title: Preoperative evaluation and surgical planning of submandibular gland tumors.
abstract: Roughly half of submandibular gland neoplasms are malignant. Because preoperative information on the nature of these tumors remains limited, both preoperative evaluation and assessment of the extent of primary surgery warrant guidelines that are more accurate.
  
  
  
  We evaluated the preoperative examinations and management of all submandibular gland neoplasms treated surgically at the Helsinki University Hospital between 2000 and 2010.
  
  
  
  Of the 83 tumors, 58 (70%) were benign and 25 (30%) were malignant. Of the benign tumors, 54 (93%) were pleomorphic adenomas. The cytology in 8 patients (10%) was class IV or V, and in 12 patients was class III; the tumors in 9 of these 12 patients turned out to be malignant. Of all malignancies, 10 (40%) required additional more extensive surgery.
  
  
  
  Ultrasound-guided fine-needle aspiration cytology (FNAC) proved useful, with limitations, in preoperative examination. Surgeons should always obtain wide margins whenever possible, even when clinical means or cytology indicates no malignancy. © 2017 Wiley Periodicals, Inc. Head Neck 39: 1071-1077, 2017.
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Timo
authors.initials: T
authors.lastname: Atula
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Juha
authors.initials: J
authors.lastname: Panigrahi
authors.affiliation: Department of Pathology, HUSLAB, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Jussi
authors.initials: J
authors.lastname: Tarkkanen
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
authors.forename: Antti
authors.initials: A
authors.lastname: Mäkitie
authors.affiliation: Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.|School of Dentistry, University of California, Los Angeles, California.
authors.forename: Katri
authors.initials: K
authors.lastname: Aro
mesh_terms: D008949:Adenoma, Pleomorphic / Q000401:mortality / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D044963:Biopsy, Fine-Needle / Q000379:methods; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005387:Finland; D006801:Humans; D061705:Image-Guided Biopsy / Q000379:methods*; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D010347:Patient Care Planning; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D018570:Risk Assessment; D013363:Submandibular Gland / Q000473:pathology / Q000601:surgery*; D013365:Submandibular Gland Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome; D018608:Ultrasonography, Doppler
keywords: cytology; fine-needle aspiration; frozen section biopsy; salivary gland; treatment