Head and neck

Vol. 45: Issue 6 - December 2025

Role of fine needle aspiration biopsy in the diagnosis of pleomorphic adenoma

Authors

Paolo Tropiano , Davide Rizzo , Dario Antonio Mele , Alessandra Manca , Michele Angelo Bella , Angelo Deiana , Claudia Crescio , Simona Varrucciu , Luca Mureddu , Lea Calò , Chiara Rita Tiana , Roberto Gallus , Antonio Cossu , Jacopo Galli , Francesco Bussu

Key words: fine needle aspiration biopsy, pleomorphic adenoma, multiparametric analysis, salivary glands, cytology
DOI: 10.14639/0392-100X-A1057
Publication Date: 2025-11-28

Abstract

Objective. The aim of the present study is to assess the reliability of fine needle aspiration biopsy (FNAB), an acknowledged diagnostic tool for head and neck lumps, in the diagnosis of pleomorphic adenoma (PA), a common benign salivary tumour.
Methods. We retrieved the FNABs performed at the Otolaryngology Division of a referral centre from September 2017 to September 2023. FNABs were ultrasound (US) guided and followed by rapid on-site evaluation (ROSE). Before surgery, cytological findings were integrated with clinical information to obtain a multiparametric diagnosis (MD).
Results. Of 633 FNAB reports, 413 involved major salivary glands. Among these, 214 patients underwent surgery, and final histopathology confirmed PA in 76 cases. FNAB and multiparametric evaluation yielded specificities of 97% each, and sensitivities of 89.5% and 93.4%, respectively.
Conclusions. US-guided FNAB, performed by head and neck surgeons, associated with ROSE, performed by anatomical pathologist, and MD, is highly reliable for diagnosing PA, thus improving clinical management and prioritisation of cases for surgery. This is particularly relevant considering that PA, even if benign, has a significant rate of malignant transformation and multifocal recurrences, creating notable concerns under both an oncological and functional (facial nerve sparing) points of view.

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Authors

Paolo Tropiano - Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0000-0002-6328-1511

Davide Rizzo - Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy https://orcid.org/0000-0003-1830-3731

Dario Antonio Mele - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy https://orcid.org/0000-0002-0765-9233

Alessandra Manca - Institute of Pathology, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0000-0002-5395-9501

Michele Angelo Bella - Institute of Pathology, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0009-0009-2801-7668

Angelo Deiana - Institute of Pathology, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0009-0002-1188-5142

Claudia Crescio - Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0000-0003-1515-1867

Simona Varrucciu - Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0009-0009-7210-0995

Luca Mureddu - Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy. Corresponding author - muredduluca@gmail.com https://orcid.org/0000-0002-2598-198X

Lea Calò - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy https://orcid.org/0000-0001-7820-3535

Chiara Rita Tiana - Institute of Radiology, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0009-0009-4303-938X

Roberto Gallus - Otolaryngology, Mater Olbia Hospital, Olbia, Italy https://orcid.org/0000-0003-3343-2806

Antonio Cossu - Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy; Institute of Pathology, Azienda Ospedaliero Universitaria, Sassari, Italy https://orcid.org/0000-0002-2390-2205

Jacopo Galli - Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy https://orcid.org/0000-0003-1599-4573

Francesco Bussu - Otolaryngology Division, Azienda Ospedaliero Universitaria, Sassari, Italy; Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy https://orcid.org/0000-0001-6261-2772

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Copyright

Copyright (c) 2025 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale

How to Cite
Tropiano, P., Rizzo, D. ., Mele, D. A., Manca, A., Bella, M. A., Deiana, A., Crescio, C. ., Varrucciu, S. ., Mureddu, L., Calò, L. ., Tiana, C. R., Gallus, R. ., Cossu, A. ., Galli, J. ., & Bussu, F. . (2025). Role of fine needle aspiration biopsy in the diagnosis of pleomorphic adenoma. ACTA Otorhinolaryngologica Italica, 45(6), 399–405. https://doi.org/10.14639/0392-100X-A1057
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