Warthin tumor, also known as papillary cystadenoma lymphomatosum, is a relatively uncommon, slow-growing benign neoplasm that typically develops in the salivary gland, most commonly in the parotid gland. It was first described by pathologist Aldred Warthin in 1929.
Warthin tumor is characterized by the formation of cysts surrounded by abundant lymphoid tissue. The tumor usually presents as a painless, palpable mass in the parotid gland or occasionally in the submandibular gland. It commonly occurs in older adults, predominantly affecting men more than women.
Histologically, Warthin tumor is composed of two distinct components: epithelial cells lining the cystic spaces and lymphoid tissue. The epithelial cells show papillary projections, forming a characteristic ‘hoof-like’ or ‘papillary’ appearance. The lymphoid stroma is composed of lymphocytes, plasma cells, and germinal centers.
The etiology of Warthin tumor remains unclear, but various theories have been proposed, including viral infections, smoking, and genetic factors. Although it is considered benign, there have been rare cases of malignant transformation.
Diagnosis of Warthin tumor is typically made through imaging techniques, such as ultrasound or MRI, which can determine the size, location, and presence of any additional lesions. Fine needle aspiration cytology or excisional biopsy may be necessary to confirm the diagnosis.
Surgical excision is the primary treatment option for Warthin tumor. Most cases require no further treatment after complete removal. However, long-term follow-up is recommended due to the risk of recurrence or malignant transformation.
