Clinicopathological analysis of parotid lesions: a single-center experience of 673 surgically treated patients.

BACKGROUND: Parotid gland lesions comprise a wide range of pathological entities with diverse clinicopathological features. AIMS/OBJECTIVES: This study aimed to evaluate the demographic, surgical, cytological, and histopathological characteristics of 673 patients who underwent parotidectomy at a tertiary referral center over a 9-year period. MATERIAL AND METHODS: Patients who underwent parotid surgery between May 2017 and May 2026 were retrospectively reviewed. Demographic, clinical, surgical, cytological, and histopathological data, including age, sex, lesion laterality, tumor size, surgical procedure, neck lymph node dissection status, fine-needle aspiration biopsy (FNAB) results, and histopathological diagnosis, were analyzed. RESULTS: Warthin tumor (54.1%) and pleomorphic adenoma (39.4%) were the most common benign parotid lesions. Metastatic squamous cell carcinoma was the most frequent malignant histopathological diagnosis (26.8%), followed by mucoepidermoid carcinoma (11.6%) and carcinoma ex pleomorphic adenoma (10.7%). Warthin tumor demonstrated significant male predominance (81.4% vs 18.6%; p < 0.001). Fine-needle aspiration biopsy demonstrated strong concordance with histopathology (p < 0.001), with 77.8% sensitivity, 99.8% specificity, and 96.8% overall diagnostic accuracy. CONCLUSIONS AND SIGNIFICANCE: Benign lesions predominate among parotidectomy patients, with Warthin tumor being the most common diagnosis. Although FNAB demonstrates high specificity and accuracy in predicting malignancy, non-diagnostic and false-negative results of FNAB necessitate correlation with clinical, radiological, and histopathological findings.