Warthin's tumor

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Warthin's tumor is a benign cystic tumor of the salivary glands containing abundant lymphocytes and germinal centers.

Warthin's tumor

Alternate names

Papillary cystadenoma lymphomatosum (formerly)

Clinical features

• Warthin tumor is a benign tumor of the salivary gland.
• The first symptom is usually a painless, slow-growing bump in front of the ear, on the bottom of the mouth, or under the chin.
• Warthin tumors may increase in size over time, but few become cancerous.

Symptoms

• Warthin tumor is a benign (noncancerous) tumor of the salivary glands.
• They most commonly arise in the parotid glands, the largest salivary glands which are located in each cheek above the jaw in front of the ears.
• Approximately 5-14% of cases are bilateral and 12-20% of affected people experience multicentric (more than one tumor which formed separately from one another) disease.

Onset

The first symptom is usually a firm, painless bump. Without treatment, the swelling may gradually increase overtime which can cause facial nerve palsy (difficulty moving one side of the face).

Cause

The exact underlying cause of Warthin tumor is currently unknown.

Risk factors

• Smoking is thought to increase the risk of developing the tumor.
• Some studies suggest that radiation exposure and autoimmune disorders may also be associated with Warthin tumor.

Diagnosis

A diagnosis of Warthin tumor is often suspected based on the presence of characteristic signs and symptoms. The following tests may then be ordered to confirm the diagnosis and rule out other conditions that cause similar features:

• X-rays of the salivary gland (called a ptyalogram or sialogram)
• CT scan, MRI and/or ultrasound
• Salivary gland biopsy

Treatment

• Treatment of Warthin tumor generally includes surgery to remove the tumor or careful observation to watch for changes in the tumor over time.
• Because Warthin tumor is almost always benign, additional treatment such as radiation therapy and/or chemotherapy are not needed commonly.

Prognosis

• The long-term outlook for people with Warthin tumor is generally good.
• The tumor is almost always benign and is generally cured with surgery.
• The risk of recurrence (the tumor returning) is thought to be 2% or less.

Name

It is named for pathologist Aldred Scott Warthin, who described two cases in 1929.

The differential diagnosis includes sebaceous lymphadenoma and oncocytoma.

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  Low magnification micrograph of a Warthin tumor arising from the parotid gland.

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  Histopathology of Warthin tumor in the parotid gland. H&E stain.

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  Histopathology of Warthin tumor in the parotid gland. Another view of a file "Warthin tumor (1).jpg". H&E stain.

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  Histopathology of Warthin tumor in the parotid gland. Higher magnification of a file "Warthin tumor (1).jpg". H&E stain.

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  Intermediate magnification micrograph of a Warthin tumor.

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  High magnification micrograph of a Warthin tumor showing the characteristic bilayered epithelium.

Research articles (Pubmed)

• Most recent articles
• Ongoing trials

Warthin's tumor: an unknown pathogenesis: a neoplasm or a reactive hyperplasia? Rabia AB, Ebru LS, Tuba K, Didar G, Gulhan O, Cengiz O.Indian J Pathol Microbiol. 2015 Jan-Mar;58(1):7-11. doi: 10.4103/0377-4929.151154.PMID: 25673583 Free article. BACKGROUND AND AIMS: To examine the probable role of angiogenesis and lymphangiogenesis in the pathogenesis of Warthin's tumor. MATERIALS AND METHODS: Sixty-one patients with Warthin's tumor (n = 40), branchial cysts (n = 6), thymic cysts …

Back to the roots of Warthin's tumor of the parotid gland. Teymoortash A.Eur Arch Otorhinolaryngol. 2013 Sep;270(9):2397-402. doi: 10.1007/s00405-012-2309-8. Epub 2012 Dec 11.PMID: 23229644 Review. The exact etiopathogenesis of the Warthin's tumor of the parotid gland is still unclear. Since the time of the first histological description of this lesion by Hildebrand and later Albrecht and Arzt many different partly confusing hypothesis about pathogenesis

Warthin's tumor: an ultrastructural and immunohistochemical study of basilar epithelium. Dardick I, Claude A, Parks WR, Hoppe D, Stinson J, Burns BF, Little J, Brown DL, Dairkee SH.Ultrastruct Pathol. 1988;12(4):419-32. doi: 10.3109/01913128809064211.PMID: 2458648 Review. The cellular characteristics of the basilar epithelium in Warthin's tumor have had limited investigation. Ultrastructural examination of basal cells in 9 Warthin's tumors reveals that in addition to numerous mitochondria these cells possess a ri …

Warthin's tumor: a 40-year experience at The Johns Hopkins Hospital. Yoo GH, Eisele DW, Askin FB, Driben JS, Johns ME.Laryngoscope. 1994 Jul;104(7):799-803. doi: 10.1288/00005537-199407000-00004.PMID: 8022240 Review. Warthin's tumor previously has been thought to occur much more commonly in men than in women and rarely in African Americans. ...A positive smoking history was found in 88% of the men and in 89% of the women with a Warthin's tumor.

Frequently asked questions on Warthin's tumor

Frequently asked questions

• What causes a warthin's tumor?

The cause is unknown, but smoking, radiation exposure etc. can increase the risk.

• Do warthin tumors need to be removed?

It depends on the size, rate of growth, cosmetic aspects of the tumor and patient's medical condition and situation.

• What doctor treats parotid glands?

Maxillofacial surgeons are the specialists in this area although, dentists, and general physicians can treat parotid glands, depending on the issue at hand.

Help answer these questions

• Can a warthin tumor shrink?

• What is the most common parotid tumor?

• Do benign parotid tumors have to be removed?

• What is the recovery time for a Parotidectomy?

• Is a Parotidectomy major surgery?

• How serious is a parotid tumor?

• How fast do parotid tumors grow?

• Can a parotid gland grow back?

• Are parotid tumors hard?

• Can lymphoma spread to parotid gland?

• What causes a tumor in the parotid gland?

• Can parotid tumors go away on their own?

• How common is parotid tumor?

• Where do parotid tumors metastasize to?

• What percentage of parotid tumors are malignant?

• How long does a swollen salivary gland last?

• How is parotid gland surgery done?

• What is the cause of pleomorphic adenoma?

• What happens when parotid gland is removed?

• What is a benign mixed tumor?

See also

• Pleomorphic adenoma

Additional sources

• Kahn, Michael A. Basic Oral and Maxillofacial Pathology. Volume 1. 2001.

External links

• Wikipedia

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