Fine-needle aspiration cytology (FNAC): is it useful in preoperative diagnosis of parotid gland lesions?

BACKGROUND: Salivary gland tumors are an uncommon entity and its histopathology is highly varied due to heterogeneous cellular composition. The role of the preoperative fine-needle aspiration cytology (FNAC) remains controversial. The purpose of this study is to compare the cytologic findings of salivary gland lesions with the histologic diagnoses, in order to assess the usefulness and accuracy of fine-needle aspiration cytology in the diagnosis of parotid gland tumors. METHODS: A retrospective study was performed, regarding patients (n = 65) submitted to surgery for the treatment of parotid gland disease, who had performed preoperative FNAC, in our department between 2002 and 2012. A histologic diagnosis was considered as the gold standard for the assessment of sensitivity and specificity of FNAC. A cytohistologic correlation was done and appropriate statistical tests were applied. RESULTS: Concordance between FNAC and histological specimen analysis was 78%. FNAC specificity was 82% and sensitivity was 71%. Positive and negative predictive values were 65% and 86% and positive likelihood ratio and negative likelihood ratio were 3.92 and 0.35, respectively. The diagnostic accuracy for this test was 78%. CONCLUSION: Preoperative FNAC of parotid lesions is reasonably accurate and useful in diagnosing benign from malignant lesions and in planning appropriate approach for treatment.

Eleven Years of Parotid Gland Surgery in a Plastic and Reconstructive Department.

BACKGROUND: Salivary gland tumors are an uncommon entity, comprising 3% to 6% of all head and neck tumors. Approximately 75% to 80% occur in the parotid gland, and 80% are benign. It is difficult to establish epidemiologic characteristics of parotid gland tumors due to their low incidence. We performed a retrospective study to analyze clinical diagnostic and therapeutic features of patients submitted to parotid gland surgery. METHODS: A retrospective study was performed, regarding all the patients (n = 96) submitted to surgery for treatment of parotid gland disease in the Department of Plastic and Reconstructive Surgery of Centro Hospitalar de S. João (Porto, Portugal) between 2002 and 2012. Medical records were analyzed and the following data were collected: patient age at diagnosis, sex, tumor location, symptom, tumor position, preoperative diagnosis techniques, type of operation performed, pathology, postoperative complications, adjuvant therapy (radiotherapy or chemotherapy), follow-up time, and tumor recurrence. SPSS was used for statistical analysis. RESULTS: Fifty-two percent of the patients were males and 48% females and mean age of 52.02. In 68.75% of the patients, superficial parotidectomy was performed. Benign pathology was found in 72% patients, and pleomorphic adenoma the most common tumor (39%). Facial paralysis (41.7%), Frey syndrome (9.4%), and great auricular nerve hyposthesia (10.4%) were major complications. Tumor recurrence was observed in 16 patients (16.7%), which forced 17 reoperations (17.7%). There were 5 deaths (5.2%). CONCLUSION: For most tumors, superficial parotidectomy is an effective treatment with acceptable morbidity. In patients of malignancy, treatment should be aggressive.

Impact of the COVID-19 pandemic on percutaneous coronary interventions in Portugal.

INTRODUCTION: The COVID-19 pandemic has imposed an unprecedented burden on healthcare systems worldwide, changing the profile of interventional cardiology activity. OBJECTIVES: To quantify and compare the number of percutaneous coronary interventions (PCIs) performed for acute and chronic coronary syndromes during the first COVID-19 outbreak with the corresponding period in previous years. METHODS: Data on PCI from the prospective multicenter Portuguese Registry on Interventional Cardiology (RNCI) were used to analyze changes in PCI for ST-elevation myocardial infarction (STEMI), non-ST-elevation acute coronary syndromes (NSTE-ACS) and chronic coronary syndromes (CCS). The number of PCIs performed during the initial period of the COVID-19 outbreak in Portugal, from March 1 to May 2, 2020, was compared with the mean frequency of PCIs performed during the corresponding period in the previous three years (2017-2019). RESULTS: The total number of PCIs procedures was significantly decreased during the initial COVID-19 outbreak in Portugal (-36%, p<0.001). The reduction in PCI procedures for STEMI, NSTE-ACS and CCS was, respectively, -25% (p<0.019), -20% (p<0.068) and -59% (p<0.001). CONCLUSIONS: Compared with the corresponding period in the previous three years, the number of PCI procedures performed for STEMI and CCS decreased markedly during the first wave of the COVID-19 pandemic in Portugal.