Signs and symptoms of malignant parotid tumours: an objective assessment

Background: The clinical features that may be associated with malignancy in parotid tumours are well known. Classical teaching dictates caution in the ir presence hut this raises a false alarm in many cases. Formal studies loo king at these features are few. The aim of this article was to study quanti tatively those features that provide a better prediction of malignancy. Met hods: Clinical records of 186 consecutive patients treated for parotid tumo urs over a 12-year period were reviewed. Presence of suspicious clinical fe atures and the final histology in each patient were noted. Results: The ove rall pick-up rate for malignancy, based on clinical features alone, was aro und 30%. Palpable cervical lymph nodes, facial nerve palsy, deep fixation a nd rapid enlargement of the tumour were significant parameters indicative o f malignancy (p= 0.000 for all 4 parameters, chi-squared test). The risk of malignancy increased when multiple parameters were present together at the same time. Conclusion: Clinical features remained the most important singl e modality identifying malignancy in patients with parotid tumours. The log istic regression model allowed for simple clinical prediction of malignancy with improved sensitivity and much better specificity.