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Malignant neck lumps: a measured approach.
M A Birchall1, N D Stafford, G P Walsh-Waring
1Ear, Nose and Throat Department, St Mary's Hospital, London.
Annals of the Royal College of Surgeons of England
|March 1, 1991
Summary
Open biopsy for neck masses can lead to complications and increased healthcare costs. A measured approach using fine-needle aspiration biopsy (FNAB) is a more reliable and less invasive diagnostic method.
Area of Science:
- Otolaryngology
- Oncology
- Surgical Pathology
Background:
- Establishing a histological diagnosis for neck masses typically involves open biopsy or a multi-step approach.
- Open biopsy carries risks of complications that can negatively impact patient management.
Purpose of the Study:
- To compare the outcomes and complications of open biopsy versus a measured approach for diagnosing neck masses.
- To evaluate the diagnostic accuracy and reliability of fine-needle aspiration biopsy (FNAB) for squamous cell carcinoma.
Main Methods:
- Retrospective analysis of 32 patients with squamous carcinoma of the neck.
- Comparison of outcomes between 10 patients managed with open biopsy and 22 patients managed with a measured approach (including FNAB and panendoscopy).
Main Results:
- Open biopsy led to complications in 70% of patients, adversely affecting management.
- Patients undergoing open biopsy required an average of one additional general anesthetic and stayed 7 days longer in the hospital.
- Fine-needle aspiration biopsy (FNAB) demonstrated high accuracy (91%), sensitivity (93%), and specificity (97%), particularly for squamous malignancy (100% specific).
Conclusions:
- Open biopsy should be avoided as a first-line investigation for neck masses.
- A measured diagnostic approach incorporating FNAB is superior to open biopsy for neck masses, offering better diagnostic yield and fewer complications.