A 52-year-old woman presents with a slow-growing painless parotid swelling. Fine-needle aspiration cytology shows hypocellular stroma with myxoid background, bland epithelial cells in a chondromyxoid matrix, and dual-cell population. The most likely diagnosis and the surgical procedure of choice are:
- A Pleomorphic adenoma — superficial parotidectomy with facial nerve preservation ✓
- B Warthin tumour — superficial parotidectomy
- C Mucoepidermoid carcinoma — total parotidectomy with neck dissection
- D Oncocytoma — enucleation
Correct answer: A. Pleomorphic adenoma — superficial parotidectomy with facial nerve preservation
Explanation
The FNAC description — dual cell population (epithelial and myoepithelial cells), chondromyxoid stroma, hypocellular background — is classic for pleomorphic adenoma (mixed parotid tumour), the commonest parotid neoplasm. Superficial parotidectomy with meticulous facial nerve identification and preservation is the gold-standard surgical treatment; enucleation alone risks recurrence due to pseudocapsule rupture. Warthin tumour typically shows oncocytic cells and lymphoid background; mucoepidermoid carcinoma shows mucous cells and intermediate cells.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.