Parotidectomy in Cape Town - a review of pathology and management

Summary Background. The spectrum of parotid disease in southern Africa has not previously been reported. Methods. A review of all parotidectomies performed by a single surgeon over a period of 10 years (1994 - 2004) in Cape Town, South Africa, is presented. Data were collected from a retrospective chart review. Results. One hundred and ninety-nine parotidectomies were performed and 196 pathology reports were reviewed. Pleomorphic adenoma was the most common benign tumour and metastatic cutaneous squamous cell carcinoma (SCC) was the most common malignancy. Warthin’s tumour had an equal gender distribution. Forty-five per cent of parotid tumours in males were malignant. The sensitivity, specificity and accuracy of fine-needle aspiration cytology (FNAC) in diagnosing malignancy were 73%, 98% and 94% respectively. Conclusions. In South African males almost half of parotid tumours are malignant. Warthin’s tumours are less common in Africa than in the West, and did not show a male preponderance. FNAC is a highly reliable method of excluding malignancy.