A Painless Swelling on the Left Cheek: Warthin Tumour

Abstract

Warthin tumour is a benign neoplasm which occurs predominantly in the parotid gland. It is the second most common benign salivary gland neoplasm in the parotid gland. Warthin tumour is hypothesized to arise from heterotopic salivary gland tissue found within parotid lymph nodes. It most often occurs in older adults between sixth and seventh decades of life with a male predilection. Warthin tumour is associated with cigarette smoking. It usually appears as a firm or fluctuant mass located at the angle of the mandible or in the tail of the parotid gland. Warthin tumour appears as a well-defined heterogeneous solid or cystic lesion in imaging investigations. It is histopathologically characterized by cystic spaces lined by bilayered oncocytic epithelium showing papillary proliferations and supported by dense lymphoid tissue. The bilayered epithelium consists of luminal tall columnar cells and outer basaloid appearing cuboidal cells. The supporting fibrovascular connective tissue is often obscured by dense lymphoid element principally of mature, small uniform lymphocytes. In most cases, well-formed germinal centres are present. Surgical removal of the tumour via local resection with minimal surrounding tissue is the most preferred treatment modality among surgeons. Most often, if removed completely, the incidence of recurrence is exceedingly low.