Neoplastic pathologies of the salivary glands are a heterogeneous group of relatively rare clinical conditions, characterized by highly variable symptoms and morpho-pathological images. These tumors account for approximately 8.5 % of oncological conditions of the head and neck region, with an incidence of .4–13.5 per 100,000 inhabitants (Stryjewska-Makuch et al., 2017). Almost 20 % of all tumors are malignant, and early treatment generally ensures acceptable therapeutic outcomes for most patients.

In the diagnostic process of salivary gland lesions, the commonly used radiological examinations include ultrasound and magnetic resonance imaging, followed by CT and PET performed in selected cases (Abdel Razek and Mukherji, 2018). The findings may be of non-unique interpretation due to the morphological heterogeneity of the lesions. Consequently, preliminary cytological and histological investigations, through fine needle aspiration cytology (FNAC), fine needle aspiration biopsy (FNAB), or more recently core needle biopsy (CNB) performed with or without ultrasound guidance, are the most commonly used subsequent diagnostic steps. These procedures generally have low morbidity and vary in sensitivity and specificity, intrinsic to the pathological analysis (Palacios-Garcia et al., 2023). Comparative studies in the literature that evaluate the diagnostic efficacy of these procedures tend to defer the definitive diagnosis to the intraoperative histological examination, highlighting inaccuracies, particularly for malignant histologies (Ashraf et al., 2010; Zbaren et al., 2018).

Core needle biopsies (CNBs) are minimally invasive biopsies performed under ultrasound guidance which have the advantage of obtaining solid samples that can be subjected to standard histological analysis (Kim and Kim, 2018). The literature supporting this therapeutic procedure is scarce and relatively recent compared to works on FNAC, whose specificity and sensitivity parameters are well defined. Nonetheless, adopting this procedure routinely may address diagnostic classification uncertainties through comprehensive histology and potential immunohistochemistry analysis, combined with ultrasound examination. The results could then guide subsequent therapeutic steps more precisely, proving to be both cost-efficient and harm-reductive.

This observational study aims to retrospectively evaluate the efficacy and reliability of the CNB procedure in parotid gland neoplasms, assessing the diagnostic accuracy in the preliminary diagnosis compared to the definitive histological analysis.