Warthin tumors – risk factors, diagnostics, treatment

Abstract

Introduction. Warthin tumors are the second most common benign tumor of the salivary gland, located mainly in the parotid glands, sometimes bilaterally. The main risk factor is nicotine addiction. The aim of the study was to present our own experience in the diagnosis and treatment of salivary gland neoplasm, and to analyze the risk factors for the development of Warthin tumors. Materials and methods. The study group consisted of 55 patients operated on with Warthin tumors (between 2009 and 2023). 55 control individuals with no Warthin tumors were recruited. The patients underwent a retrospective analysis of risk factors for head and neck cancer. Results. Warthin tumor patients reported salivary gland diseases, such as urolithiasis, inflammation, dry mouth, nicotine addiction, and chronic diseases, such as hypercholesterolemia. In 83% of cases of fine-needle aspiration biopsy (FNAB) of Warthin tumors, results were confirmed by postoperative histopathological diagnosis. The therapy included extracapsular tumor removal, partial parotidectomy with preservation of the facial nerve, and removal of the submandibular gland. Postoperative complications were a cutaneous fistula and paresis of the marginal branch of the facial nerve. Conclusions. The study confirmed that nicotine addiction (smoking duration and number of cigarettes smoked per day) was the main risk factor for developing Warthin tumors. An increase in body-mass index (BMI), hypercholesterolemia, salivary gland diseases, and dry mouth symptoms manifested Warthin tumors. FNAB, ultrasonography (USG) and computer tomography (CT) or magnetic resonance imaging (MRI) with contrast were essential in the diagnostics and planning therapeutic strategy. The main treatment used in the clinic was extracapsular tumor removal.