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[Warthin tumor with carcinoma: malignant transformation or metastasis?]
D Baumhoer1, M Pfaltz, J Seydoux
1Institut für Pathologie, Universitätsspital Basel, Schönbeinstr 40, 4031 Basel, Schweiz. dbaumhoer@mac.com
Der Pathologe
|September 29, 2009
Summary
A long-standing Warthin tumor (WT) unexpectedly enlarged and was resected. While WT was confirmed, adenocarcinoma infiltrates suggested malignant transformation, but it was actually breast cancer metastasis. Always exclude metastatic disease when diagnosing malignant Warthin tumor.
Area of Science:
- Oncology
- Pathology
- Surgical Oncology
Background:
- Warthin tumor (WT) is a benign salivary gland neoplasm.
- Malignant transformation of WT is rare.
- Differential diagnosis of enlarged WT includes malignancy and metastasis.
Observation:
- A patient presented with a long-standing Warthin tumor showing sudden enlargement.
- Histopathological examination revealed WT with concurrent adenocarcinoma infiltrates.
- Radiological staging, including PET scans, was performed.
Findings:
- Histology confirmed Warthin tumor with adenocarcinoma.
- PET scans identified metastatic breast carcinoma morphologically identical to the tumor infiltrates.
- The observed adenocarcinoma was metastatic breast cancer, not a primary malignant transformation of WT.
Implications:
- This case highlights the critical importance of excluding metastatic disease in suspected malignant Warthin tumors.
- Accurate diagnosis is crucial for appropriate patient management and treatment planning.
- Rethinking the diagnostic criteria for malignant Warthin tumor is warranted.
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