Risks of Neoplasia and Malignancy in Surgically Resected Cystic Parotid Lesions
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Brian C. Boursiquot, MD, MS, Nancy J. Fischbein, MD, Davud Sirjani, MD, Uchechukwu C. Megwalu, MD, MPHFirst Published December 3, 2019 Research Article
https://doi.org/10.1177/0194599819889699
Article information
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Abstract
Objectives
To evaluate the risks of neoplasm and malignancy in surgically treated cystic parotid masses compared with solid or mixed lesions and to evaluate the performance of fine-needle aspiration (FNA) in parotid cysts.

Study Design
Retrospective cross-sectional study.

Setting
Single-institution academic tertiary care center.

Subjects and Methods
Patients without a history of human immunodeficiency virus or head and neck cancer who underwent parotidectomy for parotid masses and had preoperative imaging to characterize lesions as cystic, solid, or mixed (ie, partially cystic and partially solid). We assessed the risks of neoplasia and malignancy, adjusting for age, sex, race/ethnicity, facial nerve weakness, and history of malignancy. We also evaluated the sensitivity and specificity of FNA.

Results
We included 308 patients, 27 of whom had cystic parotid masses (5 simple and 22 complex). Cystic masses were less likely to be neoplastic compared to solid or mixed masses (44% vs 97%; odds ratio [OR], 0.03; 95% confidence interval [CI], 0.01-0.07); however, there was no difference in the risk of malignancy (22% vs 26%; OR, 0.81; 95% CI, 0.32-2.10). Cystic masses were more likely to yield nondiagnostic FNA cytology results, but for diagnostic samples, FNA was 86% sensitive and 33% specific for diagnosing neoplasia and 75% sensitive and 83% specific for diagnosing malignancy.

Conclusion
In our population, cystic masses undergoing surgery were less likely to be neoplastic but had a similar risk of malignancy as solid masses. The risk of malignancy should be considered in the management of cystic parotid masses.

Keywords parotid gland, parotid neoplasms, cysts, fine-needle biopsy, neoplasms