Abstract
Cystic masses of the lateral neck are mostly benign. However, the incidence of metastatic
squamous cell carcinoma (SCC) in cervical cystic masses initially diagnosed as benign
is quite high in patients older than 40 years. The aim of this study was to compare
the diagnostic accuracy of preoperative cytology and intraoperative frozen section
(FS) in detecting malignancy in cystic masses of the neck. We reviewed 61 patients
who underwent preoperative ultrasound-guided fine-needle aspiration cytology (FNAC)
and neck biopsy of a cystic neck mass, and analysed the concordance between FNAC and
intraoperative FS with respect to definitive histology. HPV status was also tested.
Of 49 eligible cases, the accuracy of preoperative FNAC was 70.5% (weighted kappa
0.53), meaning moderate agreement between cytology and final diagnosis. Intraoperative
FS consultations detected 16 cases of SCC metastasis while the remaining 33 cases
were negative for SCC, showing perfect agreement with histology. Since FS results
were useful in evaluating cystic neck masses, despite a moderate accuracy of cytology,
we suggest intraoperative FS analysis for all cystic neck masses. This technique can
allow us to switch to therapeutic neck dissection, multiple upper aerodigestive tract
biopsies, tongue base mucosectomy, and bilateral tonsillectomy in the same surgical
setting.
Keywords
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Article Info
Publication History
Published online: July 28, 2022
Accepted:
July 22,
2022
Received in revised form:
June 7,
2022
Received:
March 3,
2022
Identification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
