Shared with The Gufo
Abstract
Background:Warthin tumor (WT), also known as papillary cystadenoma lymphomatosum, is the second most common benign salivary gland neoplasm after pleomorphic adenoma. It accounts for approximately 5–15% of all salivary gland tumors and occurs predominantly in the parotid gland. The tumor mainly affects older adults and is strongly associated with tobacco smoking. Although modern imaging modalities and cytological techniques contribute significantly to preoperative assessment, histopathological examination remains the definitive diagnostic standard. Case Presentation:A 70-year-old man presented with a slowly enlarging mass in the right parotid region associated with intermittent pain and local discomfort. His medical history was notable for chronic recurrent parotid sialadenitis and long-term tobacco use. Fine-needle aspiration biopsy revealed cystic-inflammatory material with a limited number of epithelial cells and no evidence of malignancy. Ultrasonography demonstrated multiple well-defined hypoechoic lesions with cystic components within the right parotid gland. The patient declined computed tomography and magnetic resonance imaging. Surgical excision was performed through a modified Blair incision using an extracapsular dissection technique with preservation of facial nerve function. Histopathological examination confirmed the diagnosis of Warthin tumor (ICD-O 8561/0). At 6-month follow-up, no evidence of recurrence was observed, and facial nerve function remained intact. Conclusion:This case highlights the importance of integrating clinical, radiological, cytological, and histopathological findings in the evaluation of parotid gland masses. Despite advances in diagnostic imaging and cytology, histopathological examination remains essential for definitive diagnosis. Surgical excision provides both effective treatment and diagnostic confirmation, particularly in symptomatic patients or when diagnostic uncertainty persists.
