Diagnostic dilemma of parotid lipomas: imaging versus fine needle aspiration cytology
Lipomas are common soft tissue neoplasms; however, they are found rarely in the parotid gland region. The purpose of this study was to analyze the diagnostic challenges of this rare condition. We performed a retrospective analysis of 11 patients with parotid lipomas, treated from November 2009 to February 2014. The mean age at diagnosis was 46.6±2.9 years, and the study population included 8 males and 3 females. Computed tomography (CT) and/or magnetic resonance imaging (MRI) were performed in radiological diagnosis. Fine needle aspiration (FNA) was performed in all cases (including two times in five patients, for a total of 16 biopsies) and results were diagnostic in four instances. Specificities of the CT, MRI, and FNA cytology tests were 100%, 100%, and 25% respectively. CT and/or MRI scans were more reliable than FNA cytologies for accurate diagnosis of parotid lipomas.
Wu CW, Chi HP, Hsu YC, Chan LP, Kuo WR. Giant lipoma arising from deep lobe of the parotid gland. World J Surg Oncol. 2006; 4: 28. http://dx.doi.org/10.1186/1477-7819-4-28
Ryu JW, Lee MC, Myong NH, Chung M, Park DK, Kim JT, et al. Lipoma of the parotid gland. J Korean Med Sci. 1996 December; 11(6): 522–525. http://dx.doi.org/10.3346/jkms.19220.127.116.112
Ethunandan M, Vura G, Umar T, Anand R, Pratt CA, Macpherson DW, et al. Lipomatous Lesions of the Parotid Gland. J Oral Maxillofac Surg2006;64:1583-1586 http://dx.doi.org/10.1016/j.joms.2005.10.059
Dispenza F, De Stefano A, Romano G, Mazzoni A. Post-traumatic lipoma of the parotid gland:case report. ACTA otorhinolaryngologica italica 2008;28:87-88
Zbaren P, Schar C, Hotz MA, Loosli H. Value of Fine-Needle Aspiration Cytology of Parotid Gland Masses. Laryngoscope, 111:1989–1992, 2001 http://dx.doi.org/10.1097/00005537-200111000-00023
Tryggvason G, Gailey MP, Hulstein SL, Karnell LH, Hoffman HT, Funk GF, et al. Accuracy of Fine-Needle Aspiration and Imaging in the Preoperative Workup of Salivary Gland Mass Lesions Treated Surgically. Laryngoscope, 123:158–163, 2013 http://dx.doi.org/10.1002/lary.23613
Kuwano Y, Ishizaki K, Watanabe R, Nanko H. Efficacy of diagnostic ultrasonography of lipomas, epidermal cysts, and ganglions. Arch Dermatol 2009;145:761–764. http://dx.doi.org/10.1001/archdermatol.2009.61
Starkman SJ, Olsen SM, Lewis JE, Olsen KD, Sabri A. Lipomatous Lesions of the Parotid Gland: Analysis of 70 Cases. Laryngoscope, 123:651–656, 2013 http://dx.doi.org/10.1002/lary.23723
Chikui T, Yonetsu K, Yoshiura K, Miwa K, Kanda S, Ozeki S, et al. Imaging findings of lipomas in the orofacial region with CT, US, and MRI. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1997, 84(1):88-95. http://dx.doi.org/10.1016/S1079-2104(97)90302-4
Kransdorf MJ, Bancroft LW, Peterson JJ, Murphey MD, Foster WC, Temple HT. Imaging of fatty tumor: distinction of lipoma and well-differentiated liposarcoma. Radiology 2002;224:99-104. http://dx.doi.org/10.1148/radiol.2241011113
Cho HW, Kim J, Choi J, Choi HS, Kim ES, Kim SH, et al. Sonographically Guided Fine-Needle Aspiration Biopsy of Major Salivary Gland Masses: A Review of 245 Cases. AJR 2011; 196:1160–1163 http://dx.doi.org/10.2214/AJR.10.4256
Layfield LJ, Glasgow BJ, Goldstein N, Lufkin R. Lipomatous lesions of the parotid gland. Potential pitfalls in fine needle aspiration biopsy diagnosis. Acta Cytol. 1991;35(5):553-6.
Ulku CH, Uyar Y, Unaldi D. Management of lipomas arising from deep lobe of the parotid gland. Auris Nasus Larynx 2005;32:49–53. http://dx.doi.org/10.1016/j.anl.2004.09.004