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Multifocal extraparotid Warthin's tumours mimicking metastatic squamous cell carcinoma of the upper neck

Published online by Cambridge University Press:  31 March 2015

S G Mistry ,
D Gouldesbrough  and
C Bem
S G Mistry*
Affiliation:
Department of Otolaryngology, Bradford Royal Infirmary, UK
D Gouldesbrough
Affiliation:
Department of Pathology, Bradford Royal Infirmary, UK
C Bem
Affiliation:
Department of Otolaryngology, Bradford Royal Infirmary, UK
*
Address for correspondence: Mr S G Mistry, Department of Otolaryngology, Bradford Royal Infirmary, Bradford BD9 6RJ, UK Fax: +44 1274 545 233 E-mail: [email protected]
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Abstract

Background:

Warthin's tumours can show features of pseudo-neoplasia. They do not usually cause problems for diagnosis and management when present within the parotid gland. However, extraparotid Warthin's tumours that are associated with pseudo-neoplasia upon cytological analysis can mimic metastatic malignant disease. The case of a patient presenting with multifocal extraparotid Warthin's tumours is described.

Case report:

A 57-year-old male smoker presented with rapidly growing upper neck lumps. Fine needle aspiration cytology, magnetic resonance imaging and positron emission tomography findings were compatible with metastatic squamous cell carcinoma secondary to either an unknown primary upper aerodigestive or a parotid malignancy. The patient subsequently underwent total conservative parotidectomy and modified radical neck dissection. Final histology findings revealed multifocal benign Warthin's tumours with four extraparotid components.

Conclusion:

Warthin's tumours may present outside the parotid gland, present with multifocal lesions and mimic metastatic disease. Frozen section examination prior to radical resection should be considered to guide management.

Keywords

Warthin tumourAdenolymphomaNeoplasm Metastasis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 5 , May 2015 , pp. 513 - 516
Copyright
Copyright © JLO (1984) Limited 2015 

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References

1Goldenberg, D, Goldstein, BJ, eds. The salivary glands. In: Handbook of Otolaryngology: Head and Neck Surgery. New York. Thieme, 2010;447Google Scholar
2Watkinson, JC, Gilbert, RW, eds. Stell & Morans Textbook of Head and Neck Surgery and Oncology. London: Hodder Arnold, 2012Google Scholar
3Cawson, RA, Gleeson, MJ, Eveson, JW, eds. The Pathology and Surgery of the Salivary Glands. Oxford: ISIS Medical Media, 1997Google Scholar
4Roland, NJ, McRae, RDR, McCombe, AW. Key Topics in Otolaryngology, 2nd edn.London: Informa Healthcare, 2010;275Google Scholar
5Naujoks, C, Sproll, C, Singh, DD, Heikaus, S, Depprich, R, Kubler, NR et al. Bilateral multifocal Warthin's tumors in upper neck lymph nodes. Report of a case and brief review of the literature. Head Face Med 2012;8:11CrossRefGoogle ScholarPubMed
6Gleeson, M, Cawson, R. Benign salivary gland tumours. In: Gleeson, M, ed. Scott-Brown's Otorhinolaryngology Head and Neck Surgery, 7th edn.London: Hodder Arnold, 2008;2475CrossRefGoogle Scholar
7Van der Wal, JE, Davids, JJ, Van der Waal, I. Extraparotid Warthin's tumours: report of 10 cases. Br J Oral Maxillofac Surg 1993;31:43–4CrossRefGoogle ScholarPubMed
8Chae, SW, Sohn, JH, Shin, HS, Choi, JJ, Kim, YB. Unilateral, multicentric Warthin's tumor mimicking a tumor metastatic to a lymph node. Acta Cytol 2004;48:229–33CrossRefGoogle ScholarPubMed
9Snyderman, C, Johnson, JT, Barnes, El. Extraparotid Warthin's tumor. Otolaryngol Head Neck Surg 1986;94:169–75CrossRefGoogle ScholarPubMed
10Gnepp, DR. Warthin's tumor. Diagnostic Surgical Pathology of the Head and Neck. Philidelphia: W.B Saunders, 2001;360Google Scholar
11Klijanienko, J, Vielh, P. Fine-needle sampling of salivary gland lesions: II. Cytology and histology correlation of 71 cases of Warthin's tumor (adenolymphoma). Diagn Cytopathol 1997;16:221–53.0.CO;2-I>CrossRefGoogle ScholarPubMed
12Van den Brekel, MW, Risse, EK, Tiwari, RM, Stel, HV. False-positive fine needle aspiration cytologic diagnosis of a Warthin's tumor with squamous metaplasia as a squamous cell carcinoma. Acta Cytol 1991;35:477–8Google ScholarPubMed
13Taylor, TR, Cozens, NJ, Robinson, I. Warthin's tumour: a retrospective case series. Br J Radiol 2009;82:916–9CrossRefGoogle ScholarPubMed
14Ikeda, M, Motoori, K, Hanazawa, T, Naqai, Y, Yamamoto, S, Ueda, T et al. Warthin tumor of the parotid gland: diagnostic value of MR imaging with histopathologic correlation. AJNR Am J Neuroradiol 2004;25:1258–62Google ScholarPubMed
15Lee, YYP, Wong, KT, King, AD, Ahuja, AT. Imaging of salivary gland tumors. Eur J Radiol 2008;66:419–36CrossRefGoogle Scholar
16Yabuuchi, H, Matsuo, Y, Kamitani, T, Setoquchi, T, Okafuji, T, Soeda, H et al. Parotid gland tumors: can addition of diffusion-weighted MR imaging to dynamic contrast-enhanced MR imaging improve diagnostic accuracy in characterization? Radiology 2008;249:909–16CrossRefGoogle ScholarPubMed