The differential diagnosis of lymphoepithelial lesion of the salivary gland.

The differential diagnosis of salivary gland lesions with epithelial components and lymphoid stroma is often challenging. Salivary gland carcinoma with tumor-associated lymphoid proliferation, tumors composed of both epithelial and lymphoid components, lymphoid neoplasms in the salivary gland, and inflammatory lesions are all included in this category. It encompasses inflammatory lesions and neoplastic lesions. With the exception of Warthin tumors, these lesions are rare, making them more difficult to diagnose. Carcinoma showing thymus-like elements has recently been reported in the salivary gland. Similar to thymic carcinoma, tumor cells are positive for CD5 and are accompanied by T lymphocytes.

Fine needle aspiration diagnosis of benign oncocytic lesions of the head and neck associated with false positive 18F-fluorodeoxyglucose uptake on positron emission tomography scan.

INTRODUCTION: 18F-fluorodeoxyglucose (FDG) uptake on positron emission tomography/computed tomography (PET/CT) has become the mainstay for staging and post-therapy surveillance of cancer as malignant neoplasms generally demonstrate higher FDG uptake that benign entities. However, there are certain benign lesions, most notably oncocytic tumors, that can display very high uptake and fine needle aspiration (FNA) is usually done to confirm malignancy. Therefore, it is important to recognize that benign oncocytic lesions of the head and neck may also present as FDG-avid lesions to avoid a diagnostic pitfall. METHODS: Electronic search of institutional surgical and cytopathology archives was conducted to identify cases of benign oncocytic lesions involving the head and neck region diagnosed by FNA from January 2012 to April 2022. Chart review was used to assess whether lesions were initially discovered via PET scanning. RESULTS: One hundred and twenty-five cases of oncocytic lesions were identified; 12 (9%) PET positive lesions were identified in the head and neck region from patients being evaluated for metastasis or for suspicion of malignancy. Cytopathology of all 12 cases demonstrated benign oncocytic lesions; eight (67%) of these cases were consistent with Warthin tumor, one (8.3%) was a benign oncocytic lesion, and one (8.3%) was consistent wit a parathyroid adenoma. Most (58%) of the PET-positive lesions were in parotid region, two from thyroid gland (17%), one from submandibular gland (8%), one from paratracheal area (8%). The PET scan SUVs ranged from 3.3 to 19.5 g mL-1. CONCLUSIONS: Oncocytic lesions including Warthin tumors can result in false-positive FDG uptake on PET scans. Clinicians and cytopathologists should be aware of PET-positive benign oncocytic head and neck lesions.

Primary intranodal Warthin-like variant of mucoepidermoid carcinoma.

This report describes a rare case of primary intranodal Warthin-like mucoepidermoid carcinoma (WL-MEC) presenting as a left level II lymph node mass in a 48-year-old man. Warthin-like mucoepidermoid carcinoma is a recently defined variant of MEC that bears a close histologic resemblance to Warthin tumor. Whereas MEC has readily identifiable key histologic features that render diagnosis relatively straightforward, WL-MEC is a challenging diagnosis due to overlapping histologic features and only limited case reports in the literature. This case was initially diagnosed as primary intranodal MEC after the exclusion of metastasis by imaging. It was not until years later, upon review of historic cases, that the diagnosis of WL-MEC was established. This diagnosis was further supported by molecular testing that was not available at the time of the original diagnosis.

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.

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...

Aneurisma intraparotídeo de vena comunicante posterior / Intraparotid aneurysm of the posterior communicating vein

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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.

Trece años de experiencia en parotidectomía parcial superficial como tratamiento de neoformaciones benignas parotideas / Thirteen years’ experience with superficial partial parotidectomy as treatment for benign parotid tumours

Introducción: La mayoría de los autores aceptan la cirugía como tratamiento de elección para los tumores benignos de parótida. La mejor técnica quirúrgica o el grado de extensión de la cirugía permanecen controvertidos. El presente estudio pretende comprobar si la parotidectomía parcial superficial (PPS) es adecuada para el tratamiento de los tumores benignos de glándula parótida. Material y métodos: Seleccionamos 63 pacientes con tumor benigno, operados de glándula parótida, 43 tenían un adenoma pleomorfo y 20 un tumor de Warthin. De este grupo de 63 pacientes no se pudo incluir a 6 (3 fallecidos y 3 no localizados). Estudiamos a 57 pacientes, 41 diagnosticados de adenoma pleomorfo y 16 de tumores de Warthin. En todos ellos realizamos PPS sin monitorización del nervio facial. Resultados: Parálisis transitoria del nervio facial 14 pacientes (24,5%). Diez se resolvieron antes del primer mes y cuatro antes del tercer mes. Un paciente (1,7%) sufrió una dificultad definitiva para mantener alineado el hemilabio inferior en la movilidad forzada, sin alteración en la movilidad de la comisura. Ninguna recidiva (control entre 3 y 13 años). Conclusiones: La PPS es una técnica con unas complicaciones y una tasa de recidivas comparables o menores que otras técnicas empleadas para el tratamiento de adenomas pleomorfos o tumores de Warthin parotídeos. La monitorización del nervio facial puede ser una ayuda durante el acto quirúrgico. La falta de monitorización no sería considerada una contraindicación para la realización de la cirugía (AU)

Introduction: Most authors agree that surgery is the treatment of choice for benign tumours of the parotid gland. However, the best surgical technique and the extent of surgery remain controversial. This study attempts to establish whether the implementation of a partial superficial parotidectomy (PSP) is appropriate for the treatment of benign parotid gland tumours. Material and methods: We selected 63 patients with benign parotid gland surgery, of whom 43 had a pleomorphic adenoma and 20, a Warthin tumour. Of this group of 63 patients, 6 could not be included. We consequently studied 57 patients, 41 of them diagnosed as pleomorphic adenoma and 16, as Warthin tumours. In all of them, a PSP was performed without intraoperative monitoring of the facial nerve. Results: Transient facial nerve paralysis, 14 patients (24.5%). Ten cases were resolved within the first month after surgery and 4 before the third month, after indicating facial physiotherapy. One patient (1.7%) had a permanent difficulty in keeping one side of the lower lip aligned under pressure-mobility, without altering commissure mobility. None of the patients studied had a recurrence (control, 3-13 years). Conclusions: Although PSP is a technique with a few complications, it has a recurrence rate comparable to or lower than other techniques used for the treatment of pleomorphic adenomas or Warthin parotid tumours. Intraoperative facial nerve monitoring can be helpful during surgery. The lack of monitoring would not be considered a contraindication for surgery (AU)

Correlación citohistológica en tumores de la glándula parótida / Cyto-histological correlation in parotid gland tumors

Objetivo: Evaluar la eficacia de la citología por punción aspiración con aguja fina (PAAF) en el diagnóstico de malignidad de los tumores de la glándula parótida con el fin de planificar el tratamiento más adecuado para cada caso. Material y método: Se realiza un estudio retrospectivo en una muestra de 41 pacientes, en el que se evalúa la correlación entre la PAAF y los hallazgos histopatológicos de la pieza quirúrgica de los tumores de la glándula parótida, realizadas entre los años 2004 y 2008. Resultados: La sensibilidad de la PAAF para detectar malignidad fue de un 71% y la especificidad de un 91%, con un valor predictivo positivo de 62,5% y un valor predictivo negativo de 93,7%. La tasa de falsos negativos fue de 29% mientras que la de falsos positivos de 9%. Conclusiones: La PAAF es un procedimiento diagnóstico de gran utilidad en el diagnóstico de malignidad de tumores de la glándula parótida, que permite establecer el tratamiento más adecuado e individualizado para cada paciente. No obstante, no está exenta de limitaciones en cuanto a su precisión diagnóstica (AU)

Objective: To evaluate the usefulness of fine needle aspiration biopsy (FNAB) in the study of parotid gland tumour malignancy in order to plan the most suitable treatment in each case. Material and Method: a retrospective study was made of 41 cases, in which we evaluated the correlation between the FNAB and the histopathological findings of the surgical piece of parotid gland tumours, from 2004 to 2008, as well as the epidemiological information of these patients. Results: The sensitivity of FNAB in the detection of malignancy was 71% and the specificity was of 91%, with a positive predictive value of 62.5% and a negative predictive value of 93.7%. The rate of false negatives was 29% whereas that of false positives was of 9%. Conclusions: The use of the FNAB in the study of parotid gland tumors is a useful and simple tool that guides us in the diagnosis and planning of treatment. Nevertheless, it is not exempt from limitations in its diagnostic accuracy (AU)

Synchronous unilateral parotid neoplasms. A case report

The parotid gland is the most usual location of benign neoplasms affecting major salivary glands and quite oftenthe recurrence of these tumours is noticed, specially in the case of pleomorphic adenoma. The occurrence of multipletumours in the parotid glands is rare and the majority of these are multifocal Warthin`s tumors (papillary cystadenomalymphomatosum). The simultaneous development of tumours with different histological types is unusualand when it occurs, the most common combination is a pleomorphic adenoma and a Warthin`s tumor. There aremany articles about Multiple Parotid Tumors (MPT) but only a few of them are focused on unilateral synchronousbenings tumors, being pleomorphic adenoma and Warthin´s these tumors.The report describes a 55 year old female with a pleomorphic adenoma occurring synchronously with a Warthin`stumor within the superficial lobe of her left parotid gland (AU)

Diagnóstico diferencial de las lesiones quísticas del páncreas / No disponible

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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(AU)

Tumores bilaterales de glándula parótida / Bilateral parotid gland tumours. A 10-year review

Los tumores bilaterales de la glándula parótida son entidades poco frecuentes. Se presenta una revisión del Servicio de Cirugía Oral y Maxilofacial de Hospitals vall de Hebron sobre 215 tumores de glándula parótida diagnosticados en los 24 meses, constatando la presencia de 6 tumores bilaterales. Se exponen los datos obtenidos, analizando las principales características de los tumores, epidemiología, diagnóstico y tratamiento. Asimismo se realiza una exhaustiva revisión bibliográfica de las series publicadas, comparando y discutiendo los datos de epidemiología, por tipos histiológicos de tumores, su diagnóstico y actitud terapéutica (AU)

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

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

Adenolinfoma: relato de um caso / Adenolinfoma: a case report

É apresentado um caso incomum de adenolinfoma, aparecendo em glândulas salivares menores do lábio inferior e as relações desta situação com o encontrado na literatura, bem como a forma de tratamento preconizada

Tumor de Warthin: estudo retrospectivo de 45 casos / Warthin's tumor: retrospective study of 45 cases

Os autores analisam 45 casos de pacientes portadores de tumor de Warthin, diagnosticados e tratados no Servico de Cirurgia de Cabeca e Pescoco do Instituto Nacional do Cancer-RJ, no periodo de 1972 a 1989. O proposito deste trabalho foi analisar os dados referentes a cor, idade, sexo e intervalo diagnostico, correlacionando-os com o tratamento efetuado, assim como com as complicacoes advindas deste tratamento e os indices de recorrencia local. Todos os pacientes foram tratados com cirurgia exclusiva, com apenas duas variantes tecnicas: parotidectomia total e parotidectomia superficial.A parotidectomia superficial se mostrou a apcao terapeutica mais adequada para a maioria dos casos e as complicacoes advindas da cirurgia obtiveram evolucao benigna,apenas com tratamento conservador. Os indices de recorrencia local foram muito baixos, confirmando os relatos da literatura internacional.

Tumor de Warthin. Informe de un caso de localización inusual / Warthin's tumor. Report of a case with unusual localization

Se hace el informe de un caso con tumor de Warthin localizado en la región lateral del cuello. Se revisa la literatura. se emiten conclusiones(AU)