Bilateral Multifocal Parotid & Extraparotid Warthin's Tumors-A Case Report

雙側多發性腮腺併腮腺外華生氏瘤－病例報告

10.7096/TJTSPS.201003.0060

張智豪(Chih-Hau Chang)；張高評(Kao-Ping Chang)；黃書鴻(Shu-Hung Huang)；賴春生(Chung-Sheng Lai)；林幸道(Sin-Daw Lin)

Warthin's tumor ； extraparotid tumor ； bilateral multifocal

臺灣整形外科醫學會雜誌

19卷1期（2010 / 03 / 01）

60 - 64

英文

背景： 華生氏瘤佔腮腺腫瘤發生率的第二位，約百分之5至34。文獻上雙側多發性腮腺華生氏瘤約佔華生氏腫瘤發生率的百分之2.3至6.5，腮腺外華生氏瘤約占發生率百分之8，但雙側多發性同時合併腮腺外華生氏瘤的個案為相當罕見。 目的及目標： 我們報告一例個案並回顧文獻對此病的發生率，診斷及治療作一探討。 材料及方法： 將一56歲有雙側臉頰及左頸部腫瘤的男性病人的臨床表現、檢查（驗）結果作一回顧並呈現。 結果： 經診斷為華生氏瘤，接受雙側淺部腮腺切除及腮腺外華生氏瘤全切除。該病患術後無併發症且追蹤一年後並無復發。 結論： 此罕見病例術前容易讓醫生懷疑是否為惡性腫瘤，緩慢變大的腫瘤病程及術前的影像學檢查有助於未察覺的病兆及鑑別診斷，此病例有助於提醒當面對頭頸部腫瘤疑似轉移時，華生氏瘤也有如此的表現方式。

Background: Warthin's tumor is a benign adenoma of the parotid gland, the second most common parotid neoplasm. The incidence was reported ranged from 5% to 34%, but bilateral multifocal, synchronous or metachronous, Warthin's tumors was quite rare. Reviewing of the literatures, only a few reports have had mentioned the incidence of bilateral multifocal Warthin's tumors ranged from 2.3% to 6.5%; and extraparotid Warthin's was 8% of Warthin's tumors. The implications of bilateral multifocal synchronous or metachronous Warthin's tumors remained relatively unclear. Aim and Objectives: We presented an unique case of bilateral multifocal metachronous combined with extraparotid Warthin's tumors in a 56 years old man. Diagnosis and treatment was discussed and clarified after literature review. Materials and Methods: A case of 56 years old man presented with bilateral infra-auricular masses and left neck nodule of the levels Ⅱ. Results: Bilateral superficial lobectomies were done and the left submandibular nodule was removed. Histopathologic examination confirmed Warthin's tumor at all specimens. The postoperative recovery was uneventful. There was no recurrence after 1 year follow up. Conclusion: This exclusive case makes it easy to doubt whether malignancy existed. History of slow-growing tumors and radiology examination preoperatively could help to detect concealed lesions and different diagnosis. Awareness of physician who treated head and neck tumors mimicking metastasis, Warthin's tumors should be considered.