title: Second opinion reporting in head and neck pathology: the pattern of referrals and impact on final diagnosis.
abstract: OBJECTIVE
  There is a need for second opinion histopathology referrals, especially for patients with head and neck pathology. The objective of this study was to determine the pattern and potential impact of referrals to a specialist oral and maxillofacial pathologist.
  
  
  METHODS
  Retrospective analysis of 566 consecutive referrals with demographic and clinical information was performed. The original diagnosis and the specialists' second opinion diagnosis were compared to assess for discrepancies and potential effect on patient management.
  
  
  RESULTS
  Seventy-five percent of cases were referred by general pathologists. Salivary gland (30%) and odontogenic tumors (12%) were the most commonly referred categories. Of the referred cases, 58 (9%) resulted in a significant change in diagnosis, impacting patient management. In 24 cases (4%) the diagnosis was revised from benign to malignant, and in 22 (4%) from malignant to benign.
  
  
  CONCLUSIONS
  This study highlights the need for referrals to oral and maxillofacial pathologists. A second opinion may assist in accurate diagnosis and patient management.
authors.affiliation: Oral Medicine and Pathology, Unit of Oral and Maxillofacial Pathology, The School of Clinical Dentistry, Sheffield, UK.
authors.forename: M H
authors.initials: MH
authors.lastname: Mullin
authors.affiliation: Specialist Registrar, Unit of Oral and Maxillofacial Pathology, The School of Clinical Dentistry, Sheffield, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Brierley
authors.affiliation: Professor in Oral and Maxillofacial Pathology, Honorary Consultant Oral & Maxillofacial Pathologist and Dean of Clinical Dentistry, Unit of Oral and Maxillofacial Pathology, The School of Clinical Dentistry, Sheffield, UK. Electronic address: p.speight@sheffield.ac.uk.
authors.forename: P M
authors.initials: PM
authors.lastname: Speight
mesh_terms: D000328:Adult; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D006801:Humans; D008297:Male; D012017:Referral and Consultation; D012189:Retrospective Studies