November 10, 2012

Parotid Warthin Tumor

Figures 1&2: Coronal and sagittal-reformatted CT images of an 80-year-old woman show a well circumscribed mass in the tail of the right parotid gland. There is homogeneous enhancement. 

Facts:  Warthin Tumor
  • Also known as papillary cystadenoma lymphomatosum
  • 14-30% of all parotid tumors
  • Almost always in older adults (peak incidence at 6th-7th decades of life)
  • Most commonly found within parotid gland (esp. tail). Occasionally in minor salivary glands.
  • MRI, although has high specificity and sensitivity for diagnosis, still cannot differentiate all malignant parotid tumors from benign ones. Tissue sampling is required for definitive diagnosis
  • Well-circumscribed solid mass, homogeneous enhancement and without calcification
  • If calcification is present in a benign-appearing parotid mass, pleomorphic adenoma should be considered first
  • US: multiple anechoic internal areas
  • MRI: low T1, high T2 signal intensity
  • Salivary scintigraphy: Accumulation of Tc-99m pertechnetate due to high mitochondrium

Hatch RL, Shah S. Warthin tumor: a common, benign tumor presenting as a highly suspicious mass. J Am Board Fam Med 2005;18: 320-322.

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