THE ROLE OF ULTRASONOGRAPHIC AND COMPUTERIZED TOMOGRAPHY IN BENIGN MALIGN DISCRIMINATION OF PAROTID GLAND MASSES

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OBJECTIVE: To investigate the role of Ultrasonography (US) and Computed-Tomography (CT) in discrimination of the benign and malign masses in the parotid gland. MATERIAL AND METHODS: Forty-five patients with parotid gland mass lesions were examined with US and CT. US features of the parotid masses including location (superficial-deep lobe), dimensions, margins (well defined (smooth-lobulated) or, irregular), echogenity (anechoic, hypoechoic, isoechoic or hyperechoic), echotexture (homogeneous or heterogeneous) were examined. Contrast enhancement (homogeneous, heterogeneous) contour (well-defined (smooth- lobulated irregular)) was assessed in CT. Thirty - nine cases were operated and diagnosed histopathologically. Six cases were diagnosed histopathologically after needle biopsy. RESULTS: Forty-five of 39 (86.7%) mass lesions were benign, and 6 (13.3) were malign. Of the 39 benign lesions, 28 were diagnosed with pleomorphic adenoma, 5 with Warthin tumor, 1 with capillary hemangioma, 1 with dermoid cyst, 1 with lipoma, 2 with tuberculous lymphadenitis, 1 with granulomatous lymphadenitis. Of the 6 malignant cases, 1 had adenoid cystic cancer, 2 had lymphoma, 1 had malignant melanoma, 1 had chondrosarcoma, and 1 had mucoepidermoid carcinoma. All benign lesions had a smooth or lobulated contour in the US and CT and the lesions were well-defined. Lymphoma was well-defined and lobulated in the two detected cases. Irregular contour was observed in 4 malign lesions with both US and CT. Homogeneous echotexture was detected in 79% of pleomorphic adenomas, 40% in Warthin tumors, and in two cases with lymphoma. Heterogeneous echotexture was found in 21% of the pleomorphic adenomas and in all malignant masses. Homogeneous contrast enhancement was observed in 92.9% of pleomorphic adenomas, 40% in Warthin tumors, and 2 cases of lymphoma in CT. 7.1% of pleomorphic adenomas, and 4 cases of malignant masses showed heterogeneous contrast enhancement. Cystic component was observed in 3 cases with Warthin tumor. CONCLUSIONS: US and CT can be used in discrimination of benign and malignant parotid masses and differential diagnosis of the parotid gland lesions. Irregular contour and invasion into the surrounding tissues should suggest malignancy. The location and extent of lesions are better evaluated by CT than US.

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Parotid gland , Mass , Ultrasonography , Computed Tomography

Kocatepe Medical Journal

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Kocatepe Medical Journal