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Quer M, Hernandez-Prera JC, Silver CE, et al. Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland. Diagnostics (Basel). 2021;11(8)doi: 10.3390/diagnostics11081467.
Quer, M., Hernandez-Prera, J. C., Silver, C. E., Casasayas, M., Simo, R., Vander Poorten, V., Guntinas-Lichius, O., Bradley, P. J., Tong-Ng, W., Rodrigo, J. P., Mäkitie, A. A., Rinaldo, A., Kowalski, L. P., Sanabria, A., de Bree, R., Takes, R. P., López, F., Olsen, K. D., Shaha, A. R., & Ferlito, A. (2021). Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland. Diagnostics (Basel, Switzerland), 11(8), . https://doi.org/10.3390/diagnostics11081467
Quer, Miquel, et al. "Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland." Diagnostics (Basel, Switzerland) vol. 11,8 (2021). doi: https://doi.org/10.3390/diagnostics11081467
Quer M, Hernandez-Prera JC, Silver CE, Casasayas M, Simo R, Vander Poorten V, Guntinas-Lichius O, Bradley PJ, Tong-Ng W, Rodrigo JP, Mäkitie AA, Rinaldo A, Kowalski LP, Sanabria A, de Bree R, Takes RP, López F, Olsen KD, Shaha AR, Ferlito A. Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland. Diagnostics (Basel). 2021 Aug 13;11(8). doi: 10.3390/diagnostics11081467. PMID: 34441400; PMCID: PMC8391156.
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Diagnostics (Basel). 2021 Aug 13;11(8). doi: 10.3390/diagnostics11081467.

Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland.

Diagnostics (Basel, Switzerland)

Miquel Quer, Juan C Hernandez-Prera, Carl E Silver, Maria Casasayas, Ricard Simo, Vincent Vander Poorten, Orlando Guntinas-Lichius, Patrick J Bradley, Wai Tong-Ng, Juan P Rodrigo, Antti A Mäkitie, Alessandra Rinaldo, Luiz P Kowalski, Alvaro Sanabria, Remco de Bree, Robert P Takes, Fernando López, Kerry D Olsen, Ashok R Shaha, Alfio Ferlito

Affiliations

  1. Department of Otorhinolaryngology, Hospital Santa Creu I Sant Pau, Universitat Autònoma de Barcelona, 08041 Barcelona, Spain.
  2. Multidisciplinary Salivary Gland Society, 1204 Genève, Switzerland.
  3. Department of Pathology, Moffitt Cancer Center, Tampa, FL 33612, USA.
  4. Department of Surgery, University of Arizona College of Medicine, Phoenix, AZ 85721, USA.
  5. Department of Otorhinolaryngology Head and Neck Surgery, Guy's and St Thomas' Hospital NHS Foundation Trust, London SE1 9RT, UK.
  6. Otorhinolaryngology-Head and Neck Surgery, University Hospitals Leuven, 3000 Leuven, Belgium.
  7. Department of Oncology, Section Head and Neck Oncology, KU Leuven, 3000 Leuven, Belgium.
  8. Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, 07740 Jena, Germany.
  9. Facial Nerve Center, Jena University Hospital, 07740 Jena, Germany.
  10. Department of Otolaryngology, Head and Neck Surgery, Nottingham University Hospital NHS Trust, Queens Medical Centre Campus, Nottingham NG7 2UH, UK.
  11. Department of Clinical Oncology, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China.
  12. Department of Otorhinolaryngology, Head and Neck Surgery, Hospital Universitario Central de Asturias, 33011 Oviedo, Spain.
  13. Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Instituto Universitario de Oncología del Principado de Asturias (IUOPA), University of Oviedo CIBERONC-ISCIII, 33011 Oviedo, Spain.
  14. Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, 00029 HUS Helsinki, Finland.
  15. Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska University Hospital, 141 86 Stockholm, Sweden.
  16. University of Udine School of Medicine, 33100 Udine, Italy.
  17. Head and Neck Surgery Department, University of Sao Paulo Medical School, São Paulo 01509, Brazil.
  18. Head and Neck Surgery and Otorhinolaryngology Department, A.C. Camargo Cancer Center, São Paulo 01509, Brazil.
  19. Department of Surgery, School of Medicine, Universidad de Antioquia, IPS Universitaria-Hospital Universitario San Vicente Fundación, Medellin 050010, Colombia.
  20. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, 3584 CX Utrecht, The Netherlands.
  21. Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.
  22. Department of Otorhinolaryngology, Mayo Clinic, Rochester, MN 55902, USA.
  23. Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
  24. Coordinator of the International Head and Neck Scientific Group, 35125 Padua, Italy.

PMID: 34441400 PMCID: PMC8391156 DOI: 10.3390/diagnostics11081467

Abstract

PURPOSE: To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol.

METHODS: A systematic literature search was conducted using PubMed and ScienceDirect database. A total of 141 publications were selected and have been included in this review. Publications were selected based on relevance, scientific evidence, and actuality.

RESULTS: The importance of parotid WTs is increasing due to its rising incidence in many countries, becoming the most frequently encountered benign parotid tumor in certain parts of the world. In the past, all WTs were treated with surgery, but because of their slow growth rate, often minimal clinical symptoms, and the advanced age of many patients, active observation has gradually become more widely used. In order to decide on active surveillance, the diagnosis of WT must be reliable, and clinical, imaging, and cytological data should be concordant. There are four clear indications for upfront surgery: uncertain diagnosis; cosmetic problems; clinical complaints, such as pain, ulceration, or recurrent infection; and the patient's wish to have the tumor removed. In the remaining cases, surgery can be elective. Active surveillance is often suggested as the first approach, with surgery being considered if the tumor progresses and/or causes clinical complaints. The extent of surgery is another controversial topic, and the current trend is to minimize the resection using partial parotidectomies and extracapsular dissections when possible. Recently, non-surgical options such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy have been proposed for selected cases.

CONCLUSIONS: The management of WT is gradually shifting from superficial or total parotidectomy to more conservative approaches, with more limited resections, and to active surveillance in an increasing number of patients. Additionally, non-surgical treatments are emerging, but their role needs to be defined in future studies.

Keywords: Warthin tumor; adenolymphoma; cystadenolymphoma; lymphomatous adenoma; papillary cystadenoma lymphomatosum; parotid tumor

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