title: Positron emission tomography in Warthin's tumor mimicking malignancy impacts the evaluation of head and neck patients.
abstract: OBJECTIVE
  1) To determine SUVs and PET/CT characteristics of Warthin's tumors in patients presenting to a head and neck cancer clinic. 2) To analyze the impact of PET/CT on the clinical course of these patients.
  
  
  METHODS
  This is a single-institution retrospective analysis of patients with proven Warthin's tumors who underwent PET/CT done at or near the time of diagnosis and presented to a head and neck cancer practice. Data were obtained from the electronic medical records of these patients and the imaging and pathology databases.
  
  
  RESULTS
  Six patients with Warthin's tumor met the criteria for and form the study cohort. Three patients had bilateral tumors. The SUVs for Warthin's varied from 3.4 to 16.1 in these patients, with an average of 7.8 and these SUVs were higher for Warthin's than for the cancers. These findings on PET/CT in this group required additional workup of all patients and required FNA, surgery or SPECT-CT to confirm the diagnosis.
  
  
  CONCLUSIONS
  Although it is known that Warthin's tumor may be hypermetabolic on PET, this finding in the parotid or neck on PET/CT alters the evaluation and treatment of head and neck cancer patients and patients with cancers outside the head and neck by raising the concern about metastatic disease or multiple primary cancers. In other patients, PET/CT obtained for other reasons may prompt concern about incidental malignancy. This series specifically characterizes clinical features, SPECT-CT and FNA findings that can help reinforce the diagnosis of Warthin's and facilitate management.
authors.affiliation: Department of Otolaryngology, West Virginia University. Electronic address: christopher.rassekh@uphs.upenn.edu.
authors.forename: Christopher H
authors.initials: CH
authors.lastname: Rassekh
authors.affiliation: Department of Otolaryngology, West Virginia University.
authors.forename: Jamey L
authors.initials: JL
authors.lastname: Cost
authors.affiliation: Department of Radiology, West Virginia University.
authors.forename: Jeffery P
authors.initials: JP
authors.lastname: Hogg
authors.affiliation: Department of Otolaryngology, West Virginia University.
authors.forename: Mike K
authors.initials: MK
authors.lastname: Hurst
authors.affiliation: Department of Radiology, West Virginia University.
authors.forename: Gary D
authors.initials: GD
authors.lastname: Marano
authors.affiliation: Department of Pathology, West Virginia University.
authors.forename: Barbara S
authors.initials: BS
authors.lastname: Ducatman
mesh_terms: D000235:Adenolymphoma / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle / Q000379:methods; D016208:Databases, Factual; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D010307:Parotid Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D012189:Retrospective Studies; D018570:Risk Assessment; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D014057:Tomography, X-Ray Computed / Q000379:methods
chemical_list: D019788:Fluorodeoxyglucose F18