Controversial issues in core needle biopsy for diagnosing parotid neoplasms

Relevance. Accurate diagnosis of benign parotid gland tumors is a critical clinical task that requires an individualized approach to exclude potential malignant transformation. From this perspective, obtaining morphological results appears more reliable with core needle biopsy than with ultrasound-guided fine-needle aspiration cytology. The accuracy of the preoperative diagnosis directly determines the extent of surgical intervention and, in turn, significantly influences treatment outcomes and patient prognosis. Materials and methods . The study analyzed diagnostic and treatment outcomes in 127 patients with benign parotid gland neoplasms treated at the I. P. Pavlov First Saint Petersburg State Medical University and the N. N. Burdenko Main Military Clinical Hospital. The methodology of ultrasound-guided core needle biopsy of parotid gland tumors is described. Diagnostic concordance and discordance between fine-needle aspiration biopsy and core needle biopsy were evaluated against final postoperative histopathological findings in the cohort of 127 patients. Results . In 88 cases, concordance between fine-needle aspiration biopsy and postoperative histopathological examination was observed in 73% of cases, discordance in 18%, and non-diagnostic results in 9%. Among 46 patients who underwent preoperative core needle biopsy, diagnostic concordance with postoperative histology was achieved in 83% of cases, discordance in 11%, and non-diagnostic results in 6%. Conclusion . The study highlights key limitations of conventional diagnostic approaches to benign parotid gland neoplasms and presents multicenter clinical experience with ultrasound-guided core needle biopsy as an alternative method for diagnostic confirmation. In addition, practical recommendations for clinicians on the performance of this biopsy technique are provided.