Warthin's Tumour (Adenolymphoma)

What is it?

Warthin's tumour is a benign growth of glandular and cystic structures that sometimes possesses a papillary cystic arrangement that is lined with eosinophilic epithelium. The stroma of the lesion has a variable amount of lymphoid tissues with follicles. As its name implies, it is of a bicellular nature.

This is a slow growing, painless mass that undergoes no fluctuation and often appears static. It most commonly occurs in the tail of the parotid and thus is found below the ear. If there is a rapid increase in size in these tumours, it is likely due to a cystic leak or infection of the lesion. The most common presentation is in male patients in their 6th to 7th decade of life.

Physical exam including:

• Palpate the glands
• Use bimanual palpation in the floor of the mouth

Imaging:

• CT scan or MRI
• Te99 scan

Fine needle aspiration biopsy

Management

• Superficial parotidectomy for superficial lesions
• Superficial parotidectomy with deep enucleation for deep lobe lesions, never facial nerve sacrifice/resection
• Submandibulectomy for submandibular lesions
• If Te99 is positive, no surgery may be required in the elderly

1. Granick M., Hanna III D., Management of Salivary Gland Lesions. Williams & Wilkins, Baltimore, 1992.
2. Thackray A.C., Sobin L.H., International Histological Classification of Tumours No.7: Histological Typing of Salivary Gland Tumours. World Health Organization, Geneva, 1972.
3. Rice D., Surgery of the Salivary Glands. B.C. Decker Inc., Toronto, 1982.

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