An 11-year tertiary level audit of surgical pathology of the parotid in Western Australia

Background: The aim of the present study was to review the pathology found following parotid surgery at three Western Australian tertiary public hospitals over an 11-year period. Method: Retrospective data was extracted on all patients who underwent parotid surgery from 2003 to 2013. Prospectively maintained electronic hospital-based Information systems were interrogated for patient demographics and surgical specimen histology. Results: Parotid surgery was performed on 706 patients, of which 65% were male. The mean age was 61.0 (SD =16.8, range 8–98). Malignancy was more common (52%), than benign neoplasia (44%), with inflammatory/infective conditions uncommon (4%). Metastatic cutaneous squamous cell carcinoma (34%) was the most prevalent pathology followed by benign pleomorphic adenoma (28%). Primary salivary gland malignancy accounted for only 9% of parotid pathology. Advancing age (>50 years) and male gender increased the risk of a malignant parotid pathology. Conclusions: Western Australians undergoing parotid surgery demonstrated concerning rates of metastatic cutaneous malignancy, particular older males. A high degree of suspicion and timely investigation of any parotid mass in this cohort is warranted. Given the poor prognosis seen in advanced disease, primary prevention strategies are paramount.