Warthin's tumor — symptoms, diagnosis, treatment

Salivary glands are relatively small organs - there are three pairs of relatively large glands and several hundred small glands located on the surface of the oral and pharyngeal mucosa. They work constantly and are able to produce as much as one liter of saliva during the day. Despite their small size, they can be affected by many different tumors - both benign and malignant. One of the most common types is knows as Warthin's tumor.

Warthin's tumor — what is it?

Warthin's tumor is a benign tumor of the parotid gland, also known as lymphatic papillomatous adenocyst. This type of tumor is of lymphoid origin and most often originates from the tail of the parotid gland. It can be bilateral or multifocal (this applies to up to 20% of cases). The size of a Warthin tumor can vary from a few millimeters to several centimeters. In general it is a rare – all salivary gland tumors taken together (both benign and malignant) account for approximately 3% of all cancers located in the head and neck area. Warthin's tumor is the second most common benign neoplasm of the salivary glands after pleomorphic adenoma.

Warthin's tumor — causes

Smoking is one of the main causes of the disease. It is assumed that smokers are 8 times more likely to develop a Warthin tumor when compared to non-smokers. In addition, the risk of developing the disease increases with age – it most often occurs in people in their 5th and 6th decade of life. Salivary gland tumors, including Warthin's tumor, may be caused by other risk factors, such as:

• radiation,
• chemical irritants,
• chronic inflammation of the oral cavity,
• genetic predisposition.

Warthin's tumor — symptoms

Warthin's tumor appears as a small, rounded or oval bump. It is painless and usually grows slowly. On palpation it is soft and movable in relation to surrounding tissues. The skin in unaffected by the tumor. Warthin's tumor can occur both unilaterally and bilaterally. It can also have several foci (multicentric Warthin’s tumor). In 90% of cases, the course of the disease is asymptomatic. Occasionally the tumor causes slight pain, is accompanied by ringing in the ears, earache or hoarseness and shortness of breath. In some cases, hearing loss is also possible.

Warthin's tumor — diagnosis

Parotid gland cancer can be detected both during a doctor’s appointment and as a result of self-examination. If a lump under the skin is detected, you should immediately see a doctor who will perform an examination, and plan further tests. Further diagnostics most often include ultrasound and biopsy (tu o histopatoogii usunąłem bo zazwyczaj te guzy sa diagnozowane cytologicznie a nie histopatologicznie). A biopsy can confirm or exclude the presence of a malignant neoplasm.

Warthin's tumor — treatment

The treatment involves a surgical procedure to remove the neoplastic lesion. This procedure is relatively easy due to the favorable, superficial location of the tumor. The exact method of tumor removal depends on its precise location. In many cases, a so-called Parotidectomy is performed, which involves the surgical removal of a part or all of the parotid gland. This procedure minimizes the risk of relapse.

Warthin's tumor — prognosis

Due to the benign nature of Warthin's tumor, the overall prognosis is good. Possible complications result from the risk of damage to the facial nerve during surgery (this nerve courses through the parotid).