I have a hypoechoic solid lesion in my right parotid gland. My doctor says to have it surgically remove it and send it for examination to determine if it's benign or malignant. Is it best to do that, or to have a fnap test to determine malignancy first before surgery?

Dr. Nikhilesh BorkarOncologist14yrs exp

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For a Parotid lesion, I usually get an FNAC and an ultrasound done. If its a large swelling, I ask for an MRI, to know the characteristics of the lesion i.e. Benign or cancerous. Sometimes it is difficult to rule out cancer even after FNAC and MRI. Hence surgery is recommended for most cases. Pleomorphic adenoma is the most common tumor of the parotid, which is benign, but malignant transformation to carcinoma ex pleomorphic adenoma is seen in some cases, hence surgery is recommended in all cases. Warthins tumor is also a benign tumor, where we can observe if very small and Patient is reluctant for surgery. If you have a Parotid lesion, the surgery is usually superficial parotidectomy, preserving the facial nerve. If it is cancer and involving the nerve, then it is sacrificed and a nerve graft is inserted where feasible. If nerve graft is not feasible then facial reanimating surgery can be done at a later date. My advise would be to get an FNAC, if needed an MRI and followed by surgery. Also better to see an expert as if inadequate surgery it leads to recurrence and if not used to doing regularly, facial nerve damage may occur.  

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