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

Imaging:

• 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

Reference:
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.