Warthin's Tumor
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Warthin's tumor is a type of benign tumor of the salivary glands. It is also known as benign papillary cystadenoma lymphomatosum. Its etiology is unknown, but there is a strong association with cigarette smoking. Smokers are at 8 times greater risk of developing Warthin's tumor than the general population. |
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Locations
The gland most likely affected is the parotid gland. Though much less likely to occur than pleomorphic adenoma, Warthin's tumor is the second most common benign parotid tumor.
Characteristic
Warthin's tumor is more likely to occur in older adults between 60 -70 years of age. There is a slight female predilection according to recent studies, but historically it has been associated with a strong male predilection. This change is possibly due to the tumor's association with cigarette smoking and the growing use of cigarettes in women. 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.
Histology
The appearance of this tumor under the microscope is unique. There are cystic spaces surrounded by two uniform rows of cells with centrally placed pyknotic nuclei. The cystic spaces have epithelium referred to as papillary infoldings that protude into them. Additionally, the epithelium has lymphoid stroma with germinal center formation.
Treatment
Most of these tumors are treated with surgical removal. Recurrence is rare, occurring in 6 - 12% of cases. Warthin's tumor is highly unlikely to become malignant.
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