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Warthin’s Tumor - Case and Review

Merilin Ivanova, Jovana Kitanovska, Kalina Naydenova, Tatyana Betova, Paulina Milanova

Abstract

Introduction: Warthin’s tumor is the second most common benign salivary gland tumor, also known as papillary cystadenoma lymphomatosum (PCL). It is located almost exclusively in the parotid gland, most commonly arising from the tail. The tumor is bilateral or multifocal, in up to 20% of the cases. Warthin’s tumor almost always occurs in older adults. In men, the peak incidence is in the 7th decade, whereas in women it is in the 6th decade. The disease was named Warthin’s tumor after the pathologist who published the first two case reports in the American literature in 1929.

Materials and Methods: The information included in this case report is based on a clinical case and detailed literature review. We present the case of a 66-year-old woman with a Warthin’s tumor of the left parotid gland. The tumor formation was painless with solid elastic consistency, movable, slowly growing and affecting the parotid gland on the left side.

Subtotal parotidectomy was carried out  without complications in the postoperative period.

Results: The pathomorphological survey showed a macroscopic view of well-demarcated encapsulated formation, the inside of which had solid whitish fields with a size of 20 mm. The result from the histological examination led to the diagnosis of Warthin’s tumor, and guided us for the treatment plan. Histologically, the tumor is with papillary and cystic structure composed of cylindrical oncocytic epithelial cells arranged in two layers and lymphocytic components often with forming of germline.

Conclusion: Medical history, clinical examination and all other investigations were indicative of a benign salivary gland tumor. Though the lesion is common, a higher number of incidences will provide better understanding of the pathology of Warthin’s tumor. The treatment consists of partial, subtotal or total parotidectomy with preservation of the facial nerve. A malignant transformation is very rare (only in 0.1% of cases) and it usually involves the epithelial component of the tumor.


Keywords

Warthin’s tumor, parotid gland, benign


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