Bilateral multifocal synchronous intra- and extra-parotid Warthin tumors: case report and review of literature

Abstract

Case reporta 72-year-old woman presented at our division with a 12 months history of bilateral parotid swelling. apart from the habit of smoking, her medical history was normal. Clinical examinations confirmed bilateral mobile, painless swelling, without intra-oral lesions. Facial nerves function was normal. Ultrasonography (US) showed multifocal bilateral parotid nodules, so magnetic resonance imaging (Mri) was programmed.Mri revealed four bilateral nodular lesions of the parotid glands: three nodules in the right parotid gland and one nodule in the left gland. They were well defined and rounded in appearance, with mild enhancement after administration of intravenous contrast medium (Figure 1). the left nodule measured 2 cm in diameter and it was in the superficial lobe. In the right parotid gland, the bigger nodules measured 2.2 cm and 2.1 cm in maximum dimension, while a minor nodule had a 1 cm diameter. the 2.1 cm nodule was in the deep lobe of right parotid gland.Fine-needle aspiration biopsy (FnaB), under ultrasonography guidance, was carried out on the bigger right nodule and on the left nodule. it was indicative of Warthin tumors.