Second opinion reporting in head and neck pathology: the pattern of referrals and impact on final diagnosis

Objective. There is a need for second opinion histopathology referrals, especially for patients with head and neck pathology. The objective of this study was to determine the pattern and potential impact of referrals to a specialist oral and maxillofacial pathologist. Study Design. Retrospective analysis of 566 consecutive referrals with demographic and clinical information was performed. The original diagnosis and the specialists' second opinion diagnosis were compared to assess for discrepancies and potential effect on patient management. Results. Seventy-five percent of cases were referred by general pathologists. Salivary gland (30%) and odontogenic tumors (12%) were the most commonly referred categories. Of the referred cases, 58 (9%) resulted in a significant change in diagnosis, impacting patient management. In 24 cases (4%) the diagnosis was revised from benign to malignant, and in 22 (4%) from malignant to benign. Conclusion. This study highlights the need for referrals to oral and maxillofacial pathologists. A second opinion may assist in accurate diagnosis and patient management.