Warthin's Tumor, a Multifocal Disease

Abstract

Of all salivary gland neoplasms Warthin's tumor is the only lesion which is truly multicentric. The most common presentation of these multiple lesions is bilateral solitary masses. We present the first reported case of bilateral multiple tumors occurring simultaneously. The embryology of the salivary glands as it relates to the pathogenesis of this tumor is discussed. The differential diagnosis of the multinodular parotid gland is reviewed.

Fine Needle Aspiration Cytology and Diagnostic Pitfalls in Warthin’s Tumor with Necrotizing Granulomatous Inflammation and Facial Nerve Paralysis

“…14,[20][21][22] The most popular theory for the origin of WT is that it represents a proliferation of the epithelium of SG ducts that were trapped in lymph nodes during embryologic development. 2,12,19,[23][24][25] This hypothesis is supported by the histologic identification of ductal inclusions within parotid and paraparotid lymph nodes. Immunologic studies of the lymphoid component of WT demonstrate T and B cell ratios comparable to benign and reactive lymph nodes.…”

Bilateral synchronous and multifocal Warthin′s tumor mimicking metastases from lung cancer: A rare cause of false positive flourodeoxy glucose positron emission tomography/computed tomography

“…[45] Also, the occurrence of multifocal disease is generally metachronous. [6] However, a combination of bilateral, synchronous, and multifocal WTs as found in our patient is a rare occurrence. [7] There is limited work on FDG PET in salivary gland tumors, but WT, though of benign nature, has been shown to concentrate FDG avidly, with uptake often falling in the range of its malignant counterparts, thereby lowering the sensitivity of PET in separating benign and malignant salivary tumors.…”

Factors influencing the occurrence of multicentric and ‘recurrent’ Warthin's tumour: a cross sectional study

“…The reported incidence of multicentric tumours varies from 12 to 50% and is dependent on the methods used to evaluate multicentricity 9,11,18,21,23 . Macroscopic examination of the surgical specimen revealed 10% of the tumours to be multicentric 11 , routine histological examination revealed 19% to be multicentric 14,20 step serial whole specimen sectioning revealed 50% to be multicentric 18,21 .…”

“…It is often found in smokers and recent studies suggest an increasing incidence in women 4,6,8,11,17,19 . The mutifocal nature of Warthin's tumour has been well documented, with a reported incidence of 12-50% 9,11,18,21,23,27 . Little is known about the potential factors predicting the occurrence of multi-centric tumours.…”