Read More...Comparison of pre-operative FNAC based on Milan system (MSRSGC) with post-operative histology in Parotid gland tumours – Single surgeon experience of 6 years.">
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Title: Comparison of pre-operative FNAC based on Milan system (MSRSGC) with post-operative histology in Parotid gland tumours – Single surgeon experience of 6 years.


Authors: Aisha Noor2, Muhammad Aaqil Khan1
Publication: Journal of The Irish Head and Neck Society - 2025
Issue: 3 Volume: 3
Published: February, 2025 View PDF

Background :
Salivary gland tumours account for almost 4-6% of all Head & Neck cancers. Of these, almost 80-86% are Parotid gland tumours. Milan System of Reporting Salivary Gland Cytopathology (MSRSGC), formally introduced in 2018 has been a great tool for risk stratification of Salivary gland malignancies. This study focussed to evaluate its accuracy for ROM, by comparing with final histology.

Methods :
Retrospective, cross-sectional analysis of data, from 136 patients who had Parotidectomy at our department, under one surgeon, between November 2018 to November 2024 was done. Pre-op FNA was compared with their post-operative histology. They were divided into 6 groups as per Milan system, based on ROM & further classified based on final histology.

Results :
Milan Category ROM N= number of patients % of Post-operative malignant histology

Milan-1 25% 01 0.0 %
Milan-2 10% 01 0.0 %
Milan-3 10-35% 06 16.6 %
Milan-4(i) <5% 81 0.0 %
Milan-4(ii) 35% 35 22.8%
Milan-5 60% 08 87.5%
Milan-6 90% 04 75%
Out of 136 patients, following was the distribution according to Milan system ;

Actual risk stratification for Milan-5 is higher than suggested, whereas for Milan-6 it has shown be lower than suggested.

Conclusion :
MSRSGC has proved as credible system to assess risk of malignancy in patients having Parotid gland tumours. However, this system needs continued updates as per the data shared among various Head & Neck centres across the globe.

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