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Published online: 2024-03-27
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Warthin tumors – risk factors, diagnostics, treatment

Katarzyna Kolary-Siekierska1, Anna Jałocha-Kaczka1, Piotr Niewiadomski1, Jarosław Miłoński1
Affiliations
  1. Department of Otolaryngology and Laryngological Oncology, Audiology and Phoniatrics, Medical University of Lodz, Lodz, Poland

open access

Ahead of print
Original articles – Tumor biology
Published online: 2024-03-27

Abstract

Introduction. Warthin's tumors are the second most common benign tumors of the salivary gland, located mainly in the parotid glands, sometimes bilaterally. The main risk factor is nicotine addiction. The aim of the study was to present our own experience in the diagnosis and treatment of salivary gland neoplasm and to analyze the risk factors for the development of Warthin tumors.

Materials and methods. The study group consisted of 55 patients operated on Warthin’s tumors (between 2009 and 2023). 55 control individuals with no Warthin tumors were recruited. The patients underwent a retrospective analysis of risk factors for head and neck cancer.

Results.  Warthin tumors patients reported salivary gland diseases, such as urolithiasis, inflammation, dry mouth, nicotine addiction, and chronic diseases, such as hypercholesterolemia. In 83% fine-needle aspiration biopsy (FNAB) of Warthin's tumor results were confirmed by the postoperative histopathological diagnosis. The therapy included extracapsular tumor removal, partial parotidectomy with preservation of the facial nerve, and removal of the submandibular gland. Postoperative complications were a cutaneous fistula and paresis of the marginal branch of the facial nerve.

Conclusions. The study confirmed that nicotine addiction (smoking duration and number of cigarettes smoked per day) was the main risk factor for the developing Warthin's tumor. An increase in BMI, hypercholesterolemia, salivary gland diseases, and dry mouth symptoms manifested Warthin’s tumors. FNAB, ultrasonography (USG) and computer tomography (CT) or magnetic resonance imaging (MRI) with contrast were essential in the diagnostics and planning therapeutic strategy. The main treatment used in the clinic was extracapsular tumor removal.

Abstract

Introduction. Warthin's tumors are the second most common benign tumors of the salivary gland, located mainly in the parotid glands, sometimes bilaterally. The main risk factor is nicotine addiction. The aim of the study was to present our own experience in the diagnosis and treatment of salivary gland neoplasm and to analyze the risk factors for the development of Warthin tumors.

Materials and methods. The study group consisted of 55 patients operated on Warthin’s tumors (between 2009 and 2023). 55 control individuals with no Warthin tumors were recruited. The patients underwent a retrospective analysis of risk factors for head and neck cancer.

Results.  Warthin tumors patients reported salivary gland diseases, such as urolithiasis, inflammation, dry mouth, nicotine addiction, and chronic diseases, such as hypercholesterolemia. In 83% fine-needle aspiration biopsy (FNAB) of Warthin's tumor results were confirmed by the postoperative histopathological diagnosis. The therapy included extracapsular tumor removal, partial parotidectomy with preservation of the facial nerve, and removal of the submandibular gland. Postoperative complications were a cutaneous fistula and paresis of the marginal branch of the facial nerve.

Conclusions. The study confirmed that nicotine addiction (smoking duration and number of cigarettes smoked per day) was the main risk factor for the developing Warthin's tumor. An increase in BMI, hypercholesterolemia, salivary gland diseases, and dry mouth symptoms manifested Warthin’s tumors. FNAB, ultrasonography (USG) and computer tomography (CT) or magnetic resonance imaging (MRI) with contrast were essential in the diagnostics and planning therapeutic strategy. The main treatment used in the clinic was extracapsular tumor removal.

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Keywords

Warthin tumor; salivary gland neoplasm; diagnostic; surgery treatment

About this article
Title

Warthin tumors – risk factors, diagnostics, treatment

Journal

Nowotwory. Journal of Oncology

Issue

Ahead of print

Article type

Research paper (original)

Published online

2024-03-27

Page views

92

Article views/downloads

40

DOI

10.5603/njo.98175

Keywords

Warthin tumor
salivary gland neoplasm
diagnostic
surgery treatment

Authors

Katarzyna Kolary-Siekierska
Anna Jałocha-Kaczka
Piotr Niewiadomski
Jarosław Miłoński

References (31)
  1. Faquin WC, Rossi ED, Baloch Z, et al. The Milan System for Reporting Salivary Gland Cytopathology. 2018.
  2. Kordzińska-Cisek I, Grzybowska-Szatkowska L. Salivary gland cancer — epidemiology. Nowotwory. Journal of Oncology. 2018; 68(1): 22–27.
  3. Psychogios G, Vlastos I, Thölken R, et al. Warthin's tumour seems to be the most common benign neoplasm of the parotid gland in Germany. Eur Arch Otorhinolaryngol. 2020; 277(7): 2081–2084.
  4. Piwowarczyk K, Bartkowiak E, Klimza H, et al. Review and characteristics of 585 salivarygland neoplasms from a tertiary hospitalregistered in the Polish National MajorSalivary Gland Benign Tumors Registry overa period of 5 years: a prospective study. Otolaryngologia Polska. 2020; 74(5): 1–6.
  5. Limaiem F, Jain P. Warthin Tumor. StatPearls 2021.
  6. Stachura J, Domagała W. Patologia znaczy słowo o chorobie. Polska Akademia Umiejętności w Krakowie 2009.
  7. Thompson AS, Bryant HC. Histogenesis of the Papillary Cystadenoma Lymphomatosum (Warthin’s Tumor) of the Parotid Salivary Gland. Am J Pathol. 1950; 26(5): 807–849.
  8. Quer M, Hernandez-Prera JC, Silver CE, et al. Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland. Diagnostics (Basel). 2021; 11(8).
  9. Smółka W, Markowski J, Piotrowska-Seweryn A, et al. Mucoepidermoid carcinoma in Warthin tumor of the parotid gland. Arch Med Sci. 2015; 11(3): 691–695.
  10. Wang YL, Zhu YX, Chen TZ, et al. Clinicopathologic study of 1176 salivary gland tumors in a Chinese population: experience of one cancer center 1997-2007. Acta Otolaryngol. 2012; 132(8): 879–886.
  11. Mohapatra M, Satyanarayana S. Low grade mucoepidermoid carcinoma in a setting of Warthin′s tumor. Indian J Pathol Microbiol. 2012; 55(3): 392.
  12. Park CK, Manning JT, Battifora H, et al. Follicle center lymphoma and Warthin tumor involving the same anatomic site. Report of two cases and review of the literature. Am J Clin Pathol. 2000; 113(1): 113–119.
  13. Sava A, Nemţoi A, Stan CI, et al. Clinical-pathological correlations in Warthin tumors of parotid gland: a series of 10 cases. Rom J Morphol Embryol. 2019; 60(2): 445–453.
  14. Orabona GD, Abbate V, Piombino P, et al. Warthin's tumour: Aetiopathogenesis dilemma, ten years of our experience. J Craniomaxillofac Surg. 2015; 43(4): 427–431.
  15. Kadletz L, Grasl S, Perisanidis C, et al. Rising incidences of Warthin's tumors may be linked to obesity: a single-institutional experience. Eur Arch Otorhinolaryngol. 2019; 276(4): 1191–1196.
  16. Yu GY, Liu XB, Li ZL, et al. Smoking and the development of Warthin's tumour of the parotid gland. Br J Oral Maxillofac Surg. 1998; 36(3): 183–185.
  17. Luers JC, Guntinas-Lichius O, Klussmann JP, et al. The incidence of Warthin tumours and pleomorphic adenomas in the parotid gland over a 25-year period. Clin Otolaryngol. 2016; 41(6): 793–797.
  18. Liu X, Du D, Lin X. Large and multiple Warthin’s tumors of bilateral parotid glands: A case report of bilateral regional excision of the parotid. Oral Maxillofac Surg Cases. 2018; 4(3): 118–123.
  19. Köybaşioğlu FF, Önal B, Han Ü, et al. Cytomorphological findings in diagnosis of Warthin tumor. Turk J Med Sci. 2020; 50(1): 148–154.
  20. Quer M, Guntinas-Lichius O, Marchal F, et al. Classification of parotidectomies: a proposal of the European Salivary Gland Society. Eur Arch Otorhinolaryngol. 2016; 273(10): 3307–3312.
  21. Rossi E, Baloch Z, Pusztaszeri M, et al. The Milan System for Reporting Salivary Gland Cytopathology (MSRSGC): An ASC-IAC-Sponsored System for Reporting Salivary Gland Fine-Needle Aspiration. Acta Cytol. 2018; 62(3): 157–165.
  22. Flezar M, Pogacnik A. Warthin's tumour: unusual vs. common morphological findings in fine needle aspiration biopsies. Cytopathology. 2002; 13(4): 232–241.
  23. Liu Y, Zheng J, Lu X, et al. Radiomics-based comparison of MRI and CT for differentiating pleomorphic adenomas and Warthin tumors of the parotid gland: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2021; 131(5): 591–599.
  24. Lee DH, Yoon TMi, Lee JK, et al. Surgical treatment strategy in Warthin tumor of the parotid gland. Braz J Otorhinolaryngol. 2019; 85(5): 546–550.
  25. Mantsopoulos K, Koch M, Klintworth N, et al. Evolution and changing trends in surgery for benign parotid tumors. Laryngoscope. 2015; 125(1): 122–127.
  26. Ruohoalho J, Mäkitie AA, Aro K, et al. Complications after surgery for benign parotid gland neoplasms: A prospective cohort study. Head Neck. 2017; 39(1): 170–176.
  27. Olejniczak I, Leduchowska A, Kozłowski Z, et al. Evaluation of benign tumors of large salivary glands according to the new classification of the European Salivary Glands Society. Otolaryngol Pol. 2021; 75(4): 7–13.
  28. Ringel B, Kraus D. Observation Rather than Surgery for Benign Parotid Tumors: Why, When, and How. Otolaryngol Clin North Am. 2021; 54(3): 593–604.
  29. Mamidi IS, Lee E, Benito DA, et al. Ultrasound-guided ethanol sclerotherapy for non-surgical treatment of Warthin's tumor. Am J Otolaryngol. 2021; 42(1): 102813.
  30. Tung YC, Luo SD, Su YY, et al. Evaluation of Outcomes following Radiofrequency Ablation for Treatment of Parotid Tail Warthin Tumors. J Vasc Interv Radiol. 2019; 30(10): 1574–1580.
  31. Jin M, Fu J, Lu J, et al. Ultrasound-guided percutaneous microwave ablation of parotid gland adenolymphoma: A case report. Medicine (Baltimore). 2019; 98(35): e16757.

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