|Other names: Papillary cystadenoma lymphomatosum, Warthin tumour, monomorphic adenoma, adenolymphoma, cystadenolymphoma|
|This Warthin's tumor presented as a parotid mass in a middle-aged male, who underwent superficial parotidectomy. The tumor, at the right of the image, is well-demarcated from the adjacent parotid tissue and tends to shell out from it.|
|Symptoms||Round, painless, slowly growing mass in the parotid gland|
|Complications||Facial nerve palsy, cancer|
|Usual onset||60s and 70s|
|Types||Epithelial predominance, mixed, lymphoid predominance|
|Risk factors||Epstein Barr virus, tobacco, autoimmune diseases, ionizing radiation, chronic inflammation|
|Differential diagnosis||Lymph node metastases, sebaceous lymphadenoma, cystadenoma|
|Frequency||2 to 15% of parotid tumors|
Warthin's tumor, also known as papillary cystadenoma lymphomatosum, is a non-cancerous tumor of the salivary glands. It generally presents as a round, painless, and slowly growing mass. It typically occurs in the parotid gland though may rarely occur in the mouth, nose, or eyelids. Complications may include facial nerve palsy, and in less than 1% of cases it may become cancerous.
Treatment is by surgical removal. Warthin's tumor represents about 2% to 15% of parotid tumors. It occurs most commonly in peoples 60s and 70s. It was first described in 1895 by Hildebrand and was subsequently named after pathologist Aldred Scott Warthin, who described two cases in 1929.
Signs and symptoms
Warthin's tumor primarily affects older individuals (age 60–70 years). There is a slight male predilection according to recent studies. The tumor is slow growing, painless, and usually appears in the tail of the parotid gland near the angle of the mandible. In 5–14% of cases, Warthin's tumor is bilateral, but the two masses usually are at different times. Warthin's tumor is highly unlikely to become malignant.
The gland most likely affected is the parotid gland. In fact, it is the only tumor virtually restricted to the parotid gland. Though much less likely to occur than pleomorphic adenoma, Warthin's tumor is the second most common benign parotid tumor.
The appearance of this tumor under the microscope is unique. There are cystic spaces surrounded by two uniform rows of epithelial cells with centrally placed pyknotic nuclei. The cystic spaces have epithelium referred to as papillary infoldings that protrude into them. Additionally, the epithelium has lymphoid stroma with germinal center formation.
Low magnification micrograph of a Warthin tumor arising from the parotid gland.
Intermediate magnification micrograph of a Warthin tumor.
High magnification micrograph of a Warthin tumor showing the characteristic bilayered epithelium.
- Limaiem, F; Jain, P (January 2020). "Warthin Tumor". PMID 32491572. Cite journal requires
- "Warthin tumor". rarediseases.info.nih.gov. Genetic and Rare Diseases Information Center (GARD) – an NCATS Program. Retrieved 13 February 2021.
- Witt, Robert L., ed. (2005). "Chapter 9 "Benign tumors, cysts, and tumor-like conditions of the salivary glands". Salivary Gland Diseases: Surgical and Medical Management. New York: Thieme Medical Publishers. p. 123. ISBN 1-58890-414-8.
- Kumar V, Abbas AK, Fausto N (2005). Robbins and Cotran pathologic basis of disease (7th ed.). St. Louis, MO: Elsevier Saunders. ISBN 0-7216-0187-1.