Risks of Neoplasia and Malignancy in Surgically Resected Cystic Parotid Lesions

Brian C. Boursiquot, Nancy J. Fischbein, Davud Sirjani, Uchechukwu C. Megwalu

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objectives: To evaluate the risks of neoplasm and malignancy in surgically treated cystic parotid masses compared with solid or mixed lesions and to evaluate the performance of fine-needle aspiration (FNA) in parotid cysts. Study Design: Retrospective cross-sectional study. Setting: Single-institution academic tertiary care center. Subjects and Methods: Patients without a history of human immunodeficiency virus or head and neck cancer who underwent parotidectomy for parotid masses and had preoperative imaging to characterize lesions as cystic, solid, or mixed (ie, partially cystic and partially solid). We assessed the risks of neoplasia and malignancy, adjusting for age, sex, race/ethnicity, facial nerve weakness, and history of malignancy. We also evaluated the sensitivity and specificity of FNA. Results: We included 308 patients, 27 of whom had cystic parotid masses (5 simple and 22 complex). Cystic masses were less likely to be neoplastic compared to solid or mixed masses (44% vs 97%; odds ratio [OR], 0.03; 95% confidence interval [CI], 0.01-0.07); however, there was no difference in the risk of malignancy (22% vs 26%; OR, 0.81; 95% CI, 0.32-2.10). Cystic masses were more likely to yield nondiagnostic FNA cytology results, but for diagnostic samples, FNA was 86% sensitive and 33% specific for diagnosing neoplasia and 75% sensitive and 83% specific for diagnosing malignancy. Conclusion: In our population, cystic masses undergoing surgery were less likely to be neoplastic but had a similar risk of malignancy as solid masses. The risk of malignancy should be considered in the management of cystic parotid masses.

Original languageEnglish
Pages (from-to)79-86
Number of pages8
JournalOtolaryngology - Head and Neck Surgery
Issue number1
StatePublished - 1 Jan 2020
Externally publishedYes


  • cysts
  • fine-needle biopsy
  • neoplasms
  • parotid gland
  • parotid neoplasms


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