancer Diagnosed?| Tests for Salivary Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/detection-diagnosis-staging/how-diagnosed.html

  Sometimes, if the FNA biopsy is not able to get enough cells to test, the doctor might do a core needle biopsy that uses a hollow needle to take out pieces of tissue from a suspicious area. […] This type of biopsy may sometimes be done if the FNA biopsy didn’t get a large enough sample. […] As mentioned above, FNA biopsy of a suspected salivary gland cancer may not always provide a clear answer. If this is the case but the physical exam and imaging tests suggest that it is cancer, the doctor may advise surgery to remove the tumor completely. […] All biopsy samples are sent to a lab to be checked by a pathologist, a doctor who is specially trained to diagnose cancer from a biopsy. […] Imaging tests use x-rays, magnetic fields, or radioactive particles to create pictures of the inside of your body. Imaging tests might be done for a number of reasons, before and after a cancer diagnosis, including: To help find a suspicious area that might be cancer.

• #58 Parotid tumors | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/parotid-tumors?content_id=CON-20380680

  Parotid tumor treatment often involves surgery to remove the tumor. If the tumor is cancerous, you might need more treatment. This could be with radiation therapy and chemotherapy. […] Sometimes a sample of tumor tissue is tested during surgery to see if it’s cancer. A doctor who uses blood and body tissue to diagnose diseases, who is called a pathologist, looks at the sample right away. The pathologist tells the surgeon if the tumor is cancerous. This helps the surgeon decide how much of the parotid gland to remove.

• #59 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  Parotid gland pathology represents a web of differential diagnoses. There are many complex cases that require extensive diagnostic tests for a complete and correct final pathology diagnosis. Currently the official classification of parotid gland tumors extends over more than 40 subtypes. […] By using fluorescence in situ hybridization (FISH), reverse transcription polymerase chain reaction (RT-PCR) or next-generation sequencing, the team managing complex cases can offer a personalized therapeutic solution. […] Ultrasonography is a useful tool for preoperative imaging of parotid gland tumors. […] CT scans with contrast media seem the most accessible imaging studies regarding parotid gland pathology. […] MRI with diffusion weighted imaging (DWI) is a widely used technique for evaluating the rate of microscopic water diffusion in parotid gland tissue.

• #60 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://www.mdpi.com/1422-0067/25/13/7350

  Parotid gland pathology represents a web of differential diagnoses. There are many complex cases that require extensive diagnostic tests for a complete and correct final pathology diagnosis. Currently the official classification of parotid gland tumors extends over more than 40 subtypes. […] We performed a query of the PubMed database regarding the use of molecular biology tests in performing a better characterization of the tumors in specific cases. By using fluorescence in situ hybridization (FISH), reverse transcription polymerase chain reaction (RT-PCR) or next-generation sequencing, the team managing complex cases can offer a personalized therapeutic solution. […] The newest ESMO guidelines on salivary gland tumor management acknowledged the role of molecular diagnostics. The defining balanced translocations are evaluable on paraffin-embedded materials either by FISH, RT-PCR or next-generation sequencing (NGS). These techniques enable diagnostic differentiation between morphologically similar tumor types.

• #61 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  FISH represents the unanimous accepted technique to highlight genetic alterations, but NGS (next-generation sequencing) can also be helpful. […] Molecular profiling and advancement in targeted therapies will increase the survival of parotid gland tumor patients, thus balancing the higher costs with equipment and training of staff.

• #62 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://www.mdpi.com/1422-0067/25/13/7350

  Molecular biology tests can also be used as predictors to the possible response to chemotherapy. […] The novelty of the current scoping review is the proposed algorithm for differential diagnosis of parotid gland tumors. […] The diagnosis of MEC is becoming more challenging nowadays due to the histopathological variants of MEC; thus, modern tests such as FISH (fluorescent in situ hybridization) and genomic sequencing (NGS) are mandatory in some cases. […] FISH represents the unanimous accepted technique to highlight genetic alterations, but NGS (next-generation sequencing) can also be helpful. […] Molecular profiling and advancement in targeted therapies will increase the survival of parotid gland tumor patients, thus balancing the higher costs with equipment and training of staff.

• #63 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  This is the central tool for the management of parotid gland tumors. FNA can obtain the necessary biopsy material for performing further molecular biology testing. […] The Milan System for Reporting Salivary Gland Cytopathology uses a diagnostic scheme including the following categories: (1) nondiagnostic, (2) nonneoplastic, (3) atypia of undetermined significance (AUS), (4) neoplasm (including benign neoplasms and salivary gland neoplasms of uncertain malignant potential [SUMPs]), (5) suspicious for malignancy (SM), and (6) malignant. […] In spite of all the diagnostic procedures available for the managing surgeon, there are numerous situations of diagnostic uncertainty. […] Molecular biology tests can also be used as predictors to the possible response to chemotherapy. […] The diagnosis of MEC is becoming more challenging nowadays due to the histopathological variants of MEC; thus, modern tests such as FISH (fluorescent in situ hybridization) and genomic sequencing (NGS) are mandatory in some cases.

• #64 Salivary Gland Cancer Diagnosis | Memorial Sloan Kettering Cancer Center

  https://www.mskcc.org/cancer-care/types/salivary-gland/salivary-gland-cancer-diagnosis

  Making an accurate diagnosis is a key first step in developing the best treatment plan for salivary gland cancer. […] You will also need to have a number of diagnostic tests. These include scans as well as laboratory tests. At Memorial Sloan Kettering, sophisticated pathology and imaging tests provide your care team with a great deal of information. […] During a salivary gland biopsy, your surgeon removes a small amount of abnormal tissue from the gland where cancer is suspected. The tissue sample is then sent to a pathologist who examines it under a microscope. […] Special x-rays may be done. These include CT scans, MRIs, or Panorex. […] Genomic testing is also called tumor sequencing or molecular profiling. It involves looking at the cells obtained from a biopsy to see if there are any genetic mutations. […] Our researchers are currently looking for salivary gland tumor markers that can help guide treatment decisions.

• #65 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  FISH represents the unanimous accepted technique to highlight genetic alterations, but NGS (next-generation sequencing) can also be helpful. […] Molecular profiling and advancement in targeted therapies will increase the survival of parotid gland tumor patients, thus balancing the higher costs with equipment and training of staff.

• #66 Tests for salivary gland cancer | Cancer Research UK

  https://www.cancerresearchuk.org/about-cancer/salivary-gland-cancer/getting-diagnosed/tests-salivary-cancer

  A biopsy is when the specialist takes a sample of tissue from the affected area. A pathologist looks at the tissue under a microscope to see if there are any cancer cells. […] It is not a common test for salivary gland cancer. You might have it if your doctor thinks you have cancer of the minor salivary glands. […] You might have a CT scan of your head and neck to see: how big the cancer is and if there are any changes to the lymph nodes in your neck; whether the cancer has spread. […] Not everyone has a PET scan when being diagnosed with salivary gland cancer. It might help your doctors see how big the cancer is and whether it has spread. […] You might have an MRI scan to see how big the salivary gland cancer is and whether it has spread. […] Your doctor can look to see if there are gene changes found on chromosomes within your cells.

• #67 How is Salivary Gland Cancer Diagnosed?| Tests for Salivary Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/detection-diagnosis-staging/how-diagnosed.html

  A CT scan uses x-rays to make detailed cross-sectional images of your body. A CT scan can show the size, shape, and exact location of a tumor and can help find enlarged lymph nodes that might have cancer. […] MRI scans can help determine the exact location and extent of a tumor (for example, if it is growing into nearby tissues). […] For a PET scan, a slightly radioactive form of sugar (known as FDG) is injected into the blood and collects mainly in cancer cells. […] An ultrasound uses sound waves and their echoes to create images of the inside of the body. […] Other tests might be done as part of a work-up if a patient has been diagnosed with salivary gland cancer. […] No blood test can diagnose cancer in the salivary glands. Still, your doctor may order routine blood tests to get an idea of your overall health, especially before treatment.

• #68 Diagnosis | Center for Advanced Parotid Surgery in Beverly Hills, CA

  https://www.parotidsurgerymd.com/conditions/diagnosis/

  Needle biopsy most often will give a clear answer and tell us what type of tumor is present. The reporting protocol is called the Milan System, which not only tells you the category of diagnosis but also the risk of the diagnosis not being accurate and a cancer instead. […] The blood tests have a limited role in helping diagnose parotid disease. They can help tell you if you have autoimmune salivary gland disease or Sjögren’s syndrome.

• #69 How is Salivary Gland Cancer Diagnosed?| Tests for Salivary Cancer | American Cancer Society

  https://www.cancer.org/cancer/types/salivary-gland-cancer/detection-diagnosis-staging/how-diagnosed.html

  If surgery is planned, you might also have an electrocardiogram (EKG) to make sure your heart is working well. […] If radiation therapy or certain types of surgery (for example, removal of part of the jawbone) will be part of the treatment, you’ll most likely be asked to see a dentist before starting. […] Cisplatin, a chemotherapy drug sometimes used to treat salivary gland cancer can cause hearing loss. […] Often, you will have a nutritionist who will evaluate your nutrition status before, during, and after your treatment to try and keep your weight and protein stores as normal as possible.

• #70 Diagnosis | Center for Advanced Parotid Surgery in Beverly Hills, CA

  https://www.parotidsurgerymd.com/conditions/diagnosis/

  There are 3 main categories of diseases that happen in the salivary glands: Tumors (benign or cancers), inflammatory (infection or autoimmune), and obstructive (stones). […] We have a variety of excellent tools that can help the doctors at the CENTER diagnose the source of your parotid disease. Scans can show the anatomy of the parotid gland and if there is a tumor or stone in the glands, or if the gland is simply enlarged. Blood tests can tell us if there is inflammation, infection or an autoimmune reaction. Needle biopsy can tell us the exact type of tumor that is present in the gland. […] There are 4 main modalities used for parotid cancer imaging. They are ultrasound, CT scan, MRI & PET scan. Each has its own particular indication and utility. […] Ultrasound, specially when done in the office by the parotid surgeon can be very helpful because it can immediately give you very important detail about the tumor. It can show the exact size and shape of the tumor; also wether the borders of the tumor are clearly visible, and is it invading any of the surrounding structures.

• #71 Diagnosis | Center for Advanced Parotid Surgery in Beverly Hills, CA

  https://www.parotidsurgerymd.com/conditions/diagnosis/

  There are 3 main categories of diseases that happen in the salivary glands: Tumors (benign or cancers), inflammatory (infection or autoimmune), and obstructive (stones). […] We have a variety of excellent tools that can help the doctors at the CENTER diagnose the source of your parotid disease. Scans can show the anatomy of the parotid gland and if there is a tumor or stone in the glands, or if the gland is simply enlarged. Blood tests can tell us if there is inflammation, infection or an autoimmune reaction. Needle biopsy can tell us the exact type of tumor that is present in the gland. […] There are 4 main modalities used for parotid cancer imaging. They are ultrasound, CT scan, MRI & PET scan. Each has its own particular indication and utility. […] Ultrasound, specially when done in the office by the parotid surgeon can be very helpful because it can immediately give you very important detail about the tumor. It can show the exact size and shape of the tumor; also wether the borders of the tumor are clearly visible, and is it invading any of the surrounding structures.

• #72 Are Multiple Tumors of the Parotid Gland Uncommon or Underestimated? | Anticancer Research

  https://ar.iiarjournals.org/content/37/9/5263

  Parotid gland tumors are mostly solitary tumors of the salivary gland tissue. There is limited evidence about multifocal tumor growth of the parotid gland. We identified 93 (13%) patients with multiple parotid lesions. Multiple parotid tumors were found unilaterally in 59% and bilaterally in 41% of cases. The contralateral tumor was diagnosed synchronously in 13 of 38 (34%) cases and in 25 of 38 (66%) cases metachronously. The same histological type was found in 95% of the tumors, and 96% of the parotid tumors had lymphatic origin. Warthin tumors (65%) were the most frequent histological type. Every sixth patient with a parotid tumor has multifocal tumor lesions. The majority of multifocal parotid tumors have a lymphoid element, while multifocal growth is uncommon in other histological types. The aim of the present study was to examine the relevance of multifocal tumor growth in parotid gland tumors. We retrospectively analyzed medical records from 796 parotidectomies performed on 758 patients between 1975 and 2016. The study included 93 of 758 (13%) patients with multifocal parotid tumors. The majority of patients had noticed the presence of a parotid lump for 12 months (range=1-120 months). In 55 of 93 (59%) cases, multifocal tumors were located unilaterally, and in 38 of 93 (41%) cases bilaterally. Unilateral multiple tumors occurred synchronously in 54 of 55 (98%) patients. In patients with bilateral tumors, we found multiple tumors in one or both parotid glands in 23 of 38 (61%) cases. The contralateral tumor was diagnosed (by ultrasonography) synchronously in 13 of 38 (34%) cases and in 25 of 38 (66%) cases metachronously. The time between the diagnoses of both contralateral tumors ranged between one and eleven years. In two thirds of multifocal tumor cases within one gland (50 of 78 cases), tumors were located in the superficial part of the gland. In all 15 cases with single tumors of the second gland, the tumor was found in the superficial part of the parotid gland. The current evidence on incidence and significance of multiple tumors is mostly based on individual cases and small series. The present study is the biggest to date, including 93 patients with multiple parotid gland tumors. The proportion of multifocal tumor growth was 13%. To emphasize the importance of multifocal tumor growth in the differential diagnosis of parotid gland tumors, we also included 5 inflammatory pseudotumors and one case of tuberculosis as well as 13 cases of parotid gland metastases. Excluding these types, the percentage of multifocal neoplasm was 12% (74 of 623). In the present study, unilateral multifocal tumors were found more frequently (59%) than bilateral (41%) tumors. The vast majority (95%) of multiple tumors in our series were of identical histologic type. Among multifocal tumors with identical histology, Warthin tumors represent the majority of cases. We detected Warthin tumors in 68% of cases. Most of them occurred bilaterally (58%). The total frequency of multiple Warthin tumors among our patients was 26% and comparably high. Our results support the findings that the risk of multiple Warthin tumors correlates with the amount of nicotine intake: all but three of our patients with multiple Warthin tumors were smokers. Multifocal tumor growth was also more common in men and older patients, which may be due to the high proportion of Warthin tumors and metastases. In the present study, multifocal tumors of different histological types were rare (5%). In all five cases, a Warthin tumor was found synchronously unilateral, in combination with four cases of a pleomorphic adenoma and one case with metastatic squamous cell carcinoma. The possibility of multifocal tumors should be considered both during the preoperative diagnostic evaluation (e.g. ultrasonography) and intraoperatively during palpation of the remaining glandular tissue. A careful postoperative follow-up including the contralateral parotid gland is recommended in cases of multifocal Warthin tumors.

• #73 Parotid Tumors Treatment – Parotid Tumor Surgery | Salivary Gland Surgery Los Angeles CA

  https://parotid.net/parotid-tumors/

  First line treatment for all parotid tumors, both benign and malignant, is generally surgical removal of the gland. […] A comprehensive evaluation of parotid tumor should include the traditional components of a comprehensive medical exam but should include consideration of the following critical components: Salivary gland specific history, Ductal system evaluation, Salivary gland biopsy, MRI imaging, Customized treatment options.

• #74 Clinical Diagnosis of Extended Parotid Tumors | SpringerLink

  https://link.springer.com/chapter/10.1007/978-3-319-26545-2_10

  The clinical examination forms the fundament for decision making in a patient with an extended parotid tumor. The examination starts with an elaborate interview of the patients looking for clinical hints for a malignant disease. The clinical examination comprises a complete head and neck examination including an investigation of all major salivary glands. Thereafter, ultrasound is the first-choice imaging technique for an immediate assessment of the parotid tumor. If available, fine-needle aspiration cytology (FNAC) continues the diagnostic workup. FNAC will determine whether the parotid tumor process is malignant. Core-needle biopsy or an open biopsy may offer an additional effective diagnostic tool in cases in which FNAC has failed to provide a definitive diagnosis. […] In extended parotid tumors, often the situation will occur that ultrasound does not allow visualizing the parotid tumor completely, due to its location in the deep lobe. In such a situation, or if FNAC or a biopsy argue for a malignant disease, further imaging with computed tomography (CT) or magnetic resonance imaging (MRI) are indicated. MRI is the first choice. If a malignant parotid tumor is suspected, MRI and CT scanning are important for the tumor staging of the primary tumor and the neck.

• #75

  https://www.bjbms.org/ojs/index.php/bjbms/article/view/5028

  An accurate preoperative diagnosis of parotid tumors is essential for the selection and planning of surgical treatment. Various modern cross-sectional imaging and cytologic investigations can support the differential diagnosis of parotid tumors. […] This literature review could serve as a guide for clinicians in selecting different types of investigations for the preoperative differential diagnosis of parotid tumors. Magnetic resonance imaging (MRI) with its dynamic and advanced sequences is the first-line imaging investigation used in differentiating parotid tumors. Computed tomography (CT) and positron emission tomography (PET)-CT provide limited indications in differentiating parotid tumors. Fine needle aspiration biopsy and core needle biopsy can contribute with satisfactory results to the cytological diagnosis of parotid tumors. Dynamic MRI with its dynamic contrast-enhanced and diffusion-weighted sequences provides the best accuracy for the preoperative differential diagnosis of parotid tumors. CT allows the best evaluation of bone invasion, being useful when MRI cannot be performed, and PET-CT has value in the follow-up of cancer patients. The dual cytological and imaging approach is the safest method for an accurate differential diagnosis of parotid tumors.

• #76

  https://www.bjbms.org/ojs/index.php/bjbms/article/view/5028

  An accurate preoperative diagnosis of parotid tumors is essential for the selection and planning of surgical treatment. Various modern cross-sectional imaging and cytologic investigations can support the differential diagnosis of parotid tumors. […] This literature review could serve as a guide for clinicians in selecting different types of investigations for the preoperative differential diagnosis of parotid tumors. Magnetic resonance imaging (MRI) with its dynamic and advanced sequences is the first-line imaging investigation used in differentiating parotid tumors. Computed tomography (CT) and positron emission tomography (PET)-CT provide limited indications in differentiating parotid tumors. Fine needle aspiration biopsy and core needle biopsy can contribute with satisfactory results to the cytological diagnosis of parotid tumors. Dynamic MRI with its dynamic contrast-enhanced and diffusion-weighted sequences provides the best accuracy for the preoperative differential diagnosis of parotid tumors. CT allows the best evaluation of bone invasion, being useful when MRI cannot be performed, and PET-CT has value in the follow-up of cancer patients. The dual cytological and imaging approach is the safest method for an accurate differential diagnosis of parotid tumors.

• #77 Current Developments in Diagnosis of Salivary Gland Tumors: From Structure to Artificial Intelligence

  https://www.mdpi.com/2075-1729/14/6/727

  The combination between non-contrast MRI with diffusion-weighted imaging, arterial spin labelling and amide proton transfer weighted imaging was shown to be able to differentiate between benign and malignant salivary gland lesions. […] Several diagnostic methods are currently studied for establishing diagnosis and guiding the treatment strategy for salivary gland tumors. […] AI-assisted salivary biomarker models for oral cancer diagnosis are now being studied. […] AI algorithms can increase the effectiveness of the pre-surgical diagnosis. […] Diagnosing salivary gland tumors with histopathological examinations, studies represented by MRI, CT or ultrasonography rely on the experience of the medical staff handling the examination tools and clinical data.

• #78 A deep learning model for the differential diagnosis of benign and malignant salivary gland tumors based on ultrasound imaging and clinical data – Zhang – Quantitative Imaging in Medicine and Surgery

  https://qims.amegroups.org/article/view/112767/html

  The preoperative differentiation between benign parotid gland tumors (BPGTs) and malignant parotid gland tumors (MPGTs) is of great significance for therapeutic decision-making. […] Therefore, as an auxiliary diagnostic tool, DL can support accurate diagnosis using massive ultrasonic (US) images. This current study developed and validated a DL-based US diagnosis for the preoperative differentiation of BPGT from MPGT. […] The DL model showed a significantly higher AUC value compared to doctor 1 + clinical data, doctor 2 + clinical data, and doctor 3 + clinical data (AUC =0.9583 vs. 0.6250, 0.7250, and 0.8025 respectively; all P0.05). […] The DL-based US imaging diagnostic model has excellent performance in differentiating BPGT from MPGT, supporting its value as a diagnostic tool for the clinical decision-making process.

• #79 Current Developments in Diagnosis of Salivary Gland Tumors: From Structure to Artificial Intelligence

  https://www.mdpi.com/2075-1729/14/6/727

  The combination between non-contrast MRI with diffusion-weighted imaging, arterial spin labelling and amide proton transfer weighted imaging was shown to be able to differentiate between benign and malignant salivary gland lesions. […] Several diagnostic methods are currently studied for establishing diagnosis and guiding the treatment strategy for salivary gland tumors. […] AI-assisted salivary biomarker models for oral cancer diagnosis are now being studied. […] AI algorithms can increase the effectiveness of the pre-surgical diagnosis. […] Diagnosing salivary gland tumors with histopathological examinations, studies represented by MRI, CT or ultrasonography rely on the experience of the medical staff handling the examination tools and clinical data.

• #80 A deep learning model for the differential diagnosis of benign and malignant salivary gland tumors based on ultrasound imaging and clinical data – Zhang – Quantitative Imaging in Medicine and Surgery

  https://qims.amegroups.org/article/view/112767/html

  In this study, we developed and validated a DL-based US imaging diagnostic model to provide a non-invasive tool for differentiating BPGT from MPGT. […] Our results showed that, after combining with clinical data, the DL model achieved an excellent result in the diagnosis of parotid gland tumor, with a significantly higher AUC value (AUC =0.9583) compared with that of doctor 1 + clinical data (AUC =0.6250), doctor 2 + clinical data (AUC =0.7250), and doctor 3 + clinical data (AUC =0.8250), respectively (all P0.05). […] The model demonstrated a tremendously high diagnostic performance for parotid gland tumor, achieving specificity, sensitivity, accuracy, and F1-score of 94.4%, 97.2%, 95.8%, and 95.9% in the testing set, respectively. […] These results demonstrated DL model can effective differentiate benign and malignant parotid gland tumor.

• #81 Multispectral optoacoustic tomography of benign parotid tumors in vivo: a prospective observational pilot study | Scientific Reports

  https://www.nature.com/articles/s41598-024-61303-z

  None of the standard imaging techniques, neither US, MRI nor CT do allow a reliable differentiation between the different types of benign parotid tumors. For differentiation of the tumor entities, cytology or histology is needed. […] Therefore, it is of clinical interest to reproduce the present results in larger sample size, as MSOT would then allow a non-invasive differentiation of different tumor entities. The aim of this pilot study was to evaluate the applicability of MSOT in parotid gland tumors. The comparison of the two most common benign parotid gland tumors, PA and WT showed only some differences, mainly in the maximum MSOT values. […] The present pilot study demonstrated how MSOT offers several compelling features for parotid tumor diagnostics that are not available using other imaging methods without invasive procedures.

• #82 A deep learning model for the differential diagnosis of benign and malignant salivary gland tumors based on ultrasound imaging and clinical data – Zhang – Quantitative Imaging in Medicine and Surgery

  https://qims.amegroups.org/article/view/112767/html

  In this study, we developed and validated a DL-based US imaging diagnostic model to provide a non-invasive tool for differentiating BPGT from MPGT. […] Our results showed that, after combining with clinical data, the DL model achieved an excellent result in the diagnosis of parotid gland tumor, with a significantly higher AUC value (AUC =0.9583) compared with that of doctor 1 + clinical data (AUC =0.6250), doctor 2 + clinical data (AUC =0.7250), and doctor 3 + clinical data (AUC =0.8250), respectively (all P0.05). […] The model demonstrated a tremendously high diagnostic performance for parotid gland tumor, achieving specificity, sensitivity, accuracy, and F1-score of 94.4%, 97.2%, 95.8%, and 95.9% in the testing set, respectively. […] These results demonstrated DL model can effective differentiate benign and malignant parotid gland tumor.

• #83 Newly Diagnosed With Parotid Tumor, Parotid Tumor Diagnosis

  https://parotidpatientproject.org/parotid-education/newly-diagnosed.html

  It is important that patients keep in mind that the vast majority of parotid tumors (80%) are benign, and the vast majority of the parotid surgeries go very well. […] At Parotid Patient Project, we believe that the most important thing for patients to do after diagnosis is to find a skilled head and neck surgeon with extensive experience handling parotid tumors. […] It is not recommended that patients have their surgery performed by a general ENT surgeon who does not handle many parotid cases. […] It is absolutely critical that this surgery is performed correctly and completely the first time to reduce the chances of having a tumor recurrence or complications, and to increase the chances of having a positive outcome. […] There is a lot of negative information on the internet that can lead a patient to believe that the chance of having permanent facial paralysis after parotid surgery is very high. In reality, the chances of having permanent facial paralysis should be very low. […] The content in this section was drafted in consultation with Eric J. Moore, M.D., and Kerry D. Olsen, M.D., of the Mayo Clinic in Rochester, MN.

• #84 Salivary Gland Malignancies: Diagnosis and Treatment of a Rare and Challenging Cancer – ENTtoday

  https://www.enttoday.org/article/salivary-gland-malignancies-diagnosis-and-treatment-of-a-rare-and-challenging-cancer/

  Salivary gland malignancies affect 2.5 to 3 in 100,000 people each year in the United States, and comprise only 6% of head and neck cancers. […] Despite current imaging technologies, tumor location and heterogeneity render diagnosis and treatment decisions challenging for the treatment team. […] The addition of neutron beam radiation, and facial nerve reconstruction options, have also moved the field forward. […] Combination treatment using surgery and radiation therapy has had a tremendous effect in our ability to give these patients a long term of tumor-free survival, he said. […] Diagnosis of salivary gland malignancy is not always straightforward, and diagnostic practices vary across regions. […] Following a full history and physical, as well as an imaging study (either CT or MRI), many head and neck surgeons perform tumor resection to establish a diagnosis.

• #85 Newly Diagnosed With Parotid Tumor, Parotid Tumor Diagnosis

  https://parotidpatientproject.org/parotid-education/newly-diagnosed.html

  It is important that patients keep in mind that the vast majority of parotid tumors (80%) are benign, and the vast majority of the parotid surgeries go very well. […] At Parotid Patient Project, we believe that the most important thing for patients to do after diagnosis is to find a skilled head and neck surgeon with extensive experience handling parotid tumors. […] It is not recommended that patients have their surgery performed by a general ENT surgeon who does not handle many parotid cases. […] It is absolutely critical that this surgery is performed correctly and completely the first time to reduce the chances of having a tumor recurrence or complications, and to increase the chances of having a positive outcome. […] There is a lot of negative information on the internet that can lead a patient to believe that the chance of having permanent facial paralysis after parotid surgery is very high. In reality, the chances of having permanent facial paralysis should be very low. […] The content in this section was drafted in consultation with Eric J. Moore, M.D., and Kerry D. Olsen, M.D., of the Mayo Clinic in Rochester, MN.

• #86 Salivary Gland Cancer Diagnosis | MD Anderson Cancer Center

  https://www.mdanderson.org/cancer-types/salivary-gland-cancer/salivary-gland-cancer-diagnosis.html

  An accurate diagnosis is the first step in successful salivary gland cancer treatment. […] If you have a suspected salivary gland cancer, your doctor will ask about your health and medical history. You will also undergo tests to diagnose the type of salivary gland cancer and the cancer stage. The following tests are used to diagnose salivary gland cancer and how much it has grown, as well as to monitor the disease and how it responds to treatment. […] A biopsy is the only way to conclusively diagnose salivary gland cancer. […] Imaging exams can help locate the suspected cancer and show whether it has spread. They are important in helping to plan surgery and determine the cancers stage. […] These tests are not used to diagnose cancer. Instead, they help doctors monitor the patients overall health during treatment. […] If you are diagnosed with salivary gland cancer, your doctor will determine the stage (or extent) of the disease. The various stages classify how far and to which parts of the body the cancer has spread. Staging helps doctors plan the best treatment for you.

• #87 Salivary gland cancer: 9 things to know | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/salivary-gland-cancer–9-things-to-know.h00-159618645.html

  Salivary gland cancer almost never has symptoms, but the high-grade aggressive types can get big fast. […] Imaging tests like CT scans, MRIs or X-rays can indicate if something is likely cancer versus not cancer. But most salivary gland cancers will require a biopsy the removal and examination of a tumors cells under a microscope to make an exact diagnosis. […] Here at MD Anderson, we almost always do an ultrasound-guided fine needle biopsy to make sure were getting a sample from the most at-risk site. […] Nationwide, the accuracy rate for this method of salivary gland cancer diagnosis is about 75%. Ours is much higher, because we have so much more experience in diagnosing this disease. […] Youre also very rarely going to see a change in your salivary cancer diagnosis or get bumped up to a higher stage of disease if you come to MD Anderson first.

• #88 Parotid Gland Tumors: Symptoms, Diagnosis, And Treatment | Oral Cancer Institute

  https://oralcancer.com/parotid-gland-tumors/

  If needed, our surgeons utilize a small gauge needle to withdraw a small amount of fluid and cellular tissue from the palpable lump or suspicious area. This fluid is sent to a lab, and the cells can be identified by a pathologist for an exact diagnosis. While FNA’s are not capable of providing a definitive diagnosis, they are a useful adjunct during the work up phase. […] Trusted surgeons at Oral Cancer Institute […] When all the information is collected, your doctor will sit with you and your family to discuss treatment options and answer all your questions. We know receiving any diagnosis can be stressful and can be a time of uncertainty. We want to assure you that you, as our patient, will be our most important priority. […] Surgeons at the Oral Cancer Institute all have completed specialty fellowships and are experts in managing tumors of the head, neck, and maxillofacial area. These include oral cancer and salivary gland tumors. All our patients with malignant salivary tumors are presented at our multidisciplinary tumor board, which consists of head and neck surgical oncologists, medical oncologists, radiation oncologists, radiologists, and pathologists, allowing for a comprehensive treatment plan. That way, our patients not only get the opinion of our head & neck surgeons, but rather the opinion of a large multidisciplinary panel of experts. We want to partner with you from diagnosis through treatment and recovery. We pledge to give compassionate and patient-centered care with the highest standards of excellence. […]

• #89 Diagnosis and Management of Malignant Salivary Gland Tumors of the Parotid Gland | Ento Key

  https://entokey.com/diagnosis-and-management-of-malignant-salivary-gland-tumors-of-the-parotid-gland/

  Malignant parotid tumors are heterogeneous and diverse. Accurate diagnosis requires a pathologist familiar with the various histologic subtypes, immunohistochemistry stains, and common translocations. […] Histology, immunohistochemistry, and identification of gene translocations are important for parotid tumor diagnosis. […] Parotid cancers have diverse histopathology and clinical behavior. […] Treatment requires a multidisciplinary approach and surgery to negative margins is a mainstay, supplemented by radiation for better locoregional control and chemotherapy, usually in the palliative recurrent or metastatic setting. […] Targeted therapies are under active investigation; however, they are not yet proven in the clinical setting. […] New molecular tests are being identified and may add to the diagnostic accuracy.

• #90 Salivary gland cancer: 9 things to know | MD Anderson Cancer Center

  https://www.mdanderson.org/cancerwise/salivary-gland-cancer–9-things-to-know.h00-159618645.html

  The most common type of parotid gland cancer is called mucoepidermoid, followed by adenoid cystic. […] Unless a salivary gland cancer is widely metastatic, the majority of patients with high-grade (or more aggressive) tumors are treated with surgery and radiation therapy. […] All patients with salivary gland cancer should have a multidisciplinary workup before starting treatment. […] It also means meeting with a radiation oncologist, a surgical oncologist and any other specialists needed to determine the best possible treatment plan. […] Some really rare and aggressive, very high-grade ductal cancers can carry markers like those found in breast cancer.

• #91 Parotid Gland Tumors: Symptoms, Diagnosis, And Treatment | Oral Cancer Institute

  https://oralcancer.com/parotid-gland-tumors/

  If needed, our surgeons utilize a small gauge needle to withdraw a small amount of fluid and cellular tissue from the palpable lump or suspicious area. This fluid is sent to a lab, and the cells can be identified by a pathologist for an exact diagnosis. While FNA’s are not capable of providing a definitive diagnosis, they are a useful adjunct during the work up phase. […] Trusted surgeons at Oral Cancer Institute […] When all the information is collected, your doctor will sit with you and your family to discuss treatment options and answer all your questions. We know receiving any diagnosis can be stressful and can be a time of uncertainty. We want to assure you that you, as our patient, will be our most important priority. […] Surgeons at the Oral Cancer Institute all have completed specialty fellowships and are experts in managing tumors of the head, neck, and maxillofacial area. These include oral cancer and salivary gland tumors. All our patients with malignant salivary tumors are presented at our multidisciplinary tumor board, which consists of head and neck surgical oncologists, medical oncologists, radiation oncologists, radiologists, and pathologists, allowing for a comprehensive treatment plan. That way, our patients not only get the opinion of our head & neck surgeons, but rather the opinion of a large multidisciplinary panel of experts. We want to partner with you from diagnosis through treatment and recovery. We pledge to give compassionate and patient-centered care with the highest standards of excellence. […]

• #92 Salivary Gland Malignancies: Diagnosis and Treatment of a Rare and Challenging Cancer – ENTtoday

  https://www.enttoday.org/article/salivary-gland-malignancies-diagnosis-and-treatment-of-a-rare-and-challenging-cancer/

  Salivary gland malignancies affect 2.5 to 3 in 100,000 people each year in the United States, and comprise only 6% of head and neck cancers. […] Despite current imaging technologies, tumor location and heterogeneity render diagnosis and treatment decisions challenging for the treatment team. […] The addition of neutron beam radiation, and facial nerve reconstruction options, have also moved the field forward. […] Combination treatment using surgery and radiation therapy has had a tremendous effect in our ability to give these patients a long term of tumor-free survival, he said. […] Diagnosis of salivary gland malignancy is not always straightforward, and diagnostic practices vary across regions. […] Following a full history and physical, as well as an imaging study (either CT or MRI), many head and neck surgeons perform tumor resection to establish a diagnosis.

• #93

  https://www.bjbms.org/ojs/index.php/bjbms/article/view/5028

  An accurate preoperative diagnosis of parotid tumors is essential for the selection and planning of surgical treatment. Various modern cross-sectional imaging and cytologic investigations can support the differential diagnosis of parotid tumors. […] This literature review could serve as a guide for clinicians in selecting different types of investigations for the preoperative differential diagnosis of parotid tumors. Magnetic resonance imaging (MRI) with its dynamic and advanced sequences is the first-line imaging investigation used in differentiating parotid tumors. Computed tomography (CT) and positron emission tomography (PET)-CT provide limited indications in differentiating parotid tumors. Fine needle aspiration biopsy and core needle biopsy can contribute with satisfactory results to the cytological diagnosis of parotid tumors. Dynamic MRI with its dynamic contrast-enhanced and diffusion-weighted sequences provides the best accuracy for the preoperative differential diagnosis of parotid tumors. CT allows the best evaluation of bone invasion, being useful when MRI cannot be performed, and PET-CT has value in the follow-up of cancer patients. The dual cytological and imaging approach is the safest method for an accurate differential diagnosis of parotid tumors.

• #94 Diagnosis and Management of Malignant Salivary Gland Tumors of the Parotid Gland | Ento Key

  https://entokey.com/diagnosis-and-management-of-malignant-salivary-gland-tumors-of-the-parotid-gland/

  Malignant parotid tumors are heterogeneous and diverse. Accurate diagnosis requires a pathologist familiar with the various histologic subtypes, immunohistochemistry stains, and common translocations. […] Histology, immunohistochemistry, and identification of gene translocations are important for parotid tumor diagnosis. […] Parotid cancers have diverse histopathology and clinical behavior. […] Treatment requires a multidisciplinary approach and surgery to negative margins is a mainstay, supplemented by radiation for better locoregional control and chemotherapy, usually in the palliative recurrent or metastatic setting. […] Targeted therapies are under active investigation; however, they are not yet proven in the clinical setting. […] New molecular tests are being identified and may add to the diagnostic accuracy.

• #95 Parotid Gland Tumors: Molecular Diagnostic Approaches

  https://pmc.ncbi.nlm.nih.gov/articles/PMC11242036/

  FISH represents the unanimous accepted technique to highlight genetic alterations, but NGS (next-generation sequencing) can also be helpful. […] Molecular profiling and advancement in targeted therapies will increase the survival of parotid gland tumor patients, thus balancing the higher costs with equipment and training of staff.

• #96 Current Developments in Diagnosis of Salivary Gland Tumors: From Structure to Artificial Intelligence

  https://www.mdpi.com/2075-1729/14/6/727

  The combination between non-contrast MRI with diffusion-weighted imaging, arterial spin labelling and amide proton transfer weighted imaging was shown to be able to differentiate between benign and malignant salivary gland lesions. […] Several diagnostic methods are currently studied for establishing diagnosis and guiding the treatment strategy for salivary gland tumors. […] AI-assisted salivary biomarker models for oral cancer diagnosis are now being studied. […] AI algorithms can increase the effectiveness of the pre-surgical diagnosis. […] Diagnosing salivary gland tumors with histopathological examinations, studies represented by MRI, CT or ultrasonography rely on the experience of the medical staff handling the examination tools and clinical data.

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