title: If cytology of Warthin tumor is accurate, can management be conservative?
abstract: We conducted a retrospective study to assess the accuracy of fine-needle aspiration cytology (FNAC) in the diagnosis of Warthin tumor and to evaluate the subsequent risk of conservative nonsurgical management. We reviewed the records of 75 patients (76 tumors) with a parotid mass that had been diagnosed as a Warthin tumor by FNAC. This patient population was made up of 64 men and 11 women, aged 46 to 93 years (mean: 67). Of the 76 tumors, 40 were treated with surgical excision and 36 with conservative measures. Histology of the 40 excised parotid masses revealed that 38 (95%) were indeed Warthin tumors, 1 (2.5%) was a low-grade adenocarcinoma, and 1 was benign-not otherwise specified. None of the 36 tumors underwent malignant transformation either clinically or on repeat FNAC (if performed) during a follow-up of 4 to 120 months (mean: 55.5 ± 32.2). We conclude that conservative management of Warthin tumors confidently diagnosed on FNAC may be an option for patients who are unwilling or unable to undergo surgical excision.
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong SAR, China. lexvlantis@cuhk.edu.hk.
authors.forename: Alexander C
authors.initials: AC
authors.lastname: Vlantis
authors.forename: Siu Kwan
authors.initials: SK
authors.lastname: Ng
authors.forename: Chi Keung
authors.initials: CK
authors.lastname: Mak
authors.forename: Jackie M
authors.initials: JM
authors.lastname: Cheung
authors.forename: Amy B
authors.initials: AB
authors.lastname: Chan
authors.forename: C Andrew
authors.initials: CA
authors.lastname: van Hasselt
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000473:pathology*; D000235:Adenolymphoma / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D000072700:Conservative Treatment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010306:Parotid Gland / Q000601:surgery*; D010307:Parotid Neoplasms / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D012680:Sensitivity and Specificity