Synchronic nasopharyngeal and intraparotid warthin tumors: A case report and literature review

Abstract

Warthin tumor is the second most frequent benign salivary gland tumor after pleomorphic adenoma; it occurs almost exclusively in the parotid gland and peri-parotideal lymph nodes, although it may rarely present in other locations. It may be multicentric and bilateral in a small percentage of cases. Nasopharyngeal Warthin tumor is very rare, and the presence of a synchronic WT involving nasopharynx and parotid is an exceptional event, as it has been described only twice in the literature. In this article we report an additional case of a synchronic Warthin tumor and review the related literature. Key words:Warthin tumor, synchronic WT, multicéntrico, nasopharynx.

Figure 1

CT scan with endovenous contrast and multiplanar reconstruction: Hyperdense lesions are seen in both parotid glands, two in each gland are identified, all lesion have well-defined borders, the largest one measures 27 x 19 mm. There is asymmetry of the Waldeyer’s ring with increased volume and hyperdensity of the right side, and contralateral calcifications.

Figure 2

(A) Low power view of nasopharyngeal tumor: Adenoid tissue with glandular and follicular structures lined by cubical cells with ample eosinophilic cytoplasm. Follicular lumens contains proteinaceous material. (B) High power view show on the surface ciliated epithelium partly replaced by cubical oncocytic cells with bland nuclei.

Figure 3

Low power view of parotid tumor: Multiple cystic structures lined by cubical oncocytic cells. The supporting stroma shows lymphocytic infiltrate and formation of lymphoid follicles.