Warthin tumor: a potential source of diagnostic error.
OBJECTIVE
Warthin tumor, also known as papillary cystadenoma lymphomatosum, is a fairly common tumor. It makes up 14% to 30% of parotid tumors. There has been much interest in this tumor because of its typical and intriguing morphologic features: the association of benign-looking lymphoid and epithelial components and its frequent occurrence in the intraparotid or periparotid lymph nodes. Moreover, multifocal and/or bilateral Warthin tumors have been reported, and malignant transformation of Warthin tumor and its association with other malignancies have been documented. Warthin tumor can sometimes be confused with other pathologic lesions because of symptoms and signs that accompany the disease, so it could be treated as other pathologic lesions.


METHODS
We present 3 patients. The first one had a differentiated squamous cell carcinoma, no lymph node metastasis, and a Warthin tumor of the left parotid gland. The other 2 patients presented monoclonal gammopathy and a high tracer uptake in the left parotid gland by the 18F-fluorodeoxyglucose positron emission tomography/computed tomography total body.


CONCLUSIONS
The aim of this study was to evaluate the clinical and histopathologic features of 3 cases where clinical presentation of a Warthin tumor lies in the possible errors in diagnosis and decision making and not least in the management of the patient.
Department of Oral and Maxillo-Facial Surgery, Piazza Miraglia SUN, Naples, Italy. giuseppe.colella@unina2.it
Giuseppe
G
Colella
Umberto
U
Tozzi
Valentina
V
Pagliarulo
Pierfrancesco
P
Bove
D000235:Adenolymphoma / Q000175:diagnosis*; D000368:Aged; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008441:Maxillary Neoplasms / Q000175:diagnosis; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis; D010265:Paraproteinemias / Q000175:diagnosis; D010305:Parotid Diseases / Q000175:diagnosis; D010307:Parotid Neoplasms / Q000175:diagnosis*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18