Extraparotid Warthin's tumor: Clinical manifestations, challenges, and controversies☆☆☆★

Abstract

Extraparotid Warthin's tumors continue to challenge the head and neck surgeon's diagnostic and therapeutic skills. A series of six extraporotid Warthin's tumors are presented to illustrate the need to keep a high index of suspicion for this lesion in the workup of cystic masses involving cervical levels II and III or in the event of a concomitant neck mass and a parotid Warthin's tumor. Discussion of the debate surrounding the embryogenesis and histogenesis of extraparotid Warthin's tumors follows. Clinical guidelines are suggested for the diagnosis, treatment, and follow-up of patients with extraparotid Warthin's tumors.

•Warthin-like papillary thyroid carcinoma: A rare tumor of the thyroid

“…1,2 Although about 8% of Warthin's tumors can be seen in extraparotideal locations such as in the lymph nodes of the cervical region, submandibular gland, minor salivary glands of the oral cavity, pharynx, and larynx, real extraparotideal Warthin's tumor are not expected to be at any other site than cervical nodes and does not exhibit the nuclear features of papillary carcinoma. 7 In the differential diagnosis of the reported case included a non-neoplastic nodule in Hashimoto's thyroiditis and extraparotideal Warthin's tumor but observation of the nuclear features of papillary carcinoma and immunohistochemical findings ensured the diagnosis of Warthin-like papillary thyroid carcinoma.…”

Multifocal Warthin’s Tumor: An Uncommon Presentation of Bilateral Cervical Lymphadenopathy

“…Late encapsulation of the parotid in the embryo allows the intermingling of undifferentiated lymphoid stroma with branching salivary ducts. After encapsulation, salivary ducts and acini may be trapped heterotopically within lymph nodes [ 8 ]. Heterotopic salivary gland tissue in the neck may arise sporadically via failed closure of the pre-cervical sinus of His within the branchial apparatus [ 9 ].…”

Extraparotid Warthin's Tumor: A Diagnostic Dilemma

“…7 Synderman et al have reviewed 14 cases of extraparotid Warthin's tumor. 8 Three patients had lesions discovered in periparotid tissue after superficial parotidectomy for intraparotid Warthin's tumor. One presented later with a contralateral, clinically evident cervical mass.…”