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Parotid incidentalomas: a systematic review

Published online by Cambridge University Press:  26 July 2021

CSG Thompson ,
T Nolli  and
M Bannister
CSG Thompson*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Victoria Hospital, Kirkcaldy, Fife, Scotland, UK
T Nolli
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Victoria Hospital, Kirkcaldy, Fife, Scotland, UK
M Bannister
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, Victoria Hospital, Kirkcaldy, Fife, Scotland, UK
*
Author for correspondence: Mr C Thompson, Department of Otolaryngology – Head and Neck Surgery, Victoria Hospital, Fife, Scotland, UK E-mail: chris.thompson2@nhs.scot
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Abstract

Objective

Parotid incidentalomas on fluorodeoxyglucose positron emission tomography/computed tomography imaging are rare. A systematic review was performed to assess their aetiology and association with scanning indication, and to develop an evidence-based algorithm for their management.

Methods

A literature search was performed on 25 August 2020 using the keywords ‘incidentaloma’, ‘incidental finding’, ‘parotid’, ‘parotid gland’, ‘salivary gland’ and ‘head and neck’. Articles were reviewed by two authors before their inclusion.

Results

Forty articles were included, totalling 558 incidentalomas. The mean incidence was 0.74 per cent. Lung cancer was the most common imaging indication. The most common aetiologies were cystadenolymphoma, pleomorphic salivary adenoma and metastases. Only cystadenolymphoma (p = 0.015) and pleomorphic salivary adenoma (p = 0.011) were significantly associated with a primary malignancy (lung). The most common further investigations were aspiration cytology, ultrasound imaging and core biopsy, usually prior to parotidectomy.

Conclusion

If appropriate, parotid incidentalomas should be followed up with flexible endoscopy, skin examinations, and head and neck examinations. Ultrasound-guided core biopsy provides higher accuracy, avoiding repeat sampling and excision biopsy.

Keywords

IncidentalomaParotid GlandSalivary GlandsPositron-Emission Tomography
Type
Review Article
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 9 , September 2021 , pp. 765 - 769
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Footnotes

Mr C Thompson takes responsibility for the integrity of the content of the paper

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