MARCH 22nd, 2023
Papillary Cystadenoma Lymphomatosum (Warthin Tumor)
Benign lymphoid tumor of the parotid gland
Presenting Symptoms: superficial, painless, well-circumscribed, cystic, slow-growing parotid mass
Epidemiology:
Second most common salivary tumor (behind pleomorphic adenoma),
M>>F
Smoking (almost always found in middle-aged to elderly men)
10% are multicentric and 10% bilateral
Etiology: Unclear; suggested risk factors include: EBV, tobacco use, autoimmune reaction, radiation
Pathophysiology: proposed mechanisms include:
Neoplastic proliferation of salivary ducts within intraparotid lymph nodes
Lymphoid tissue entrapped within parotid gland resulting from embryological variant
Hypersensitivity disease with accompanying metaplasia
Diagnosis: US (first-choice, includes evaluation of the contralateral as well), FNA, surgical biopsy, or technetium-99m scan
Treatment: Parotidectomy with CN VII preservation; recurrence rate effectively 0%
Afshin Teymoortash. Head and Neck: Salivary gland tumors: Warthins tumors. Atlas Genet Cytogenet Oncol Haematol.
Wikimedia Commons, 2023
Coronal CT (note heterogeneity)
Anil K. Lalwani: Current Diagnosis & Treatment Otolaryngology—Head and Neck Surgery, Fourth Edition Copyright McGraw-Hill Education. All rights reserved.
Further Reading:
Written by: Graham Pingree
