A case of simultaneous occurrence of pleomorphic adenoma and Warthin's tumor in the left parotid gland

The synchronous occurrence of histologically distinct tumors in the same parotid gland is rare, withonly a frequency of 0.2 % based on a report by Turnbull and Frazell. We report a case of pleomorphic adenomaand Warthin's tumor that occurred simultaneously in the same parotid gland. A 55-year-o...

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Published inJapanese Journal of Oral and Maxillofacial Surgery Vol. 53; no. 8; pp. 509 - 513
Main Authors ISHIDA, Kosei, HOSODA, Masaru, HATA, Tsuyoshi, ITO, Satoshi, DEGUCHI, Hiroyo, KITAMURA, Naoya
Format Journal Article
LanguageEnglish
Published Japanese Society of Oral and Maxillofacial Surgeons 2007
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ISSN0021-5163
2186-1579
DOI10.5794/jjoms.53.509

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Abstract The synchronous occurrence of histologically distinct tumors in the same parotid gland is rare, withonly a frequency of 0.2 % based on a report by Turnbull and Frazell. We report a case of pleomorphic adenomaand Warthin's tumor that occurred simultaneously in the same parotid gland. A 55-year-old man presented with a painless swelling in the left parotid region, present for 9 years. The patientvisited our hospital at this time because of a recent increase in the size of the swelling. The mass in the superiorpart of the parotid gland was elastic hard and clearly demarcated. In contrast, the mass in the lower pole of parotidgland was elastic soft and indistinctly demarcated. We evaluated the tumors by 99mTc salivary gland scintigraphy, 67Ga scintigraphy, ultrasonography, parotidsialography, and computed tomographic scanning. We also performed an aspiration biopsy of the tumor in thelower pole of the parotid gland to make a preoperative diagnosis. The tumor in the lower pole of the parotid glandwas strongly suspected to be a Warthin's tumor, while the tumor in the superior part was considered to most likelybe a benign tumor. These tumors were resected by a superficial parotidectomy. As for the histopathologicaldiagnosis, the tumor from the lower pole was confirmed to be a Warthin's tumor, while the tumor in superior partturned out to be a pleomorphic adenoma.
AbstractList The synchronous occurrence of histologically distinct tumors in the same parotid gland is rare, withonly a frequency of 0.2 % based on a report by Turnbull and Frazell. We report a case of pleomorphic adenomaand Warthin's tumor that occurred simultaneously in the same parotid gland. A 55-year-old man presented with a painless swelling in the left parotid region, present for 9 years. The patientvisited our hospital at this time because of a recent increase in the size of the swelling. The mass in the superiorpart of the parotid gland was elastic hard and clearly demarcated. In contrast, the mass in the lower pole of parotidgland was elastic soft and indistinctly demarcated. We evaluated the tumors by 99mTc salivary gland scintigraphy, 67Ga scintigraphy, ultrasonography, parotidsialography, and computed tomographic scanning. We also performed an aspiration biopsy of the tumor in thelower pole of the parotid gland to make a preoperative diagnosis. The tumor in the lower pole of the parotid glandwas strongly suspected to be a Warthin's tumor, while the tumor in the superior part was considered to most likelybe a benign tumor. These tumors were resected by a superficial parotidectomy. As for the histopathologicaldiagnosis, the tumor from the lower pole was confirmed to be a Warthin's tumor, while the tumor in superior partturned out to be a pleomorphic adenoma.
Author DEGUCHI, Hiroyo
ISHIDA, Kosei
HATA, Tsuyoshi
HOSODA, Masaru
ITO, Satoshi
KITAMURA, Naoya
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  organization: Department of Oral Surgery, Kawasaki Medical University
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  fullname: HATA, Tsuyoshi
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  fullname: ITO, Satoshi
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  fullname: DEGUCHI, Hiroyo
  organization: Department of Oral Surgery, Kawasaki Medical University
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  fullname: KITAMURA, Naoya
  organization: Department of Oral Surgery, Kawasaki Medical University
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References 4) 石川秀俊, 石井保雄, 他: Warthin腫瘍 (2症例) の総合画像診断. 日口外誌 26: 991-998 1980.
2) Janecka, I. P., Perzin, K. H., et al.: Rare synchronous parotid tumors of different histologic types. Plast Reconst Surg 72: 798-802 1983.
5) Johons, M. E., Batsakis, J. G., et al.: Oncocytic and oncocytoid tumors of the salivary glands. Laryngoscope 83: 1940-1952 1973.
1) Turnbull, A. D. and Frazell, E. L.: Multiple tumors of the major salivary glands. Am J Surg 118: 787-789 1969.
7) 今野昭義, 沼田勉: 耳下腺腫瘍の画像診断. 日耳鼻 100: 952-955 1997.
11) 本田雅彦, 山本晃司, 他: 多形性腺腫の臨床統計的検討. 日大歯学 72: 813-823 1998.
8) Shugar, J. M., Som, P. M., et al.: Warthin's tumor, a multifocal disease. Ann Oto Rhinol Laryngol 91: 246-249 1982.
3) Schilling, J. A., Block, B. L., et al.: Synchronous unilateral parotid neoplasms of different histologic types. Head and Neck 11: 179-183 1989.
6) 鈴木晴彦, 竹内洋介, 他: 耳下腺腫瘍の超音波診断日耳鼻 100: 893-899 1997.
9) 飯田洋子, 小田野幾雄, 他: 99mTcO4-による唾液腺シンチグラフィで集積像を呈したWarthin腫瘍の1例. 核医学 20: 215-222 1983.
10) 滝波修一, 八幡英子, 他: ワルチン腫瘍の2例-99mTcO4-による唾液腺シンチグラフィーについて-. 歯放 33: 29-34 1993.
References_xml – reference: 1) Turnbull, A. D. and Frazell, E. L.: Multiple tumors of the major salivary glands. Am J Surg 118: 787-789 1969.
– reference: 11) 本田雅彦, 山本晃司, 他: 多形性腺腫の臨床統計的検討. 日大歯学 72: 813-823 1998.
– reference: 6) 鈴木晴彦, 竹内洋介, 他: 耳下腺腫瘍の超音波診断日耳鼻 100: 893-899 1997.
– reference: 3) Schilling, J. A., Block, B. L., et al.: Synchronous unilateral parotid neoplasms of different histologic types. Head and Neck 11: 179-183 1989.
– reference: 4) 石川秀俊, 石井保雄, 他: Warthin腫瘍 (2症例) の総合画像診断. 日口外誌 26: 991-998 1980.
– reference: 9) 飯田洋子, 小田野幾雄, 他: 99mTcO4-による唾液腺シンチグラフィで集積像を呈したWarthin腫瘍の1例. 核医学 20: 215-222 1983.
– reference: 7) 今野昭義, 沼田勉: 耳下腺腫瘍の画像診断. 日耳鼻 100: 952-955 1997.
– reference: 5) Johons, M. E., Batsakis, J. G., et al.: Oncocytic and oncocytoid tumors of the salivary glands. Laryngoscope 83: 1940-1952 1973.
– reference: 10) 滝波修一, 八幡英子, 他: ワルチン腫瘍の2例-99mTcO4-による唾液腺シンチグラフィーについて-. 歯放 33: 29-34 1993.
– reference: 8) Shugar, J. M., Som, P. M., et al.: Warthin's tumor, a multifocal disease. Ann Oto Rhinol Laryngol 91: 246-249 1982.
– reference: 2) Janecka, I. P., Perzin, K. H., et al.: Rare synchronous parotid tumors of different histologic types. Plast Reconst Surg 72: 798-802 1983.
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SubjectTerms pleomorphic adenoma
unilateral parotidgland
Warthin's tumor
Title A case of simultaneous occurrence of pleomorphic adenoma and Warthin's tumor in the left parotid gland
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