Abstract:Introduction Warthin tumor is described as papillary cystadenoma lymphomatosum and is the second most common tumor of the parotid glands. Bilateral synchronous incidence is rare, occurring in 7 to 10% of the cases. It is more common in males between 60 and 70 years of age and is closely related to smoking. There is slow growth and the condition is a delimited nodule of regular outlines; it has low rates of malignant progression and recurrence.
Objective Report a case of synchronous bilateral Warthin tumor occu… Show more
“…WTs are the most common parotid tumor to present as multifocal bilateral nodules, which occurs in up to 10% of cases [17]. They often appear as a slowly progressive parotid gland swelling in older male subjects (typically >60 years) [20][21][22].…”
Even if the management of parotid gland tumors depends on the histopathological subtype, preoperative imaging of parotid gland tumors is clinically relevant. Preoperative imaging gives insight into the differentiation between benign and malignant tumors, which might potentially decrease the number of unnecessary aggressive surgeries. Characteristic imaging findings on cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can help narrow the differential diagnosis and guide the further management of patients presenting with parotid masses. While MRI is imperative for the determination of perineural spread, which is frequently encountered with malignant parotid tumors, CT is important for the evaluation of osseous invasion. Furthermore, multi-parametric MRI protocols provide insights into the tumor behavior and internal composition, which is helpful in the case of benign mixed tumors and others. While distant metastasis is uncommon with parotid neoplasms, PET/CT provides a valuable tool for the improved evaluation of loco-regional and distant metastatic disease. This article discusses the imaging features of common benign and malignant parotid tumors.
“…WTs are the most common parotid tumor to present as multifocal bilateral nodules, which occurs in up to 10% of cases [17]. They often appear as a slowly progressive parotid gland swelling in older male subjects (typically >60 years) [20][21][22].…”
Even if the management of parotid gland tumors depends on the histopathological subtype, preoperative imaging of parotid gland tumors is clinically relevant. Preoperative imaging gives insight into the differentiation between benign and malignant tumors, which might potentially decrease the number of unnecessary aggressive surgeries. Characteristic imaging findings on cross-sectional imaging, such as computed tomography (CT) and magnetic resonance imaging (MRI), can help narrow the differential diagnosis and guide the further management of patients presenting with parotid masses. While MRI is imperative for the determination of perineural spread, which is frequently encountered with malignant parotid tumors, CT is important for the evaluation of osseous invasion. Furthermore, multi-parametric MRI protocols provide insights into the tumor behavior and internal composition, which is helpful in the case of benign mixed tumors and others. While distant metastasis is uncommon with parotid neoplasms, PET/CT provides a valuable tool for the improved evaluation of loco-regional and distant metastatic disease. This article discusses the imaging features of common benign and malignant parotid tumors.
“…Most of the bilateral tumors are metachronous, with a very few cases of synchronous bilateral tumors reported in the literature. 2,[4][5][6][7] Only one previous case had simultaneous bilateral parotid and neck localizations. 5 We present a rare case of a patient with four bilateral synchronous intra-and extra-parotid Warthin tumors.…”
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.
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