Epidemiological Characterizations and Diagnostic Strategies Variation in Parotid Gland Tumors (2010-2024): Observations Based on 2133 Cases.

OBJECTIVE: To analyze epidemiological trends and diagnostic approaches for parotid gland tumors (PGTs) from 2010 to 2024 and predict future trends. METHODS: A total of 2591 surgically and pathologically confirmed PGTs were reviewed. After excluding metastatic tumors, non-neoplastic lesions, hematolymphoid tumors, and other non-epithelial lesions, 2133 primary epithelial PGTs were included. Temporal trends in the benign-to-malignant ratio and the distribution of pathological subtypes were analyzed across five consecutive 3-year intervals. An autoregressive moving average (ARMA) model was employed to forecast future trends. The diagnostic performance of ultrasonography, CT, and MRI was subsequently evaluated. RESULTS: Benign tumors comprised 88.0% (n = 1876), with Warthin tumor (WT, 48.5%) surpassing pleomorphic adenoma (PA, 40.7%). Malignant tumors constituted 12.0% (n = 257), with mucoepidermoid carcinoma predominating (27.8%). The proportion of WTs increased over time and is projected to rise further, while malignant tumors are expected to reach a plateau at around 11%. WT was most common in older males (51-70 years), whereas PA predominated in females. MRI showed the highest sensitivity for malignancy (51%) but moderate specificity (81%). CT had a sensitivity of 39% and specificity of 87%. Ultrasound had high specificity (85%) but very low sensitivity (10%). Ultrasound use declined after 2019, while CT and MRI utilization increased. CONCLUSION: The histological landscape of PGTs has shifted, with WT now emerging as the most common benign neoplasm. While ultrasonography remains the primary imaging modality, CT and MRI are increasingly preferred due to their superior diagnostic accuracy.