Diagnostic Accuracy of Fine-Needle Aspiration Cytology and MRI in Parotid Tumors: Correlation with Histopathology

Introduction: Parotid gland tumors represent the majority of salivary gland tumors and pose a diagnostic challenge due to their wide histological diversity. Reliable preoperative assessment is essential to guide surgical management.
Objective: To evaluate the degree of concordance between parotid fine-needle aspiration cytology (FNAC), imaging findings (MRI ± CT), and the definitive histological results of parotidectomy specimens.
Materials and Methods: A retrospective descriptive study was conducted in the Department of Otolaryngology and Head and Neck Surgery at Mohammed VI University Hospital of Marrakech, including 90 patients operated on for parotid tumors over a five-year period (2021–2025). All patients underwent FNAC and parotid imaging, followed by parotidectomy with histopathological examination.
Results: The mean age was 45 years (range: 18–75 years), with a female predominance. Benign tumors accounted for the majority of cases, mainly pleomorphic adenoma. FNAC showed a sensitivity of 75% and a specificity of 84.8% for the diagnosis of malignancy. MRI showed a sensitivity of 83.3% and specificity of 87.9%, while the combined FNAC–MRI approach improved diagnostic accuracy to 91.1%.
Conclusion: FNAC is a useful diagnostic tool for guiding the management of parotid tumors, with excellent specificity. MRI remains the reference imaging modality for preoperative characterization and should be performed prior to FNAC whenever possible.