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    The Importance of Imaging and Fine Needle Aspiration Biopsy in Primary Benign Parapharyngeal Space Tumors
    (2021) Aslan Felek, Sevim; Kaptan, Zeynep; Uğurlu, Burak Numan; Yiğit, Hasan; Ünverdi, Hatice; Demirci, Münir
    Objective: The purpose of this study is the comparison of the radiological pre-diagnosis with the cytopathological results acquired from fine needle aspiration biopsy (FNAB) and the post-operative final histopathological results in operated patients diagnosed to have primary benign parapharyngeal space (PPS) tumors. Material and Methods: In our study, 20 patients who were considered to be benign with preoperative imaging and FNAB between 2011 and 2017 were observed retrospectively. Patients suspected of malignancy with preoperative imaging or FNAB were excluded from the study. Results: From a total of 20 patients, 11 were female while 9 were male, and the mean age was 54 (21-78). In post-styloid region (n=10), the pre-operative radiological diagnosis was reported as paraganglioma (n=6), and peripheral nerve sheath tumors (n=4). In pre-styloid region (n=10), the preoperative radiological diagnosis was reported as deep lobe parotid tumor (warthin and pleomorphic adenoma) (n=6), lymphadenitis (n=1), minor salivary gland cyst (n=1), lipoma (n=1) and branchial cleft cyst (n=1). Compared to specimen results, preoperative imaging results of 20 patients were consistent with specimen in 18 patients, while specimen results were reported as malignant in 2 patients, although imaging was benign. FNAB was performed in 13 patients without vascular tumor suspicion, and results consistent with specimen results were obtained in 11 patients. Although FNAB results were reported as benign in 2 patients, the specimen result was reported as malignant. Conclusion: In our study, we found that, even if imaging and FNAB in PPS benign masses reported largely accurate results, it is rarely not able to rule out malignancy. These possibilities should be kept in mind when approaching the benign tumors of the parapharyngeal region.