Surgical treatment strategy in Warthin tumor of the parotid gland / Estratégia de tratamento cirúrgico no tumor de Warthin de glândula parótida

Abstract Introduction: Warthin tumors are the second most common benign tumors of the parotid gland. We examined the clinical features of Warthin tumors in our hospital, and analyzed the consistency within the literatures. Objective: The aim of this study is to analyze the clinical features of Warthin tumors in our 10-year experience of 118 Warthin tumors undergoing surgery at a single institute. Methods: From December 2006 to December 2016, 110 patients who underwent surgical treatment for Warthin tumors were identified based on their medical records. Results: A total of 118 parotid gland operations were performed in 110 patients. Almost 90% of Warthin tumors were found in males, and average patient age was 66.1 ± 6.1 years. The prevalence of smoking history was 89.1% (98/110). Eight patients (7.3%) had bilateral Warthin tumors. Seventy-seven lesions (65.3%) were located in the parotid tail portion, followed by 34 lesions in the superficial lobe (28.8%) and 7 lesions in the deep lobe (5.9%). Conclusion: We determined the appropriate extent of surgery depending on the fine needle aspiration cytology and tumor location by computed tomography scans. Partial facial dysfunction after the operation was detected in 12 cases, and facial nerve function recovered within 3 months. Only one patient experienced a recurrence, and was disease free after the re-operation. We suggest that our treatment algorithm, depending on the location of tumors and the result of fine needle aspiration cytology, can be useful to determine the appropriate extent of surgery for Warthin tumors.

Resumo Introdução: Os tumores de Warthin são os segundos tumores benignos mais comuns da glândula parótida. Avaliamos as características clínicas dos tumores de Warthin em nosso hospital e analisamos a consistência com a literatura. Objetivo: Analisar as características clínicas dos tumores de Warthin em nossa experiência de 10 anos de 118 tumores de Warthin submetidos a tratamento cirúrgico em um único instituto. Método: De dezembro de 2006 a dezembro de 2016, 110 pacientes que receberam tratamento cirúrgico para tumores de Warthin foram identificados com base em seus prontuários médicos. Resultados: Foram feitas 118 cirurgias na glândula parótida em 110 pacientes. Quase 90% dos tumores de Warthin foram encontrados em homens e a média da idade dos pacientes foi de 66,1 ± 6,1 anos. A prevalência de tabagismo foi de 89,1% (98/110). Oito pacientes (7,3%) tinham tumores de Warthin bilaterais na glândula parótida. Das lesões, 77 (65,3%) localizavam-se na porção da cauda da parótida, seguidas por 34 no lobo superficial (28,8%) e 7 no lobo profundo (5,9%). Conclusão: Determinamos a extensão apropriada da cirurgia de acordo com a punção aspirativa com agulha fina e localização do tumor por tomografia computadorizada. Disfunção facial parcial após a cirurgia foi detectada em 12 casos e a função do nervo facial foi recuperada em 3 meses. Apenas um paciente apresentou recidiva e ficou livre da doença após reoperação. Sugerimos que nosso algoritmo de tratamento, a depender da localização dos tumores e do resultado da PAAF, pode ser útil para determinar a extensão apropriada da cirurgia para os tumores de Warthin.

Avaliação das complicações pós-operatórias em pacientes idosos submetidos à parotidectomia / Evaluation of postoperative complications in elderly patients submitted to parotidectomy

RESUMO Objetivo: avaliar subtipos histológicos mais incidentes e as principais complicações pós-operatórias em pacientes idosos portadores de tumor de parótida e submetidos à parotidectomia. Métodos: estudo retrospectivo de 57 pacientes idosos submetidos à parotidectomia, no período de 2003 a 2017, no Hospital Municipal São José de Joinville, Santa Catarina, Brasil. Resultados: trinta e três (57,9%) pacientes tinham tumores benignos, sendo o mais frequente o tumor de Warthin, e 17(29,8%) tumores malignos, sendo o carcinoma escamoso o mais frequente. Sete (12,3%) pacientes evoluíram com complicações clínicas, sendo a labilidade pressórica e as complicações respiratórias as mais incidentes em quatro (7%) e três (5,3%) casos, respectivamente. Treze (22,1%) pacientes apresentaram complicações cirúrgicas relacionadas à ferida operatória, sendo o hematoma e a infecção de ferida as mais incidentes, com seis (10,5%) casos cada. Vinte e quatro (42,1%) pacientes tiveram algum grau de disfunção do nervo facial no pós-operatório, sendo o grau III de Brackman-House, em 11 casos (19,3%), o mais frequente. O tempo cirúrgico e a linfadenectomia mostraram associação com complicações clínicas. As principais variáveis que apresentaram associação com complicações cirúrgicas foram: tamanho do tumor, tempo cirúrgico mais longo, reoperação e volume de infusão de cristaloides no transoperatório. Conclusão: as neoplasias parotídeas apresentam perfil diferenciado na população idosa, destacando-se o tumor de Warthin e o carcinoma escamoso. Hematoma e infecção da ferida operatória, e as lesões do nervo facial foram as complicações mais prevalentes no pós-operatório.

ABSTRACT Objective: to evaluate the most incident histological subtypes and the main postoperative complications in elderly patients with parotid tumors submitted to parotidectomy. Methods: we conducted a retrospective study with 57 elderly patients submitted to parotidectomy from 2003 to 2017, at the São José County Hospital of Joinville, Santa Catarina, Brazil. Results: thirty-three (57.9%) patients had benign tumors, the most frequent being Warthin's tumor, and 17 (29.8%), malignant tumors, squamous cell carcinoma being the most frequent. Seven patients (12.3%) presented clinical complications, arterial pressure instability and respiratory complications being the most frequent, in four (7%) and three (5.3%) cases, respectively. Thirteen (22.1%) patients presented complications related to the surgical wound, hematoma and wound infection being the most frequent, with six (10.5%) cases each. Twenty-four (42.1%) patients had some degree of facial nerve dysfunction in the postoperative period, Brackman-House grade III being the most frequent, in 11 cases (19.3%). Surgical time and lymphadenectomy were associated with clinical complications. The main variables that showed an association with surgical complications were tumor size, longer surgical time, reoperation, and perioperative crystalloid infusion volume. Conclusion: parotid neoplasms present a differentiated profile in the elderly population, especially Warthin's tumor and squamous cell carcinoma. Hematoma and infection of the operative wound and facial nerve lesions were the most prevalent complications in the postoperative period.

Linfadenoma sebáceo en glándula parótida: a propósito de 2 casos / Lymphadenoma sebaceous of the parotid gland: a report of 2 cases

Objetivo: Reportar casos de linfadenoma sebáceo, un tumor raro, localizado principalmente en la glándula parótida, con muy pocos casos descritos en la literatura. Casos clínicos: Presentamos 2 casos de esta rara afección, tratados en el Hospital Universitario Miguel Servet de Zaragoza, de enero de 2010 a diciembre de 2014. El diagnóstico, tanto por imagen como citológico, es difícil debido a su baja prevalencia y a la gran variedad de tumores de glándula parótida que existen. En los 2 casos presentados ha sido necesaria la exéresis para llegar al diagnóstico. El tratamiento curativo consiste en la exéresis completa de la tumoración.

Aim: To report a rare parotid tumour: sebaceous lymphadenoma, with very few cases reported in the literature. Cases report: We present 2 cases of lymphadenoma sebaceous of the parotid gland treated by surgery at University Hospital Miguel Servet of Zaragoza between January 2010 and December 2014. The diagnosis, both radiological and cytological, is difficult because of their low prevalence and the great variety of parotid gland tumors existent. In our 2 cases described, excision has been required for diagnosis. A complete excision of the tumor is required for curative treatment.

Clinicopathological analysis of salivary gland tumors over a 15-year period

Abstract Salivary gland tumors (SGT) are rare neoplasms that generate interest due to their histopathological diversity and clinical behavior. The aims of the present study were to investigate clinicopathological aspects of SGTs diagnosed at a tertiary health center and compare the findings with epidemiological data from different geographic locations. Cases of tumor in the head and neck region at a single health center in the period between 1995 and 2010 were reviewed. Patient gender, age and ethnic group as well as anatomic location, histological type and clinical behavior of the tumor were recorded. Availability of complete information about these aspects was considered the inclusion criteria. Descriptive statistical analysis of the data was performed using the frequencies of categorical variables. Among the 2168 cases of tumors in the head and neck region, 243 (11.20%) cases were diagnosed in the salivary glands, 109 of which met the inclusion criteria: 85 (78%) benign tumors and 24 (22%) malignant tumors. Mean patient age was 46.47 years. The female gender accounted for 56 cases (51.4%) and the male gender accounted for 53 (48.3%). The major salivary glands were affected more (75.2%) than the minor glands. The most frequent benign and malignant SGTs were pleomorphic adenoma (81.2%) and adenoid cystic carcinoma (58.3%), respectively. In conclusion, pleomorphic adenoma and adenoid cystic carcinoma are the most frequent benign and malignant lesions, respectively. Comparing the present data with previous studies on SGTs, one may infer that some demographic characteristics and the predominance of malignant tumors vary in different geographic regions.

Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease / Estudo do Ventrículo Direito na Forma Indeterminada da Doença de Chagas pelo Doppler Ecocardiograma

Background: Patients with indeterminate form of Chagas disease/cardiac normality (ICD/CN) exhibited normal electrocardiograms and chest X-rays; however, more sophisticated tests detected some degree of morphological and functional changes in the heart. Objective: To assess the prevalence of systolic and diastolic dysfunction of the right ventricle (RV) in patients with ICD/CN. Methods: This was a case–control and prevalence study. Using Doppler two-dimensional echocardiography (2D), 92 patients were assessed and divided into two groups: group I (normal, n = 31) and group II (ICD/CN, n = 61). Results: The prevalence of RV systolic dysfunction in patients in groups I and II was as follows: fractional area change (0.0% versus 0.6%), mobility of the tricuspid annulus (0.0% versus 0.0%), and S-wave tissue Doppler (6.4% versus 26.0%, p = 0.016). The prevalence of global disorders such as the right myocardial performance index using tissue Doppler (16.1% versus 27.8%, p = 0.099) and pulsed Doppler (61.3% versus 68%, p = 0.141) and diastolic disorders such as abnormal relaxation (0.0% versus 6.0%), pseudonormal pattern (0.0% versus 0.0%), and restrictive pattern (0.0% versus 0.0%) was not statistically different between groups. Conclusion: The prevalence of RV systolic dysfunction was estimated to be 26% (S wave velocity compared with other variables), suggesting incipient changes in RV systolic function in the ICD/CN group. .

Fundamento: Pacientes com forma indeterminada da doença de Chagas/normalidade cardíaca (FIDC/NC) apresentam eletrocardiograma e raios X de tórax normais, porém, quando submetidos a exames mais sofisticados, são detectados alguns graus de alterações morfofuncionais do coração. Objetivo: Avaliar a prevalência de disfunção sistólica e diastólica do ventrículo direito (VD) em pacientes com FIDC/NC. Métodos: Estudo de caso-controle e prevalência. Foram avaliados 92 pacientes com Doppler ecocardiograma bidimensional (2D), divididos em dois grupos: grupo I (normal, n = 31) e grupo II (FIDC/NC, n = 61). Resultados: A prevalência da disfunção sistólica do VD em pacientes dos grupos I e II foi: mudança de área fracional (0,0% versus 0,6%), mobilidade do anel tricuspídeo (0,0% versus 0,0%) e onda S ao Doppler tecidual (6,4% versus 26,0%, com p = 0,016). As prevalências das disfunções globais – como índice de performance miocárdica direita ao Doppler tecidual (16,1% versus 27,8% com p = 0,099) e ao Doppler pulsado (61,3% versus 68% com p = 0,141) e diastólico, como alteração do relaxamento (0,0% versus 6,0%), padrão pseudonormal (0,0% versus 0,0%) e padrão restritivo (0,0% versus 0,0%) – não apresentaram significância estatística entre os grupos. Conclusão: A prevalência de disfunção sistólica do VD foi estimada em 26% (velocidade da onda S em comparação a outras variáveis), sugerindo alterações incipientes da função sistólica do VD no grupo FIDC/NC. .

Synchronous Bilateral Warthin Tumors: A Case Report

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 occurring in an elderly patient, and review incidence and peculiarities of this tumor. Case Report: A 78-year-old man who used to smoke had a history of mild pain in the topography of right parotid three weeks ago. Patient with hypertension, diabetes and a longtime smoker (smoking a pack per day for 32 years) noticed a progressive bulging in the right parotid region for about 2.5 years ago, and noticed another progressive bulging (althought in the left parotid region), for about one year ago. Patient denied fever, redness, skin lesions and pain during this period until last three weeks, when he sought medical attention for a mild pain in the right facial region. The patient underwent cervical magnetic resonance imaging that showed tumor lesions in both parotids. Fine needle aspiration revealed a typical lesion of epithelial oxyphilic cells associated with reactive lymphoid proliferation, suggesting Warthin tumor. The patient underwent two superficial parotidectomies, and the histopathologic result from both tumors of parotid glands showed papillary cystadenoma lymphomatosum. Conclusion: The occurrence of synchronous bilateral Warthin tumor is extremely rare, and anamnesis and physical examination, as well as some complementary examinations, are important means for diagnostic evaluation. Confirmation of the diagnosis can only be obtained through a histopathologic study. A superficial or total parotidectomy is the recommended treatment for the disease...

Carcinoma tiroideo papilar oncocítico variante Warthin-like tumor: caso clínico y revisión de la literatura / Oncocytic variant of papillary thyroid carcinoma with lymphocytic stroma (Warthin-like variant): report of one case

Recently, an oncocytic variant of papillary thyroid carcinoma with lymphocytic stroma, called Warthin like tumor, has been described. Its evolution is similar to the usual papillary carcinoma. We report a 61 years old female with a multinodular goiter and a predominant nodule in the right lobe. A fine needle aspiration biopsy was compatible with a papillary thyroid carcinoma. A total thyroidectomy was performed and the pathological examination revealed a Warthin tumor of 2.2 cm. The patient was treated posteriorly with radioiodine and after six months of follow up, there is no evidence of disease...

Consideraciones anatómicas en la parotidectomía: revisión de la literatura a propósito de un caso / Anatomical considerations in parotidectomy: review of the literature and case report

La parotidectomía es un procedimiento quirúrgico habitualmente realizado por Cirujanos Maxilofaciales y Cirujanos de Cabeza y Cuello, en el cual se remueve parcialmente o en su totalidad a la glándula parótida. Las indicaciones más comunes para éste procedimiento son las neoplasias de la glándula. Aproximadamente el 80% del total de los tumores de glándulas salivales ocurren en la parótida. De estos, el 75-80% son de naturaleza benigna. Sin embargo, la parotidectomía es un procedimiento sumamente complejo debido a la anatomía regional y por la íntima relación de la glándula parótida con el nervio facial. Siendo la clave de este procedimiento la preservación funcional de éste nervio y de sus ramos. Por lo tanto el conocimiento acabado de la anatomía de la glándula parótida y de sus estructuras anexas es necesario para el éxito quirúrgico. Esta revisión y reporte de caso discutirá las consideraciones anatómicas que deben tenerse durante la parotidectomía para disminuir la posibilidad de alguna complicación.

Parotidectomy is a surgical procedure usually performed by Oral and Maxillofacial Surgeons and Head and Neck Surgeons, in which the parotid gland may be removed partially or totally. The most common indications for this procedure are the neoplasms of the gland. Approximately 80% of total salivary gland tumors occur in the parotid gland. Of these, 75-80% are benign. However, the parotidectomy is a highly complex procedure because of the regional anatomy and the close relationship of the parotid gland with the facial nerve. The most important aspect of this procedure is the functional preservation of the facial nerve and its branches. Therefore, the thorough knowledge of the anatomy of the parotid gland and related structures is necessary for surgical success. This review and case report will discuss the anatomical considerations that must be taken during parotidectomy to reduce the possibility of complications.

Signos neurológicos asociados a pacientes caninos con linfoma / Neurological Symptoms Associated to Canine Patients with Lymphoma

El cáncer altera las estructuras o las funciones de órganos vecinos por su simple presencia, con las consiguientes manifestaciones clínicas; pero también produce efectos nocivos en órganos distantes. Estas alteraciones clínicas inducidas por la acción no invasiva del tumor son de gran diversidad clínica y se conocen como síndromes paraneoplásicos. En el presente trabajo se describen cuatro casos de pacientes caninos con alteraciones neurológicas asociadas a linfadenopatía superficial generalizada...

Cancer alters the structure or functions of adjacent organs with their sole presence, and subsequentclinical manifestations, but can also cause harmful effects in distant organs. Theseclinical changes induced by non-invasive tumor action are of great clinical diversity and areknown as paraneoplastic syndromes. This paper describes four cases of canine patients withneurological disorders associated to generalized superficial lymphadenopathy...

O câncer altera as estruturas ou as funções de órgãos vizinhos por sua simples presença, comas consequentes manifestações clínicas; mas também produz efeitos nocivos em órgãos distantes.Estas alterações clínicas induzidas pela ação não invasiva do tumor são de grande diversidadeclínica e são conhecidas como síndromes paraneoplásicas. No presente trabalho descrevemsequatro casos de pacientes caninos com alterações neurológicas associadas à linfadenopatiasuperficial generalizada...

Tumor de Warthin da glândula parótida: estudo de 70 casos / Warthin's tumor of the parotid gland: study of 70 cases

OBJETIVO: Relatar as características clínicas, tratamento e complicações.dos tumores de Warthin. MÉTODOS: Estudo retrospectivo com 70 pacientes submetidos à ressecção de cistoadenoma papilífero linfomatoso,. Variáveis analisadas: idade, sexo, etnia, presença ou não de tabagismo, sítio primário do tumor, tamanho do tumor em centímetros, presença de bilateralidade, tipo de operação, multicentricidade, complicações do tratamento, presença de recidiva no seguimento e tempo de seguimento.. RESULTADOS: Quarenta e quatro pacientes (62,8 por cento) eram do sexo masculino e 26 (37,2 por cento), do sexo feminino, com média etária de 56,7 anos, O tabagismo estava presente em 55 (78,6 por cento) pacientes, (94,3 por cento) dos tumores eram unilaterais e quatro (5,7 por cento) bilaterais, com tamanho médio de 4,1cm ao exame físico. As complicações foram 14 (19 por cento) casos de paresia e/ou paralisia facial, seroma em 10 (13,8 por cento), síndrome de Frey em três (4 por cento), hematoma em dois (2,7 por cento) e infecção de ferida operatória em um (1,5 por cento) caso. CONCLUSÃO: O tumor de Warthin tem maior incidência no sexo masculino, em tabagistas e localização unilateral predominante na glândula parótida. A parotidectomia superficial com preservação do nervo facial mostrou-se eficaz em 100 por cento casos. As complicações encontradas foram paresias ou paralisias transitórias, seroma, síndrome de Frey, hematoma e infecção de ferida operatória.

OBJECTIVE: To report the clinical characteristics, treatment and complication of Warthin tumors. METHODS: we conducted a retrospective study of 70 patients undergoing resection of papillary lymphomatous cystadenoma. Variables: age, sex, ethnicity, presence or absence of smoking, primary site of tumor, tumor size in cm, presence of bilateral tumor, type of operation, multicentricity, treatment complications, recurrence and follow up. RESULTS: Forty-four patients (62.8 percent) were male and 26 (37.2 percent) female, with a mean age of 56.7; smoking was present in 55 (78.6 percent) patients; 66 (94.3 percent) tumors were unilateral and four (5.7 percent) bilateral, with an average size of 4.1 cm on physical examination. The complications were 14 (19 percent) cases of facial paresis and / or paralysis, seroma in 10 (13.8 percent), Frey's syndrome in three (4 percent), hematoma in two (2.7 percent) and wound infection in one (1.5 percent) case. CONCLUSIONS: Warthin tumors have a higher incidence in male smokers and predominantly unilateral location of the parotid gland. Superficial parotidectomy with preservation of facial nerve was effective in 100 percent cases. Complications were transient paresis or paralysis, seroma, Frey syndrome, hematoma and wound infection.

Tumor solido pseudopapilar: presentacion de caso, manejo y tratamiento quirurgico curativo / Solid pseudopapilar tumor: case presentation, handling and surgical healing treatment

Descrito por primera vez por Frantz en 19591,2 lostumores sólidos pseudopapilares (TSS) son neoplasiasde origen epitelial, de etiología incierta que afectangeneralmente a mujeres jóvenes.2 Dentro la sinonimiapara referir dicha lesión se los conoce también comoneoplasia papilar epitelial, tumor acinar sólido y quístico,neoplasia papilar quística, carcinoma papilar quístico, tumor papilar de bajo grado y finalmente tumor de Frantzpor su primera descripción. Si bien es cierto que tienenun potencial maligno, este es solo del 1 a 2 3 y no fuesino hasta 1996 cuando la OMS4 lo reconoce con suactual nombre, tumor sólido pseudopapilar.Debido a que la neoplasia es muy rara, el objetivode este reporte de casos es presentar el caso clínicoy discutir sobre algunos hechos de su diagnóstico y manejo quirúrgico.

Cistoadenoma papilar bilateral: a propósito de un caso raro descrito por primera vez en nuestro medio / Papillary bilateral cystoadenoma: report o f a rare case described for the first time

Se presenta un paciente de 58 años de edad, del sexo masculino, que acudió a la consulta de Otorrinolaringología con aumento de volumen de ambas regiones parotideas, sin otros síntomas acompañantes. Después de realizar diversos estudios, incluyendo biopsia por aspiración con aguja fina se definió el patrón celular compatible con un tumor de Warthin, por lo que al realizar el tratamiento hubo plena coincidencia con la biopsia por parafina. Dado lo infrecuente de esta tumoración en nuestro medio se realizó el presente trabajo

Salivary gland tumors in a Brazilian population: a retrospective study of 124 cases

Salivary gland tumors constitute a highly heterogeneous histopathologic group. There are few epidemiological studies of large series of benign and malignant salivary gland tumors in Brazil. MATERIAL AND METHODS: Hospital records of 124 patients with salivary gland tumors diagnosed from January 1993 to December 1999 were reviewed. The patients were analyzed according to gender, age, size, location, and histopathology of the tumor. RESULTS AND CONCLUSIONS: Patients with benign and malignant tumors presented with a mean age of 47.7 and 48.8 years, respectively. The frequency of benign tumors was 80 percent (n = 99) and malignant tumors 20 percent (n = 25). Tumors were localized in the parotid gland 71 percent (n = 88), in the submandibular gland 24 percent (n = 30), and in the minor salivary glands 5 percent (n = 6). The most common benign tumors were pleomorphic adenoma in 84 percent (n = 84) and Warthin's tumor in 13 percent (n = 13). Among malignant tumors, mucoepidermoid carcinoma was the most common in 52 percent (n = 13), adenoid cystic carcinoma occurred in 20 percent (n = 5), and carcinoma ex pleomorphic adenoma was detected in 12 percent (n = 3)

Tumor de warthin: report de un caso bilateral / Warthin's tumor: report of a bilateral case

El tumor de Warthin es la segunda neoplasia benigna más frecuente de la glándula parótida (6 a 10 por ciento). Predomina en varones en relación 5:1 y su mayor frecuencia es entre la sexta y séptima décadas de la vida. Estos tumores pueden ser multicéntricos y aparecer en varias regiones de la misma glándula; en 6 a 10 por ciento son bilaterales. Se originan de tejido salival glandular ductal heterotópico y entre los ganglios incluidos o adyacentes de la glándula parótida. Las recurrencias ocurren en 12 por ciento y se explican por el carácter multicéntrico de esta enfermedad. La etiología del tumor de Warthin ha sido discutida por mucho tiempo, pero sigue siendo aún motivo de controversia. El tabaquismo es un importante factor de riesgo asociado al desarrollo de esta neoplasia. Se presenta el caso de un hombre de 51 años, de raza blanca, con tumor de Warthin bilateral; fue tratado mediante parotidectomía superficial, primero del lado izquierdo y dos años después del lado derecho. Evolucionó favorablemente, sin complicaciones y con integridad de ambos nervios faciales.

Tumor de Warthin y sida. Caso clínico / Warthinïs tumor and sida. case report

Se presenta el caso de un paciente de 22 años, portador de SIDA, con masa quística en la glándula parótida derecha y tumor de Warthin adyacente

Estudo por imagem de tumor de Warthin bilateral: relato de um caso / Imaging study of a bilateral Warthin's tumor: a case report

Os autores apresentam um caso de tumor de Warthin bilateral em uma paciente de 62 anos de idade, negra, do sexo feminino, com história de tabagismo importante, investigado por meio de ultra-sonografia, tomografia computadorizada, cintilografia com tecnécio-99m-pertecnetato e punção aspirativa por agulha fina.

Biopsia por aspiración con aguja fina de glándula salival. Experiencia en el Instituto Nacional de Cancerología de México / Fine needle aspiration of salivary gland. experience at he Instituto nacional de Cancerologia de Mexico

La biopsia por aspiración con aguja final de glándula saliva es un procedimiento fácil, seguro y económico que en muchas circunstancias permite un diagnóstico rápido con molestias mínimas para el paciente y con sensibilidad de 81-100 por ciento y especificidad de 94-100 por ciento. En este trabajo revisamos 237 biopsias por aspiración con aguja fina de glándula salival realizadas en un periodo de ocho años en el Instituto Nacional de Cancerología (INCan), México. En 185 pacientes se obtuvieron aspirados satisfactorios y en 144 casos de efectuó correlación con diagnóstico de histopatología. Se encontraron 65 (45 por ciento) verdaderos positivos, 62 (43 por ciento) verdaderos negativos, 11 (8 por ciento falsos negativos, seis (4 por ciento) falsos positivos. La sensibilidad fue de 85.52 por ciento, la especificidad de 91.17 por ciento, el valor predictivo positivo de 91.54 por ciento, el valor predictivo negativo de 84.93 por ciento y la eficiencia de 88.19 por ciento (p< 0.001). Nuestros resultados fueron similares a los obtenidos en 14 series publicadas previamente de biopsia por aspiración con aguja fina de glándula salival