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Multifocal extraparotid Warthin's tumours mimicking metastatic squamous cell carcinoma of the upper neck

Published online by Cambridge University Press:  31 March 2015

S G Mistry ,
D Gouldesbrough  and
C Bem
S G Mistry*
Affiliation:
Department of Otolaryngology, Bradford Royal Infirmary, UK
D Gouldesbrough
Affiliation:
Department of Pathology, Bradford Royal Infirmary, UK
C Bem
Affiliation:
Department of Otolaryngology, Bradford Royal Infirmary, UK
*
Address for correspondence: Mr S G Mistry, Department of Otolaryngology, Bradford Royal Infirmary, Bradford BD9 6RJ, UK Fax: +44 1274 545 233 E-mail: smis83@doctors.org.uk
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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.

Case report:

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.

Conclusion:

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.

Keywords

Warthin tumourAdenolymphomaNeoplasm Metastasis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 5 , May 2015 , pp. 513 - 516
Copyright
Copyright © JLO (1984) Limited 2015 

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