Diapositiva 1

Frozen section in
diagnosis and
treatment of salivary
gland tumors
M. Mastromauro, M.A. Cascarano, F. Pezzuto, G. Musci, O.
Bega, G. Serio, L. Resta
UNIVERSITA’ DEGLI STUDI DI BARI
“ALDO MORO”
DETO, Sezione di Anatomia Patologica
Background
Treatment of salivary gland tumors are firstly
conditioned by the exact definition of the
lesion at moment of surgical intervention, as
defined by fine needle aspiration cytology or
frozen section. The latter procedure is
preferred in our Institution. The efficacy of
frozen section is evaluated retrospectively in
our cases of the last years.
Schmidt et al, 2011
Methods
• Since May 2005 to December 2012 we
examined 588 salivary lesions and the surgery
was supported by frozen section in 144 cases.
A neoplastic lesion was found in 119 (20%). 58
patients (49%) were male and 61 female
(51%). Site of tumor was the parotid gland in
110 cases, the submandibular gland in 3 cases
and the minor salivary glands in 6 cases.
SEDE
SESSO
Maschi (330 casi)
Femmine (258 casi)
Parotide (438 casi)
74,50%
44%
18,70%
56%
6,80%
Sottomandibolare (110
casi)
Ghiandole salivari minori
(40 casi)
LESIONI SALIVARI
Neoplasie benigne (268 casi)
Flogosi (249 casi)
Neoplasie maligne (71 casi)
42%
46%
12%
Total neoplastic cases: 339 (58%)
Total neoplastic cases: 339 (58%)
NEOPLASIE BENIGNE
Adenoma pleomorfo (161 casi)
Altro (24 casi)
NEOPLASIE MALIGNE
Tumore di Warthin (83 casi)
9%
Primitive (54 casi)
Metastatiche (17 casi)
24%
31%
60%
76%
Frozen section
ESTEMPORANEA
Sì (144 casi)
DIAGNOSI ESTEMPORANEA
No (195 casi)
Maligni (32
casi)
27%
58%
43%
Benigni (87
casi)
73%
Results
• All cases was diagnosed at frozen section as
tumoral lesions, confirmed at final
examination: 87 benign (73%) and 32
malignant (27%).
Results
• Among the benign proliferation we observed
51 pleomorph adenomas and 33 Whartin
tumors.
• 30 malignancies were primitive (12 poorly
differentiated carcinomas and 8
adenocarcinomas) and 2 secondary.
Results
• The frozen section diagnosis was confirmed in all
(100%) of benign tumors. Among the
malignancies, in 8 cases the diagnosis was
deferred.
• In 3 cases (2 non-Hodgkin lymphoma and 1
pleomorph adenoma) the frozen section
diagnosis was different with the conclusive
report: 85% of concordance.
• The sensitivity for malignancies was 92%;
specificity was 99% in the histotype definition.
Conclusions
• The intraoperative frozen section in salivary
gland diagnosis and treatment is an important
and valid procedure, as confirmed by our
series, which is one of the most numerous in
literature. The fresh material examined during
surgical treatment may be utilized for biobanking and ultratsructural examination.
Acinic cell carcinoma, follicular type?
Adenoid cystic carcinoma!