Background: Neck masses are common presentations of various benign, malignant, and infectious diseases. In the majority, there is a need to perform histopathological examination to confirm diagnosis. This study reviews the diagnostic utility of ultrasound-guided core needle biopsy for the evaluation of head and neck masses in a monocentric setting.

Material and Methods: Core needle biopsies were performed with the disposable biopsy-system 'HistoCore' (BIP, Germany). A retrospective analysis on 239 core-needle biopsies in the head and neck area, performed between December 2017 and May 2023 at the Department for Otorhinolaryngology of the University Hospital Regensburg was performed. Analysis included the diagnostic performance and safety of the core needle biopsies.

Results: A total of 239 samples were evaluated. 97 Patients obtained a benign diagnosis, 128 a malignant diagnosis, in which in 39 cases the diagnosis was lymphoma. In 14 patients, subsequent excisional biopsy or curative surgery was necessary after core needle biopsy to confirm diagnosis. The analysis shows that the sensitivity for malignant diagnosis is 81% and the specificity 100%. Predictive positive value for malignancy was 100% and negative predictive value 66%. Overall, only three complications (all of them minor bleeding events) occurred.

Conclusions: Ultrasound-guided core-needle biopsy is a safe and quickly performed procedure with a high diagnostic yield in the diagnosis of head and neck masses. Additional examinations are rarely necessary and in patients with benign findings, more invasive procedures to confirm diagnosis could be avoided.

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