Accuracy of intraoperative consultation in the evaluation of salivary gland tumors

Albina Altemani
J. Bras. Patol. Med. Lab. 2015;51(1):6


Intraoperative consultation is mainly indicated when the histopathological diagnosis can influence the surgical approach. Regarding salivary gland lesions, intraoperative consultation is usually requested in the following circumstances: a) for cases with equivocal or inconclusive diagnosis by fine-needle aspiration biopsy, or when confirmation of the diagnosis is desired; b) to evaluate the adequacy of surgical margins; c) to determine whether lymph-node metastases are present; d) to determine the tumor type for optimal surgical management(1).

Classification of salivary gland tumors is commonly a challenging task. Benign and malignant tumors frequently share architecture and cytologic features, and, in addition, absence of significant cellular atypia, as well as of mitosis and necrosis, is a usual finding in the malignant ones(1-3). For this reason, in salivary gland tumors, an important key to differentiating benignancy from malignancy is infiltrative growth(1, 2). However, regardless of these difficulties, the accuracy rates of frozen section diagnosis have been reported to range from 88% to 98%, showing that this procedure is reliable and clinically valuable(1, 4, 5).Read more…