Iranian Journal of Otorhinolaryngology

Iranian Journal of Otorhinolaryngology

Mucoepidermoid Carcinoma Superimposed on a Warthin's Tumor: A Case Report and Review of the Literature

Document Type : Case Report

Authors
Shirin Taraz-Jamshidi 1
Samaneh Mahjouri 1
Leila Vazifeh-Mostaan 2
1 Department of Pathology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
2 Cancer Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
10.22038/ijorl.2020.46189.2514
Abstract
Introduction:
Warthin's tumor (WT) is the second most common neoplasm of the parotid gland and consists of two components, including lymphoid stroma and glandular epithelium. The malignant transformation of this tumor occurs most often in the lymphoid component; however, the carcinomatous transformation of the epithelial component is rare.
 
Case Report:
We present a patient who had a mass in the right mandibular angle two years before referral. A cystic mass was reported on sonography, and the patient underwent superficial parotidectomy with a pre-operative impression of lymphangiomatouse-like lesions. In the microscopic view, the sections revealed salivary gland neoplastic lesion with the diagnosis of WT. On the periphery of the neoplasm, another neoplastic lesion was observed along with infiltrative borders and diagnosis of mucoepidermoid carcinoma.
 
Conclusion:
The WT is one of the most common tumors of the salivary glands. Malignancy transformation of the WT is a rare event. However, due to the importance of the treatment type, the surgeon should consider this issue in cystic lesions suspected of WT.
Keywords
Mucoepidermoid carcinoma
Parotid gland
Salivary glands
Warthin's tumor
  1. Goldblum J, Lamps L, McKenney J, Myers J, Ackerman L & Rosai J. Rosai and Ackerman's surgical pathology. Elsevier. 2018. 2892 p. ISBN: 9780323442084
  2. Bell D, Luna MA. Warthin adenocarcinoma: analysis of 2 cases of a distinct salivary neoplasm. Annals of Diagnostic Pathology [Internet]. 2009 Jun;13(3):201–7. Available from: http://dx.doi.org/ 10.1016/j.anndiagpath.2008.02.015
  3. Tian Z, Li L, Wang L, Hu Y, Li J. Salivary gland neoplasms in oral and maxillofacial regions: a 23-year retrospective study of 6982 cases in an eastern Chinese population. International Journal of Oral and Maxillofacial Surgery [Internet]. 2010 Mar; 39(3): 235–42. Available from: http://dx.doi.org/ 10.1016/j.ijom.2009.10.016
  4. Tumors of the Salivary Glands, Atlas of Tumor Pathology: Third Series, Fascicle 17 G. L. Ellis and P. L. Auclair. Armed Forces Institute of Pathology, Washington D.C. ISBN: 1 881041 26 3 (Printed). 1996. Price: $69.00. ISBN: 1 881041 41 7 (CD-ROM). 1998. Price: $65.00. The Journal of Pathology [Internet]. 2000;192(4):564–5. Available from: http://dx.doi.org/ 10.1002/1096-9896 (200012)192:4 3.0.CO; 2-M
  5. Peter Klussmann J, Wittekindt C, Florian Preuss S, Al Attab A, Schroeder U, Guntinas-Lichius O. High risk for bilateral Warthin tumor in heavy smokers – review of 185 cases. Acta Oto-Laryngologica [Internet]. 2006 Jan;126(11):1213–7. Available from:http://dx.doi.org/10.1080/0001648 0600740605
  6. Gorai S, Numata T, Kawada S, Nakano M, Tamaru J, Kobayashi T. Malignant Lymphoma Arising from Heterotopic Warthin’s Tumor in the Neck: Case Report and Review of the Literature. The Tohoku Journal of Experimental Medicine [Internet]. 2007;212(2):199–205. Available from: http://dx.doi.org/10.1620/tjem.212.199
  7. Yu C, Song Z, Xiao Z, Lin Q, Dong X. Mucoepidermoid carcinoma arising in Warthin’s tumor of the parotid gland: Clinicopathological characteristics and immunophenotypes. Scientific Reports [Internet]. 2016 Jul;6(1). Available from: http://dx.doi.org/10.1038/srep30149
  8. Yaranal PJ. Squamous Cell Carcinoma Arising in Warthin’s Tumour: A Case Report. Journal of Clinical and Diagnostic Research [Internet]. 2013; Available from:http://dx.doi.org/10.7860/jcdr/ 2012/ 4683.2697
  9. Mohapatra M, Satyanarayana S. Low grade mucoepidermoid carcinoma in a setting of Warthin′s tumor. Indian Journal of Pathology and Microbiology [Internet]. 2012;55(3):392. Available from: http://dx.doi.org/10.4103/0377-4929.101756
  10. Gadient SE, Kalfayan B. Mucoepidermoid carcinoma arising within a Warthin’s tumor. Oral Surgery, Oral Medicine, Oral Pathology [Internet]. 1975 Sep; 40(3):391–8. Available from: http://dx.doi. org/10.1016/0030-4220(75)90426-0
  11. Seifert G. Bilateral mucoepidermoid carcinomas arising in bilateral pre-existing Warthin’s tumours of the parotid gland. Oral Oncology [Internet]. 1997 Jul; 33(4):284–7. Available from: http:// dx.doi.org/ 10.1016/s0964-1955(97)00018-3.
  12. Saku T, Hayashi Y, Takahara O, Matsuura H, Tokunaga M, Tokuoka S, et al. Salivary gland tumors among atomic bomb survivors, 1950-1987. Cancer [Internet]. 1997 Apr 15;79(8):1465–75. Available from:http://dx.doi.org/10.1002/(sici) 1097-0142(19970415)79:8 3.0.co; 2-a
  13. Nagao T, Sugano I, Ishida Y, Tajima Y, Furuya N, Kondo Y, et al. Mucoepidermoid carcinoma arising in Warthin’s tumour of the parotid gland: report of two cases with histopathological, ultrastructural and immunohistochemical studies. Histopathology [Internet]. 1998 Oct;33(4):379–86. Available from: http://dx.doi.org/10.1046/j.1365-2559.1998.00502.x
  14. Williamson JD, Simmons BH, El-Naggar A, Medeiros LJ. Mucoepidermoid Carcinoma Involving Warthin Tumor. American Journal of Clinical Pathology [Internet]. 2000 Oct 1;114 (4): 564–70. Available from: http://dx.doi.org/ 10.1309/ gut1-f58a-v4wv-0d8p
  15. Mardi K, Sharma J. Mucoepidermoid carcinoma arising in Warthin's tumor: a case report. Indian J Pathol Microbial. 2007; 50:331-333. PMID: 17883061
  16. Smółka W, Markowski J, Piotrowska-Seweryn A, Paleń P, Dobrosz Z, Dziubdziela W. Letter to the Editor Mucoepidermoid carcinoma in Warthin tumor of the parotid gland. Archives of Medical Science [Internet]. 2015;3:691–5. Available from: http://dx.doi.org/10.5114/aoms.2015.52379
  17. Hakeem A, Hakeem I, Wani F. Intermediate-grade mucoepidermoid carcinoma arising from Warthin′s tumour of parotid gland. The Egyptian Journal of Otolaryngology [Internet]. 2016; 32(2): 113. Available from: http://dx.doi.org/10. 4103/1012-5574.181087
  18. Citak EC, Yilmaz EB, Sagcan F, Bozkurt F, Arpaci RB, Vayisoglu Y. Mucoepidermoid Carcinoma in Warthin Tumor of the Parotis in Childhood. Journal of Pediatric Hematology/Oncology [Internet]. 2019 Aug; 41(6): 494–7. Available from:http:// dx.doi.org/ 10.1097/ mph.0000000000001303
  19. Yamada S, Matsuo T, Fujita S, Suyama K, Yamaguchi A, Mizuno A. Mucoepidermoid carcinoma arising in Warthin’s tumor of the parotid gland. Pathology International [Internet]. 2002 Oct; 52(10):653–6. Available from: http:// dx.doi. org/10.1046/j.1440-1827.2002.01408.x

 

 

Iranian Journal of Otorhinolaryngology
Volume 33, Issue 1
January and February 2021
Pages 49-54