Role of ultrasonography in diagnosis and differentiation of pleomorphic adenomas: work in progress.

OBJECTIVE To estimate the utility of ultrasonography in diagnosis and differentiation of pleomorphic adenomas. DESIGN From the group of 88 patients examined by ultrasound, who were referred because of the tumor in the preauricular area, submandibular area, or cheek, pleomorphic adenoma was finally diagnosed in 24 (with multiple recurrent tumors in 2 patients). RESULTS Ultrasound was able to differentiate between benign and malignant lesions with 96% accuracy in this study. Predicting that the detected tumor was pleomorphic adenoma was possible with up to 84% accuracy. In 15 of 22 patients with primary pleomorphic adenoma, ultrasound guided fine-needle aspiration biopsy. High-resolution probes and harmonic imaging enabled demonstrationof histopathologic heterogeneity of pleomorphic adenomas (in 16 primary tumors [73%]). Of primary pleomorphic adenomas, 95% (21/22) had 5 or fewer vessels detectable in the whole lesion. CONCLUSIONS Modern ultrasound is highly valuable, useful, and reliable in differential diagnosis of tumors in the preauricular area, submandibular area, and cheek. It enables precise localization, measurements, and assessment of the structure of lesions. It may be the first and last imaging method needed to formulate the final diagnosis, or it may guide fine-needle aspiration biopsy. In many cases, ultrasound may also suggest the nature of the tumor.