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Inflammation following invasive procedures for Warthin's tumour: A retrospective case series
U Alkan1,2, Y Shkedy1,2, A Mizrachi1,2
1Department of Otorhinolaryngology - Head and Neck Surgery, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
Objective:
To determine the risk of inflammation associated with fine-needle aspiration during evaluation of Warthin's tumour.
Design:
Retrospective case series.
Setting:
Tertiary medical centre.
Participants:
All patients who underwent fine-needle aspiration followed by parotidectomy between 1992 and 2009 for the diagnosis/evaluation of a parotid gland tumour.
Main Outcome Measure:
Rate of fine-needle-aspiration-related parotitis in patients with Warthin's tumour or other parotid pathologies.
Results:
A total of 593 parotidectomies were performed in 553 patients during the study period, 96 (16.2%) for Warthin's tumour (study group) and 497 for other parotid-related pathologies (control group). Parotid gland inflammation following fine-needle aspiration was observed in 16 cases in the study group (16.7%) and eight (1.6%) in the control group (P<.001). On multivariate regression analysis, parotitis following fine-needle aspiration was more common in patients with Warthin's tumour than other parotid-related pathologies even after adjustment for possible confounders (P<.007). Signs of inflammation were noted during surgery in six cases in the study group (6.3%) and none in the control group (P<.001); respective rates of postoperative inflammation (wound infection) were 1.04% and 3.3% (P=NS). Management of parotitis consisted of hospitalisation and systemic antibiotic therapy.
Conclusions:
Warthin's tumour is associated with a tenfold higher risk of inflammation compared to other parotid tumours following invasive procedures. Clinicians should be alert to this complication in order to initiate proper treatment and patients must be properly counselled.
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