Elsevier Pathology

Anatomic Pathology: Salivary Gland Pathology

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320a) A 45-year-old man presented to his primary care physician with moderately severe facial pain. Subsequent work-up revealed a 3 cm parotid tumor, which was resected via subtotal parotidectomy. Histologic examination led to a diagnosis of Warthin tumor. Which other benign salivary gland tumor characteristically presents as a painful lesion?

• Warthin tumor displays a lymphoid stroma underlying a bilayered oncocytic epithelium.

• This tumor occurs almost exclusively in the parotid gland and periparotid lymph nodes.

• Warthin tumor sometimes undergoes infarction, and consequently presents as a painful lesion. No other benign salivary gland tumor characteristically causes pain.

• Warthin tumor sometimes occurs bilaterally. Oncocytoma represents another benign salivary gland tumor with occasional bilateral distribution.

• Malignant salivary gland tumors with bilateral occurrence are very rare. Of the few reported instances, over half are cases of acinic cell carcinoma.

Simpson RHW: Warthin tumour.In: Barnes L, Eveson JW, Reichart P, Sidransky D (eds): Pathology and Genetics of Head and Neck Tumours. World Health Organization Classification of Tumours. Lyon: IARC Press, 2005, pp 263-265.

Jia Y-L, Bishwo SP, Nie X, Chen L-L: Synchronous bilateral multifocal acinic cell carcinoma of parotid gland: case report and review of the literature. J Oral Maxillofac Surg. 2012 Oct;70(10):e574-80. doi: 10.1016/j.joms.2012.06.006. Epub 2012 Aug 3.

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