Tumours of the parotid--the value of clinical assessment

A series of 131 tumours of the parotid was reviewed retrospectively to ascertain the value of clinical features in distinguishing between malignant and benign tumours. The overall proportion of malignancy in this group of tumours was 17% (23 tumours). It was found that sex, age, size, duration of symptoms, and history of rapid enlargement were non-contributory to a diagnosis of malignancy, while the presence of facial nerve paralysis, skin infiltration or ulceration, and metastatic neck nodes were found only in patients with malignant tumours. A history of pain, hardness, and fixity, found in 30-50% of parotid cancers, were significant indicators of malignancy. As the yield of routine frozen section examination on all resected parotid tumours is low, it is recommended that if resources are limited, the examination be reserved for tumours highly suspicious of being malignant.