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Experience with follow-up strategy in selected patients with Warthin tumour diagnosed by ultrasound-guided fine-needle aspiration biopsy (FNAB)

  • Head and Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

Warthin tumour (WT) management options comprise surgery or follow-up. The purpose of this study was to asses our experience with the follow-up strategy in selected patients with an ultrasound-guided fine-needle aspiration biopsy (FNAB) showing WT.

Methods

We performed a retrospective analysis of patients diagnosed with WT using FNAB between 1.1.2006 and 31.12.2019. Patients were divided into three groups according to the therapeutic approach—immediate surgery, follow-up or surgery and follow-up.

Results

323 patients were diagnosed with WT and met the study’s inclusion criteria (154 women, 47.7% and 169 men, 52.3%). 192 patients were operated right after the diagnosis, 109 patients were observed with their first detected tumour and 22 patients had parotid WT surgery and were in the wait-and-scan protocol with a contralateral tumour, recurrence or both. The growth rate (GR) of observed WT was highly variable (mean GR 1.0 mm/year (5%), median GR 0.8 mm (9%), range − 19.7 to +20.0 mm/year). From 131 patients in the follow-up group, 19 patients underwent surgery and definitive histology revealed 17 WTs and 2 adenocarcinomas. However, these 2 patients had changes in sonographic findings at their next control. The mean observation time was 44.7 months (range 12–138 months) in patients followed exclusively at our institution and 50.9 months (range 12–110 months) in patients observed in cooperation with an otorhinolaryngologist at the patients’ place of residence.

Conclusion

Ultrasound-guided FNAB is an accurate and simple method in WT diagnosis and based on its result a follow-up strategy can be chosen for selected patients with WT.

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References

  1. Patel DK, Morton RP (2016) Demographics of benign parotid tumours: Warthin’s tumour versus other benign salivary tumours. Acta Otolaryngol 136(1):83–86

    Article  PubMed  Google Scholar 

  2. Stárek I, Salzman R, Skálová A et al (2017) Doporučené postupy v diagnostice a léčbě nádorů příušní žlázy. Otorinolaryngol Foniatr 66(3):119–126

    Google Scholar 

  3. Franzen AM, Kaup Franzen C, Guenzel T et al (2018) Increased incidence of Warthin tumours of the parotid gland: a 42 year evaluation. Eur Arch Otorhinolaryngol 275(10):2593–2598

    Article  PubMed  Google Scholar 

  4. Tunc O, Gonuldas B, Arslanhan Y et al (2020) Change in Warthin’s tumor incidence: a 20 year joinpoint trend analysis. Eur Arch Otorhinolaryngol 277(12):3431–3434

    Article  PubMed  Google Scholar 

  5. Chulam TC, Noronha Francisco AL, Goncalves Filho J et al (2013) Warthin’s tumour of the parotid gland: our experience. Acta Otorhinolaryngol Ital 33(6):393–397

    CAS  PubMed  PubMed Central  Google Scholar 

  6. Hellquist H, Paiva-Correia A, Vander Poorten V et al (2019) Analysis of the clinical relevance of histological classification of benign epithelial salivary gland tumours. Adv Ther 36(8):1950–1974

    Article  PubMed  PubMed Central  Google Scholar 

  7. Thangarajah T, Reddy VM, Castellanos-Arango F et al (2009) Current controversies in the management of Warthin tumour. Postgrad Med J 85(999):3–8

    Article  CAS  PubMed  Google Scholar 

  8. Orabona GD, Abbate V, Piombino P et al (2015) Warthin’s tumour: Aetiopathogenesis dilemma, ten years of our experience. J Craniomaxillofac Surg 43(4):427–431

    Article  PubMed  Google Scholar 

  9. Teymoortash A, Werner JA (2005) Tissue that has lost its track: Warthin’s tumour. Virchows Arch 446(6):585–588

    Article  CAS  PubMed  Google Scholar 

  10. Honda K, Kashima K, Daa T et al (2000) Clonal analysis of the epithelial component of Warthin’s tumor. Hum Pathol 31(11):1377–1380

    Article  CAS  PubMed  Google Scholar 

  11. Alnoor FNU, Gandhi JS, Stein MK et al (2020) Prevalence of lymphoid neoplasia in a retrospective analysis of Warthin tumor: a single institution experience. Head Neck Pathol 14(4):944–950

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Yu C, Song Z, Xiao Z et al (2016) Mucoepidermoid carcinoma arising in Warthin’s tumor of the parotid gland: clinicopathological characteristics and immunophenotypes. Sci Rep 6:30149

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Jechova A, Kuchar M, Novak S et al (2019) The role of fine-needle aspiration biopsy (FNAB) in Warthin tumour diagnosis and management. Eur Arch Otorhinolaryngol 276(10):2941–2946

    Article  PubMed  Google Scholar 

  14. Dostalova L, Kalfert D, Jechova A et al (2020) The role of fine-needle aspiration biopsy (FNAB) in the diagnostic management of parotid gland masses with emphasis on potential pitfalls. Eur Arch Otorhinolaryngol 277(6):1763–1769

    Article  PubMed  Google Scholar 

  15. Allison DB, Smith AP, An D et al (2020) Assessing the diagnostic accuracy for pleomorphic adenoma and Warthin tumor by employing the Milan system for reporting salivary gland cytopathology: an international, multi-institutional study. Cancer Cytopathol. https://doi.org/10.1002/cncy.22339

    Article  PubMed  Google Scholar 

  16. Mantsopoulos K, Goncalves M, Koch M et al (2019) Going beyond extracapsular dissection in cystadenolymphomas of the parotid gland. Oral Oncol 88:168–171

    Article  PubMed  Google Scholar 

  17. Lewis DR, Webb AJ, Lott MF et al (1999) Improving cytological diagnosis and surgical management of parotid adenolymphoma. Br J Surg 86(10):1275–1279

    Article  CAS  PubMed  Google Scholar 

  18. Heller KS, Attie JN (1988) Treatment of Warthin’s tumor by enucleation. Am J Surg 156(4):294–296

    Article  CAS  PubMed  Google Scholar 

  19. Bakker EJ, van de Luijtgaarden KM, van Lier F et al (2012) General anaesthesia is associated with adverse cardiac outcome after endovascular aneurysm repair. Eur J Vasc Endovasc Surg 44(2):121–125

    Article  CAS  PubMed  Google Scholar 

  20. Ciuman RR, Oels W, Jaussi R et al (2012) Outcome, general, and symptom-specific quality of life after various types of parotid resection. Laryngoscope 122(6):1254–1261

    Article  PubMed  Google Scholar 

  21. Borsetto D, Fussey JM, Cazzador D et al (2020) The diagnostic value of cytology in parotid Warthin’s tumors: international multicenter series. Head Neck 42(3):522–529

    Article  PubMed  Google Scholar 

  22. Schwalje AT, Uzelac A, Ryan WR (2015) Growth rate characteristics of Warthin’s tumours of the parotid gland. Int J Oral Maxillofac Surg 44(12):1474–1479

    Article  CAS  PubMed  Google Scholar 

  23. Allison DB, Smith AP, An D et al (2021) Assessing the diagnostic accuracy for pleomorphic adenoma and Warthin tumor by employing the Milan system for reporting salivary gland cytopathology: an international, multi-institutional study. Cancer Cytopathol 129(1):43–52

    Article  PubMed  Google Scholar 

  24. Vlantis AC, Ng SK, Mak CK et al (2016) If cytology of Warthin tumor is accurate, can management be conservative? Ear Nose Throat J 95(4–5):185–188

    PubMed  Google Scholar 

  25. Mantsopoulos K, Goncalves M, Koch M et al (2019) Watchful waiting in carefully selected metachronous cystadenolymphomas of the parotid gland: a reliable option? Br J Oral Maxillofac Surg 57(5):425–429

    Article  CAS  PubMed  Google Scholar 

  26. Espinoza S, Felter A, Malinvaud D et al (2016) Warthin’s tumor of parotid gland: surgery or follow-up? Diagnostic value of a decisional algorithm with functional MRI. Diagn Interv Imaging 97(1):37–43

    Article  CAS  PubMed  Google Scholar 

  27. Mamidi IS, Lee E, Benito DA et al (2021) Ultrasound-guided ethanol sclerotherapy for non-surgical treatment of Warthin’s tumor. Am J Otolaryngol. https://doi.org/10.1016/j.amjoto.2020.102813

    Article  PubMed  Google Scholar 

  28. Seok J, Jeong WJ, Ahn SH et al (2019) The growth rate and the positive prediction of needle biopsy of clinically diagnosed Warthin’s tumor. Eur Arch Otorhinolaryngol 276(7):2091–2096

    Article  PubMed  Google Scholar 

  29. Shkedy Y, Alkan U, Mizrachi A et al (2018) Fine-needle aspiration cytology for parotid lesions, can we avoid surgery? Clin Otolaryngol 43(2):632–637

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

The authors would like to thank the nurses and technical staff that were present during the interventions, for their professional assistance and also Erick Harr for proof reading.

Funding

The Charles University Research Fund (Progres Q28/LF1(UNCE 204013)) supported this study.

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Authors and Affiliations

  1. Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06, Prague, Czech Republic

    Alžběta Fíková, Martin Kuchař, David Kalfeřt, Lucie Dostálová, Michal Zábrodský & Jan Plzák

  2. Department of Pathology and Molecular Medicine 2nd Faculty of Medicine, Charles University, Faculty Hospital Motol, V Úvalu 84, 15006, Prague, Czech Republic

    Jan Balko

Authors
  1. Alžběta Fíková
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  2. Martin Kuchař
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Correspondence to Alžběta Fíková.

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The authors have no relevant financial or non-financial interests to disclose.

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This article does not contain any animal studies conducted by the authors. The study was conducted in accordance with the guidelines of the Helsinki Declaration and its subsequent amendments. Retrospective study does not require approval by an ethical committee in our country.

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Informed consent was not needed; it is a retrospective study.

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Fíková, A., Kuchař, M., Kalfeřt, D. et al. Experience with follow-up strategy in selected patients with Warthin tumour diagnosed by ultrasound-guided fine-needle aspiration biopsy (FNAB). Eur Arch Otorhinolaryngol 279, 2049–2055 (2022). https://doi.org/10.1007/s00405-021-06959-3

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