title: Multifocal extraparotid Warthin's tumours mimicking metastatic squamous cell carcinoma of the upper neck.
abstract: BACKGROUND
  Warthin's tumours can show features of pseudo-neoplasia. They do not usually cause problems for diagnosis and management when present within the parotid gland. However, extraparotid Warthin's tumours that are associated with pseudo-neoplasia upon cytological analysis can mimic metastatic malignant disease. The case of a patient presenting with multifocal extraparotid Warthin's tumours is described.
  
  
  METHODS
  A 57-year-old male smoker presented with rapidly growing upper neck lumps. Fine needle aspiration cytology, magnetic resonance imaging and positron emission tomography findings were compatible with metastatic squamous cell carcinoma secondary to either an unknown primary upper aerodigestive or a parotid malignancy. The patient subsequently underwent total conservative parotidectomy and modified radical neck dissection. Final histology findings revealed multifocal benign Warthin's tumours with four extraparotid components.
  
  
  CONCLUSIONS
  Warthin's tumours may present outside the parotid gland, present with multifocal lesions and mimic metastatic disease. Frozen section examination prior to radical resection should be considered to guide management.
authors.affiliation: Department of Otolaryngology,Bradford Royal Infirmary,UK.
authors.forename: S G
authors.initials: SG
authors.lastname: Mistry
authors.affiliation: Department of Pathology,Bradford Royal Infirmary,UK.
authors.forename: D
authors.initials: D
authors.lastname: Gouldesbrough
authors.affiliation: Department of Otolaryngology,Bradford Royal Infirmary,UK.
authors.forename: C
authors.initials: C
authors.lastname: Bem
mesh_terms: D000235:Adenolymphoma / Q000175:diagnosis*; D044963:Biopsy, Fine-Needle; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000556:secondary; D003937:Diagnosis, Differential; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000556:secondary; D006801:Humans; D008297:Male; D008875:Middle Aged; D010307:Parotid Neoplasms / Q000175:diagnosis*; D000077195:Squamous Cell Carcinoma of Head and Neck
keywords: Adenolymphoma; Neoplasm Metastasis; Warthin tumour