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© Borgis - Medycyna Rodzinna 3/2015, s. 144-146
Konrad Wroński1, 2, Zbigniew Masłowski2, Przemysław Stefaniak2, Leszek Frąckowiak3
Chirurgiczne leczenie olbrzymiego guza Warthina – opis przypadku
Surgical treatment giant Warthin’s tumor – case report
1Department of Oncology, Faculty of Medicine, University of Warmia and Mazury, Olsztyn
2Department of Surgical Oncology, Hospital Ministry of Internal Affairs with Warmia and Mazury Oncology Centre, Olsztyn
3Department of Public Health and Epidemiology, University of Warmia and Mazury, Olsztyn
Summary
Warthin’s tumor, also known as papillary cystadenoma lymphomatosum or adenolymphoma, is the second most common benign tumor of the parotid gland. The incidence of Warthin’s tumors are observed more often in male population but in the last four decades more and more women suffered from this tumors. At that time, the male-to-female ratio is approximately 5:1. Malignant transformation is very rare in this tumor. It has been reported up 14% to 30 % of parotid tumors. First time it was described in 1929 by the American pathologist Aldred Scott Warthin. The number of patients with a benign Warthin’s tumor is increasing and their optimal treatment is a problem for health care. Optimal treatment of Warthin’s tumor remains controversial. In this article the authors presented a case of a 75-year-old woman who was admitted to the hospital because of giant tumor located in the left parotid gland. The patient underwent partial excision of the parotid gland on the left side with the Warthin’s tumor and inthe first dayafter surgerywas discharged home.
Introduction
Warthin’s tumor, also known as papillary cystadenoma lymphomatosum or adenolymphoma, is the second most common benign tumor of the parotid gland (1). It has been reported up 14 to 30% of parotid tumors (2). First time it was described in 1929 by the American pathologist Aldred Scott Warthin (3). Doctor Warthin called this tumor papilliferous, or papillary, or cystadenomas (3).
Case report
A 75-year-old woman, Caucasian race, was admitted to the Department of Surgical Oncology because of giant Warthin’s tumor located in the left parotid gland. In an interview with the patient, she informed us that the tumor of the left parotid gland appeared in her 10 years earlier and gradually expanded. The patient reported pain related to Warthin’s tumor.
She had no any other symptoms, there was no history of weight loss and loss of appetite. The patient was treated chronically for hypertension disease and ischemic heart disease. She had two surgeries (thyroidectomy due to thyroid nodular goiter and hysterectomy because of myomas) and there was no history of carcinoma in patient family. Blood test and other routine hematological examinations and biochemical tests were within normal limits.
On physical examination, in the left parotid gland area there was palpable 60 millimeters tumor (fig. 1). Ultrasound examination showed a pathological mass in the region of the left parotid gland, the size of tumor was approximately 55 x 58 mm. During examination there was observed solid tumor with cystic spaces. The neck lymph nodes were not enlarged during ultrasound and palpation. The patient had fine-needle biopsy without complication. The histopathology examination revealed a benign Warthin’s tumor.
Fig. 1. Whartin’s tumor located in the left parotid gland diameter 55 x 58 mm.

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Piśmiennictwo
1. Batsakis JG, El-Naggar AK: Warthin’s tumor. Ann Otol Rhinol Laryngol 1990; 99: 588-591. 2. Yoo GH, Eisele DW, Askin FB et al.: Warthin’s tumor: a 40-year experience at the Johns Hopkins Hospital. Laryngoscope 1994; 104: 799-803. 3. Warthin AS: Papillary cystadenoma lymphomatosum. J Cancer Res 1929; 13: 116-125. 4. Evenson JW, Cawson RA: Warthin’s tumor (cystadenolymphoma) of the salivary glands: a clinicopathological investigation of 278 cases. Oral Surg 1986; 61: 256-262. 5. Ebbs SR, Webb AJ: Adenolymphoma of the parotid: aetiology, diagnosis and treatment. Br J Surg 1986; 73: 627-630. 6. Kotwall C: Smoking as an etiologic factor in the development of Warthin’s tumor of the parotid gland. Am J Surg 1992; 164: 646-647. 7. Batsakis JG: Tumors of the head and neck. 2nd ed., Williams and Wilkins, Baltimore 1974: 54-55. 8. Yabuuchi H, Fukuya T, Tajima T et al.: Salivary gland tumors: diagnostic value of gadolinium-enhanced dynamic MR imaging with histopathologic correlation. Radiology 2003; 226: 345-354. 9. Stewart CJ, MacKenzie K, McGarry GW, Mowat A: Fine-needle aspiration cytology of salivary gland: a review of 341 cases. Diagn Cytopathol 2000; 22: 139-146. 10. Batsakis JG: Carcinoma ex papillary cystadenoma lymphomatosum malignant Warthin’s tumor. Ann Oto Rhinol Laryngol 1987; 96: 234-235. 11. Heller KS, Attie JN: Treatment of Warthin’s tumor by enucleation. Am J Surg 1988; 156: 294-296. 12. Butt FY: Benign diseases of the salivary glands. [In:] Lalwani AK (ed.): Current diagnosis and treatment in otolaryngology: head and neck surgery. McGraw-Hill, New York 2002: 307-324.
otrzymano: 2015-08-12
zaakceptowano do druku: 2015-08-26

Adres do korespondencji:
Konrad Wroński
Department of Surgical Oncology Faculty of Medicine University of Warmia and Mazury
ul. 37 Wojska Polskiego, 10-228 Olsztyn
tel. +48 505-818-126
konradwronski@wp.pl

Medycyna Rodzinna 3/2015
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