A case of Warthin's tumor and a review of the literature

Wathin's tumor is a comparatively rare epithelial benign tumor of the salivary glands. The tumor hasbeen known to represent 5% to 10% of all salivary gland tumors. It occurs most frequently in the region of the parotid gland.Recently, we experienced a case of Warthin's tumor. The patient, 55 year-old man, visited our clinic with the chief complaint of a painless mass below the right parotid gland. The mass was well-defined, movable, firm, resilient in consistency, and not adherent to the surrounding tissues. Clinical diagnosis was a benign tumor inferior to the right parotid gland.The tumor was surgically removed. The remo ved tumor was encapsulated by a fibrosis connective tissue. It was 20×20×25mm in size, reddish brown in color and weighed 7.2g.Microscopically, the tumor had epithelial component and lymphoid component. The epithelium consisted of cells arranged in double layers around cystic spaces. The inner layer was composed of tall columnar cells with acidophilic cytoplasm, the outer layer was composed of cuboidal cells. The stroma had lymphoid tissue which demonstrated germinal cells. As a consequence histopathologic diagnosis was Warthin's tumor.The post-operative course was uneventful and no recurrence was observed.Additionally, we discussed 154 cases of Warthin's tumor reported in our country. 136 Warthin's tumors located in the region of the parotid gland, comprised 88.3%. Bilateral lesions were found to occur in 9.1% of the 154 cases. Age distribution ranged from 6 to 82 years old, the greatest frequency was between the fifth and sixth decades. There were 127 males and 27 females, a ratio of about 5:1. The symptom duration was usually within 5 years.Most of the masses ranged from the size of the first joint of adult Japanese male thumb to the size of a chicken egg. The doctrine that the tumor of originates from heterotropic salivary gland ducts in lymph nodes has been supported by many investigators.