Surgical treatment strategy in Warthin tumor of the parotid gland / Estratégia de tratamento cirúrgico no tumor de Warthin de glândula parótida

Abstract Introduction: Warthin tumors are the second most common benign tumors of the parotid gland. We examined the clinical features of Warthin tumors in our hospital, and analyzed the consistency within the literatures. Objective: The aim of this study is to analyze the clinical features of Warthin tumors in our 10-year experience of 118 Warthin tumors undergoing surgery at a single institute. Methods: From December 2006 to December 2016, 110 patients who underwent surgical treatment for Warthin tumors were identified based on their medical records. Results: A total of 118 parotid gland operations were performed in 110 patients. Almost 90% of Warthin tumors were found in males, and average patient age was 66.1 ± 6.1 years. The prevalence of smoking history was 89.1% (98/110). Eight patients (7.3%) had bilateral Warthin tumors. Seventy-seven lesions (65.3%) were located in the parotid tail portion, followed by 34 lesions in the superficial lobe (28.8%) and 7 lesions in the deep lobe (5.9%). Conclusion: We determined the appropriate extent of surgery depending on the fine needle aspiration cytology and tumor location by computed tomography scans. Partial facial dysfunction after the operation was detected in 12 cases, and facial nerve function recovered within 3 months. Only one patient experienced a recurrence, and was disease free after the re-operation. We suggest that our treatment algorithm, depending on the location of tumors and the result of fine needle aspiration cytology, can be useful to determine the appropriate extent of surgery for Warthin tumors.

Resumo Introdução: Os tumores de Warthin são os segundos tumores benignos mais comuns da glândula parótida. Avaliamos as características clínicas dos tumores de Warthin em nosso hospital e analisamos a consistência com a literatura. Objetivo: Analisar as características clínicas dos tumores de Warthin em nossa experiência de 10 anos de 118 tumores de Warthin submetidos a tratamento cirúrgico em um único instituto. Método: De dezembro de 2006 a dezembro de 2016, 110 pacientes que receberam tratamento cirúrgico para tumores de Warthin foram identificados com base em seus prontuários médicos. Resultados: Foram feitas 118 cirurgias na glândula parótida em 110 pacientes. Quase 90% dos tumores de Warthin foram encontrados em homens e a média da idade dos pacientes foi de 66,1 ± 6,1 anos. A prevalência de tabagismo foi de 89,1% (98/110). Oito pacientes (7,3%) tinham tumores de Warthin bilaterais na glândula parótida. Das lesões, 77 (65,3%) localizavam-se na porção da cauda da parótida, seguidas por 34 no lobo superficial (28,8%) e 7 no lobo profundo (5,9%). Conclusão: Determinamos a extensão apropriada da cirurgia de acordo com a punção aspirativa com agulha fina e localização do tumor por tomografia computadorizada. Disfunção facial parcial após a cirurgia foi detectada em 12 casos e a função do nervo facial foi recuperada em 3 meses. Apenas um paciente apresentou recidiva e ficou livre da doença após reoperação. Sugerimos que nosso algoritmo de tratamento, a depender da localização dos tumores e do resultado da PAAF, pode ser útil para determinar a extensão apropriada da cirurgia para os tumores de Warthin.

Avaliação das complicações pós-operatórias em pacientes idosos submetidos à parotidectomia / Evaluation of postoperative complications in elderly patients submitted to parotidectomy

RESUMO Objetivo: avaliar subtipos histológicos mais incidentes e as principais complicações pós-operatórias em pacientes idosos portadores de tumor de parótida e submetidos à parotidectomia. Métodos: estudo retrospectivo de 57 pacientes idosos submetidos à parotidectomia, no período de 2003 a 2017, no Hospital Municipal São José de Joinville, Santa Catarina, Brasil. Resultados: trinta e três (57,9%) pacientes tinham tumores benignos, sendo o mais frequente o tumor de Warthin, e 17(29,8%) tumores malignos, sendo o carcinoma escamoso o mais frequente. Sete (12,3%) pacientes evoluíram com complicações clínicas, sendo a labilidade pressórica e as complicações respiratórias as mais incidentes em quatro (7%) e três (5,3%) casos, respectivamente. Treze (22,1%) pacientes apresentaram complicações cirúrgicas relacionadas à ferida operatória, sendo o hematoma e a infecção de ferida as mais incidentes, com seis (10,5%) casos cada. Vinte e quatro (42,1%) pacientes tiveram algum grau de disfunção do nervo facial no pós-operatório, sendo o grau III de Brackman-House, em 11 casos (19,3%), o mais frequente. O tempo cirúrgico e a linfadenectomia mostraram associação com complicações clínicas. As principais variáveis que apresentaram associação com complicações cirúrgicas foram: tamanho do tumor, tempo cirúrgico mais longo, reoperação e volume de infusão de cristaloides no transoperatório. Conclusão: as neoplasias parotídeas apresentam perfil diferenciado na população idosa, destacando-se o tumor de Warthin e o carcinoma escamoso. Hematoma e infecção da ferida operatória, e as lesões do nervo facial foram as complicações mais prevalentes no pós-operatório.

ABSTRACT Objective: to evaluate the most incident histological subtypes and the main postoperative complications in elderly patients with parotid tumors submitted to parotidectomy. Methods: we conducted a retrospective study with 57 elderly patients submitted to parotidectomy from 2003 to 2017, at the São José County Hospital of Joinville, Santa Catarina, Brazil. Results: thirty-three (57.9%) patients had benign tumors, the most frequent being Warthin's tumor, and 17 (29.8%), malignant tumors, squamous cell carcinoma being the most frequent. Seven patients (12.3%) presented clinical complications, arterial pressure instability and respiratory complications being the most frequent, in four (7%) and three (5.3%) cases, respectively. Thirteen (22.1%) patients presented complications related to the surgical wound, hematoma and wound infection being the most frequent, with six (10.5%) cases each. Twenty-four (42.1%) patients had some degree of facial nerve dysfunction in the postoperative period, Brackman-House grade III being the most frequent, in 11 cases (19.3%). Surgical time and lymphadenectomy were associated with clinical complications. The main variables that showed an association with surgical complications were tumor size, longer surgical time, reoperation, and perioperative crystalloid infusion volume. Conclusion: parotid neoplasms present a differentiated profile in the elderly population, especially Warthin's tumor and squamous cell carcinoma. Hematoma and infection of the operative wound and facial nerve lesions were the most prevalent complications in the postoperative period.

Linfadenoma sebáceo en glándula parótida: a propósito de 2 casos / Lymphadenoma sebaceous of the parotid gland: a report of 2 cases

Objetivo: Reportar casos de linfadenoma sebáceo, un tumor raro, localizado principalmente en la glándula parótida, con muy pocos casos descritos en la literatura. Casos clínicos: Presentamos 2 casos de esta rara afección, tratados en el Hospital Universitario Miguel Servet de Zaragoza, de enero de 2010 a diciembre de 2014. El diagnóstico, tanto por imagen como citológico, es difícil debido a su baja prevalencia y a la gran variedad de tumores de glándula parótida que existen. En los 2 casos presentados ha sido necesaria la exéresis para llegar al diagnóstico. El tratamiento curativo consiste en la exéresis completa de la tumoración.

Aim: To report a rare parotid tumour: sebaceous lymphadenoma, with very few cases reported in the literature. Cases report: We present 2 cases of lymphadenoma sebaceous of the parotid gland treated by surgery at University Hospital Miguel Servet of Zaragoza between January 2010 and December 2014. The diagnosis, both radiological and cytological, is difficult because of their low prevalence and the great variety of parotid gland tumors existent. In our 2 cases described, excision has been required for diagnosis. A complete excision of the tumor is required for curative treatment.

Clinicopathological analysis of salivary gland tumors over a 15-year period

Abstract Salivary gland tumors (SGT) are rare neoplasms that generate interest due to their histopathological diversity and clinical behavior. The aims of the present study were to investigate clinicopathological aspects of SGTs diagnosed at a tertiary health center and compare the findings with epidemiological data from different geographic locations. Cases of tumor in the head and neck region at a single health center in the period between 1995 and 2010 were reviewed. Patient gender, age and ethnic group as well as anatomic location, histological type and clinical behavior of the tumor were recorded. Availability of complete information about these aspects was considered the inclusion criteria. Descriptive statistical analysis of the data was performed using the frequencies of categorical variables. Among the 2168 cases of tumors in the head and neck region, 243 (11.20%) cases were diagnosed in the salivary glands, 109 of which met the inclusion criteria: 85 (78%) benign tumors and 24 (22%) malignant tumors. Mean patient age was 46.47 years. The female gender accounted for 56 cases (51.4%) and the male gender accounted for 53 (48.3%). The major salivary glands were affected more (75.2%) than the minor glands. The most frequent benign and malignant SGTs were pleomorphic adenoma (81.2%) and adenoid cystic carcinoma (58.3%), respectively. In conclusion, pleomorphic adenoma and adenoid cystic carcinoma are the most frequent benign and malignant lesions, respectively. Comparing the present data with previous studies on SGTs, one may infer that some demographic characteristics and the predominance of malignant tumors vary in different geographic regions.

Right Ventricular Doppler Echocardiographic Study of Indeterminate Form of Chagas Disease / Estudo do Ventrículo Direito na Forma Indeterminada da Doença de Chagas pelo Doppler Ecocardiograma

Background: Patients with indeterminate form of Chagas disease/cardiac normality (ICD/CN) exhibited normal electrocardiograms and chest X-rays; however, more sophisticated tests detected some degree of morphological and functional changes in the heart. Objective: To assess the prevalence of systolic and diastolic dysfunction of the right ventricle (RV) in patients with ICD/CN. Methods: This was a case–control and prevalence study. Using Doppler two-dimensional echocardiography (2D), 92 patients were assessed and divided into two groups: group I (normal, n = 31) and group II (ICD/CN, n = 61). Results: The prevalence of RV systolic dysfunction in patients in groups I and II was as follows: fractional area change (0.0% versus 0.6%), mobility of the tricuspid annulus (0.0% versus 0.0%), and S-wave tissue Doppler (6.4% versus 26.0%, p = 0.016). The prevalence of global disorders such as the right myocardial performance index using tissue Doppler (16.1% versus 27.8%, p = 0.099) and pulsed Doppler (61.3% versus 68%, p = 0.141) and diastolic disorders such as abnormal relaxation (0.0% versus 6.0%), pseudonormal pattern (0.0% versus 0.0%), and restrictive pattern (0.0% versus 0.0%) was not statistically different between groups. Conclusion: The prevalence of RV systolic dysfunction was estimated to be 26% (S wave velocity compared with other variables), suggesting incipient changes in RV systolic function in the ICD/CN group. .

Fundamento: Pacientes com forma indeterminada da doença de Chagas/normalidade cardíaca (FIDC/NC) apresentam eletrocardiograma e raios X de tórax normais, porém, quando submetidos a exames mais sofisticados, são detectados alguns graus de alterações morfofuncionais do coração. Objetivo: Avaliar a prevalência de disfunção sistólica e diastólica do ventrículo direito (VD) em pacientes com FIDC/NC. Métodos: Estudo de caso-controle e prevalência. Foram avaliados 92 pacientes com Doppler ecocardiograma bidimensional (2D), divididos em dois grupos: grupo I (normal, n = 31) e grupo II (FIDC/NC, n = 61). Resultados: A prevalência da disfunção sistólica do VD em pacientes dos grupos I e II foi: mudança de área fracional (0,0% versus 0,6%), mobilidade do anel tricuspídeo (0,0% versus 0,0%) e onda S ao Doppler tecidual (6,4% versus 26,0%, com p = 0,016). As prevalências das disfunções globais – como índice de performance miocárdica direita ao Doppler tecidual (16,1% versus 27,8% com p = 0,099) e ao Doppler pulsado (61,3% versus 68% com p = 0,141) e diastólico, como alteração do relaxamento (0,0% versus 6,0%), padrão pseudonormal (0,0% versus 0,0%) e padrão restritivo (0,0% versus 0,0%) – não apresentaram significância estatística entre os grupos. Conclusão: A prevalência de disfunção sistólica do VD foi estimada em 26% (velocidade da onda S em comparação a outras variáveis), sugerindo alterações incipientes da função sistólica do VD no grupo FIDC/NC. .

Parotid adenolymphoma: the enhanced MSCT manifestations and clinical pathological analysis / 临床耳鼻咽喉头颈外科杂志

OBJECTIVE@#To investigate the imaging manifestations of 16-slice enhanced CT of parotid adenolymphoma in the parotid gland and the corresponding pathology,in order to improve the understanding of the CT imaging manifestations of parotid adenolymphoma in the parotid gland.@*METHOD@#The enhanced CT characteristics of 34 cases of parotid adenolymphoma in the parotid gland confirmed by histological pathology were retrospectively analyzed.@*RESULT@#There were totally 86 lesions in 34 cases, of which 12 cases with lesions in bilateral sides and 22 cases with lesions in unilateral side. Sixty-six lesions located behind and below the superficial lobe of the parotid gland. The lesions showed moderate to obvious enhancement at arterial phase, and the cystic region within the lesions showed no enhancement.@*CONCLUSION@#The relatively specific enhanced MSCT manifestations of parotid adenolymphoma in parotid gland include lesions located behind and below the superficial lobe of parotid gland unilaterally or bilaterally, sometimes exhibited as multiple masses, with clear edge, obvious enhancement and cystic degeneration inside.

Synchronous Bilateral Warthin Tumors: A Case Report

Introduction: Warthin tumor is described as papillary cystadenoma lymphomatosum and is the second most common tumor of the parotid glands. Bilateral synchronous incidence is rare, occurring in 7 to 10% of the cases. It is more common in males between 60 and 70 years of age and is closely related to smoking. There is slow growth and the condition is a delimited nodule of regular outlines; it has low rates of malignant progression and recurrence. Objective: Report a case of synchronous bilateral Warthin tumor occurring in an elderly patient, and review incidence and peculiarities of this tumor. Case Report: A 78-year-old man who used to smoke had a history of mild pain in the topography of right parotid three weeks ago. Patient with hypertension, diabetes and a longtime smoker (smoking a pack per day for 32 years) noticed a progressive bulging in the right parotid region for about 2.5 years ago, and noticed another progressive bulging (althought in the left parotid region), for about one year ago. Patient denied fever, redness, skin lesions and pain during this period until last three weeks, when he sought medical attention for a mild pain in the right facial region. The patient underwent cervical magnetic resonance imaging that showed tumor lesions in both parotids. Fine needle aspiration revealed a typical lesion of epithelial oxyphilic cells associated with reactive lymphoid proliferation, suggesting Warthin tumor. The patient underwent two superficial parotidectomies, and the histopathologic result from both tumors of parotid glands showed papillary cystadenoma lymphomatosum. Conclusion: The occurrence of synchronous bilateral Warthin tumor is extremely rare, and anamnesis and physical examination, as well as some complementary examinations, are important means for diagnostic evaluation. Confirmation of the diagnosis can only be obtained through a histopathologic study. A superficial or total parotidectomy is the recommended treatment for the disease...

Two-Phase Helical Computed Tomography Study of Salivary Gland Warthin Tumors: A Radiologic Findings and Surgical Applications

OBJECTIVES: The goal of this study was to define the radiologic characteristics of two-phase computed tomography (CT) of salivary gland Warthin tumors and to compare them to pleomorphic adenomas. We also aimed to provide a foundation for selecting a surgical method on the basis of radiologic findings. METHODS: We prospectively enrolled 116 patients with parotid gland tumors, who underwent two-phase CT preoperatively. Early and delayed phase scans were obtained, with scanning delays of 30 and 120 seconds, respectively. The attenuation changes and enhancement patterns were analyzed. In cases when the attenuation changes were decreased, we presumed Warthin tumor preoperatively and performed extracapsular dissection. When the attenuation changes were increased, superficial parotidectomy was performed on the parotid gland tumors. We analyzed the operation times, incision sizes, complications, and recurrence rates. RESULTS: Attenuation of Warthin tumors was decreased from early to delayed scans. The ratio of CT numbers in Warthin tumors was also significantly different from other tumors. Warthin tumors were diagnosed with a sensitivity of 96.1% and specificity of 97% using two-phase CT. The mean operation time was 38 minutes and the mean incision size was 36.2 mm for Warthin tumors. However, for the other parotid tumors, the average operation time was 122 minutes and the average incision size was 91.8 mm (P<0.05). CONCLUSION: Salivary Warthin tumor has a distinct pattern of contrast enhancement on two-phase CT, which can guide treatment decisions. The preoperative diagnosis of Warthin tumor made extracapsular dissection possible instead of superficial parotidectomy.

Warthin's Tumor with Skin Ulceration Mimicking Parotid Malignancy / 대한이비인후과학회지

Warthin's tumor with skin ulceration is extremely uncommon. We report on a 64-year-old man with Warthin's tumor with skin ulceration in the right parotid gland. The ulceration may have resulted from malignant transformation of either the epithelial or lymphoid component, or, as in very rare cases, an inflammatory process crossing the capsule of the tumor into the adjacent parotid parenchyma and overlying skin. Although Warthin's tumor is a common benign tumor of the parotid area, once ulcerated, it is difficult to make a clinical diagnosis. The gross finding of the case reported herein was close to the malignant form, but because an fine needle aspiration biopsy history existed, the possibility of whether more inflammatory changes might have occurred was considered. Therefore, since complications such as facial nerve injury may arise, extensive surgeries should be avoided.

Carcinoma tiroideo papilar oncocítico variante Warthin-like tumor: caso clínico y revisión de la literatura / Oncocytic variant of papillary thyroid carcinoma with lymphocytic stroma (Warthin-like variant): report of one case

Recently, an oncocytic variant of papillary thyroid carcinoma with lymphocytic stroma, called Warthin like tumor, has been described. Its evolution is similar to the usual papillary carcinoma. We report a 61 years old female with a multinodular goiter and a predominant nodule in the right lobe. A fine needle aspiration biopsy was compatible with a papillary thyroid carcinoma. A total thyroidectomy was performed and the pathological examination revealed a Warthin tumor of 2.2 cm. The patient was treated posteriorly with radioiodine and after six months of follow up, there is no evidence of disease...

Consideraciones anatómicas en la parotidectomía: revisión de la literatura a propósito de un caso / Anatomical considerations in parotidectomy: review of the literature and case report

La parotidectomía es un procedimiento quirúrgico habitualmente realizado por Cirujanos Maxilofaciales y Cirujanos de Cabeza y Cuello, en el cual se remueve parcialmente o en su totalidad a la glándula parótida. Las indicaciones más comunes para éste procedimiento son las neoplasias de la glándula. Aproximadamente el 80% del total de los tumores de glándulas salivales ocurren en la parótida. De estos, el 75-80% son de naturaleza benigna. Sin embargo, la parotidectomía es un procedimiento sumamente complejo debido a la anatomía regional y por la íntima relación de la glándula parótida con el nervio facial. Siendo la clave de este procedimiento la preservación funcional de éste nervio y de sus ramos. Por lo tanto el conocimiento acabado de la anatomía de la glándula parótida y de sus estructuras anexas es necesario para el éxito quirúrgico. Esta revisión y reporte de caso discutirá las consideraciones anatómicas que deben tenerse durante la parotidectomía para disminuir la posibilidad de alguna complicación.

Parotidectomy is a surgical procedure usually performed by Oral and Maxillofacial Surgeons and Head and Neck Surgeons, in which the parotid gland may be removed partially or totally. The most common indications for this procedure are the neoplasms of the gland. Approximately 80% of total salivary gland tumors occur in the parotid gland. Of these, 75-80% are benign. However, the parotidectomy is a highly complex procedure because of the regional anatomy and the close relationship of the parotid gland with the facial nerve. The most important aspect of this procedure is the functional preservation of the facial nerve and its branches. Therefore, the thorough knowledge of the anatomy of the parotid gland and related structures is necessary for surgical success. This review and case report will discuss the anatomical considerations that must be taken during parotidectomy to reduce the possibility of complications.

Diffuse Large B-Cell Lymphoma Arising in Warthin's Tumor: Case Study and Review of the Literature

Warthin's tumor is the second most common type of salivary gland tumor. Microscopically, Warthin's tumor displays a proliferative epithelial component and lymphoid stroma. Carcinomas arising from the epithelial component are well known, but malignant transformations of the lymphoid stroma are rare. When they do occur, they are most commonly B-cell type non-Hodgkin lymphomas. A 60-year-old male patient underwent surgical resection of a parotid mass. After superficial parotidectomy, microscopic examination indicated that the tumor was of epithelial components with basaloid and oncocytic columns of cells neighboring lymphoid components. In addition to the lymphoid follicles with distinct germinal centers, there were large, bizarre and extremely atypical neoplastic cells seen in the lymphoid component. Large neoplastic cells were diffusely CD20 and CD30 positive. The patient was diagnosed with "Warthin's tumor and diffuse large B-cell lymphoma with expression of CD30." The histopathologic and clinical features are discussed along with a review of the literature.

Concurrent Presence of Sjogren's Syndrome, Warthin Tumor, and MALT Lymphoma in a Parotid Gland and Hashimoto's Thyroiditis / 대한갑상선학회지

A 54-year-old female patient was referred due to a mass in the left salivary gland. A neck CT was performed and surgery was agreed due to a suspected Warthin tumor. The patient was also diagnosed with Sjogren's syndrome and Hashimoto's thyroiditis and treated. Warthin tumor and extranodal marginal zone B-cell lymphoma were also diagnosed after parotidectomy. The coexistence of the two autoimmune diseases, Hashimoto's thyroiditis and Sjogren's syndrome, has been reported, as has the coexistence of Warthin tumor and malignant tumor within a single salivary gland. However, these four diseases have not previously been reported in an individual patient. The authors treated a patient who was first diagnosed with Sjogren's syndrome and Hashimoto's thyroiditis, and subsequently also with Warthin tumor and extranodal marginal zone B-cell lymphoma after superficial parotidectomy. Therefore, this case is reported together with a related literature review.

Comparative analysis of ultrasonographic feature and histopathology in salivary Warthin's tumor / 华西口腔医学杂志

<p><b>OBJECTIVE</b>To promote the diagnostic accuracy of salivary Warthin's tumor by summarizing the ultrasonographic features of salivary Warthin's tumor.</p><p><b>METHODS</b>Sixty-nine lesions (58 patients with salivary Warthin's tumor) were retrospectively studied by ultrasonography and confirmed by histopathology.</p><p><b>RESULTS</b>The ultrasonographic manifestations of salivary Warthin's tumor demonstrated in three patterns.Type I: Solid mass(34 lesions, 49.3%), the mass was solid, grid-shaped echo inside. The mass was pathologically composed of such various tissues as epithelial cells, lymphatic organization, fibrous tissue which were compactly and evenly arranged, and little mucous formed the cyst cavity in which there projected epithelial papilla. Type II: Cystic-solid mixed mass(30 lesions, 43.5%), there was no flake-like echo, cystic-solid boundary was clear. Histopathological study revealed glandular epithelium made up irregular catheter and cyst cavity with yellowish mucous, glue-frozen-like stuff or brown colloidal substances. Type III: Cystic mass (5 lesions, 7.2%), the mass manifested separated cystic echo crumbs. The histopathological study showed salivary Warthin's tumor with infarctions and infections. The coincidence of ultrasound and histopathology diagnose was 79.7%.</p><p><b>CONCLUSION</b>The ultrasonographic features of salivary Warthin's tumor are mainly based on the organization of histopathological study. The grasp of various ultrasonographic imagings and pathological changes is beneficial for increasing the accuracy rate of diagnosis higher.</p>

morphological spectrum of salivary gland tumours at Kemu and Mayo hospital, Lahore

Salivary gland tumours constitute an important aspect of oral and maxillofacial pathology. The aim of this study was to classify and analyse the diverse spectrum of major and minor salivary gland tumours according to the revised WHO Classification [2005] of Salivary Gland Tumours [SGT]. This was a 4 year descriptive cross - sectional study [from 1[st] July 2008 - 30[th] June 2012] of 259 salivary gland tumours reported at the Department of Pathology, King Edward Medical University, Lahore. In a total 0/259 salivary gland tumours, 162 tumours [62.54%] were classified as benign and 97 tumours [37.45%] as malignant. The male to female ratio was almost equal and patients ranged in age from 8 years to 80 years. Maximum number of tumours were diagnosed in the 3[rd] to 5[th] decade of life. The commonest benign SGT was pleomorphic adenoma PA which constituted a total of 146 cases [90.12%] followed far down in frequency by Warthin tumour which comprised of 8 cases [4.93%]. Tlie commonest malignant SGT was mucoepidermoid carcinoma which constituted 43 cases [44.32%] followed by adenoid cystic carcinoma constituting 30 cases [30.92%]. A total of 200 tumours [77.22%] were reported in the major salivary glands of which 134 cases [67%] were classified as benign and 66 cases [33%] were malignant. The commonest benign tumour in the major salivary glands was pleomorphic adenoma constituting 118 cases [80.05%] out of 134 benign tumours and the commonest malignant tumour was mucoepidermoid carcinoma constituting 37 cases [56.06%] out of 66 malignant tumours. Fifty nine tumours [22.78%] were reported in the minor salivary glands of which 28 cases [47.45%] were benign and 31 cases [52.54%] were malignant. Pleomorphic adenoma was the sole benign tumour reported in the minor glands and adenoid cystic carcinoma was the commonest malignant tumour of minor salivary glands constituting 20 cases [64.51%] followed by mucoepidermoid carcinoma constituting 6 cases [19.35%]. The palate constituted the commonest site of minor salivary gland tumours harbouring 35 cases [59.32%] followed by the lips containing 10 cases [16.94%]. Other sites of minor salivary gland tumours included the buccal region [10.16%], pharynxgeal wall [5.08%], nasal cavity [3.39%], maxillary sinus [3.39%] and tongue [1.69%]. In the major salivary glands, benign tumours are much more common than the malignant tumours with the parotid being the most common location of both benign and malignant tumours. The sublingual gland harbours only a minor fraction of salivary tumours of which malignant tumours are more common than the benign. In the mmor salivary glands, malignant tumours outnumber the benign tumours and the palate constitutes the most common location of minor salivary gland tumours. In fact the palate harbours more tumours than the submandibular and the sublingual glands thus constituting the 2[nd] most common site of salivary gland tumours after the parotid gland

Low grade mucoepidermoid carcinoma in a setting of Warthin's tumor.

Warthin's tumor also known as papillary cystadenoma lymphomatosum is a common benign salivary gland neoplasm that occurs exclusively in parotid gland. Rarely, the tumor can undergo carcinomatous or lymphomatous transformation of epithelial or lymphoid component, respectively. Herein, we describe a case of 55-year-old female who had undergone parotidectomy for a rapidly growing tumor in the right parotid gland. The case was diagnosed as mucoepidermoid carcinoma developed in a setting of Warthin's tumor based on the histomorphology, special staining characters, and immunohistochemical findings. The pathogenesis and differential diagnoses of such rare malignancy has been discussed briefly.

Signos neurológicos asociados a pacientes caninos con linfoma / Neurological Symptoms Associated to Canine Patients with Lymphoma

El cáncer altera las estructuras o las funciones de órganos vecinos por su simple presencia, con las consiguientes manifestaciones clínicas; pero también produce efectos nocivos en órganos distantes. Estas alteraciones clínicas inducidas por la acción no invasiva del tumor son de gran diversidad clínica y se conocen como síndromes paraneoplásicos. En el presente trabajo se describen cuatro casos de pacientes caninos con alteraciones neurológicas asociadas a linfadenopatía superficial generalizada...

Cancer alters the structure or functions of adjacent organs with their sole presence, and subsequentclinical manifestations, but can also cause harmful effects in distant organs. Theseclinical changes induced by non-invasive tumor action are of great clinical diversity and areknown as paraneoplastic syndromes. This paper describes four cases of canine patients withneurological disorders associated to generalized superficial lymphadenopathy...

O câncer altera as estruturas ou as funções de órgãos vizinhos por sua simples presença, comas consequentes manifestações clínicas; mas também produz efeitos nocivos em órgãos distantes.Estas alterações clínicas induzidas pela ação não invasiva do tumor são de grande diversidadeclínica e são conhecidas como síndromes paraneoplásicas. No presente trabalho descrevemsequatro casos de pacientes caninos com alterações neurológicas associadas à linfadenopatiasuperficial generalizada...

Warthin's tumor of the parotid gland: a case report

Initially described in 1929, Warthin's tumor is a benign neoplasm predominantly found in the parotid gland of the salivary glands. Warthin's tumor is synonymous for cystadenoma lymphomatosum, adenolymphoma, and cystadenolymphoma. This tumor usually causes minimal pain, but the patient may complain of tinnitus, pain in the ear, or deafness. The tumor is treated with surgical excision, which is easily performed due to the superficial location of the tumor. In our case, a 69-year-old man visited our clinic primarily complaining of swelling in the left parotid gland area. Computed tomography revealed well-defined margins of the tumor in the superficial lobe of the left parotid gland and heterogeneous contrast enhancement. We performed superficial parotidectomy, with the pathological examination confirming Warthin's tumor. We report a typical case of Warthin's tumor and a literature review.