Abstract
PURPOSE
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) evaluation in detecting malignancy in cystic masses of the neck.
METHODS
We reviewed 61 patients who underwent preoperative ultrasound-guided FNAC and neck
biopsy of a cystic neck mass. We analysed the concordance between FNAC and intraoperative
FS respect of definitive histology. HPV status was also tested.
RESULTS
Out of 49 eligible cases, the accuracy of preoperative FNAC was 70.5% and the weighted
Kappa resulted 0.53 meaning a 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 a perfect agreement with histology.
CONCLUSION
Since FS analysis resulted useful in evaluating cystic neck masses, despite of moderate
accuracy of cytology, we suggest intraoperative FS analysis for all cystic neck masses.
This technique allows to switch towards a therapeutical 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
Accepted:
July 22,
2022
Received in revised form:
June 7,
2022
Received:
March 3,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2022 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
