Parotid Tumour FNA Investigation — ORE Part 1 MCQ
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Correct answer: A — Ultrasound-guided fine needle aspiration (FNA) cytology
UK national guidelines explicitly recommend ultrasound-guided fine needle aspiration cytology (reported by an expert histopathologist) for all salivary gland tumours, including those of the parotid. FNA is minimally invasive, carries no risk of facial nerve injury or tumour spillage, and provides cytological diagnosis essential for staging and treatment planning. Incisional biopsy risks tumour cell dissemination and facial nerve injury; imaging (MRI/CT) is used for staging after tissue diagnosis is established, not before; and serum tumour markers are not used for diagnosis of parotid neoplasia. This question discriminates candidates who understand the diagnostic algorithm—tissue sampling first, then imaging for surgical planning.
Reference: Management of Salivary Gland Tumours: United Kingdom National Multidisciplinary Guidelines (Sood S, McGurk M, Vaz F, 2016); https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4873929/