Background and aim: Salivary gland tumors constitute three percent of tumors in the head and neck region, with eighty percent of these originating in the parotid gland. The study aimed to evaluate and clarify the use of PI-RADS Scoring system and FNAC in diagnosing parotid lesions and compare it with post-operative histo-pathological diagnosis.
Patients and methods: This was an observational study conducted on patients presented with parotid swelling to the out-patient clinic of endocrine surgery unit at Mansoura University hospital. This study was conducted between October 2021 and the end of 2024.
Results: The PIRADS system was used to identify various types of parotid swellings, including warthin tumors, pleomorphic adenoma, and lipoma. The system's sensitivity and specificity were 100.0% and 61.11% for identifying malignant tumors, 72.7% and 62.5% for warthin tumors, 85.7% and 58.33% for pleomorphic adenoma, 100.0% and 47.1% for lipoma, and 100.0% and 61.1% for lympho-epithelial cysts. A malignant tumor was initially diagnosed as suspicious, but eight benign lesions were classified, including Warthin tumors, pleomorphic adenoma, bloody smear, reactive lymphoid tissue, and lipoma due to inaccessible aspiration.
Conclusion: The PI-RADS system and FNAC are effective in diagnosing parotid lesions, with the PI-RADS system being particularly effective in categorizing lesions as benign or potentially malignant. Its reliability in identifying different types of lesions and its high sensitivity for identifying malignancies like epithelial myoepithelial carcinoma, make it a valuable diagnostic tool for surgical planning and decision-making.