Can preoperative fine-needle aspiration of parotid tumors pose problems for a definitive histological diagnosis?

Introduction. Fine-needle aspiration cytology ( FNAC) is a minimally invasive procedure that offers high specifity and acceptable sensitivity in the preoperative diagnosis of parotid tumors. FNAC provides in formation that can be particularly valuable in surgical planning and patient education. In some cases, it may even help prevent unnecessary surgery. After an FNA procedure, on rare occasions, morphological changes in the tumor may be ob served and can make a definitive histo logical examination difficult or even impossible. Methods. Histo pathological changes in parotid tumors after preoperative FNAC are described on the basis of a case re port and a survey of the literature. Results. In rare cases, puncture-induced histo pathological changes, such as hyalinization of the subepithelial stroma, necrosis and squamous metaplasia, so extensive that a definitive histo logical diagnosis is difficult, are ob served. In the present case report, fine-needle aspiration of a 3 x 2 cm tumor, which had been classified as malignant on the basis of cytological findings, resulted in complete necrosis and made a definitive histo logical diagnosis impossible. Similar cases have been described by other authors in recent years. Discussion. In rare cases, his to logical changes in the tumor tissue can occur after an FNA procedure, making a definitive histo logical examination difficult or even impossible. When a preoperative FNAC is performed, the pathologist in charge should be advised accordingly. In addition, patients should be in formed about this in frequent risk be fore under going the procedure.