Warthin’s Tumor USMLE Notes

Warthin’s Tumor USMLE Notes & Mnemonics contains all the high-yield points you need to know.

• Warthin’s Tumor (Papillary Cystadenoma Lymphomatosum): A benign, cystic tumor of the salivary glands, most commonly affecting the parotid gland.

Epidemiology:

• Represents 5-10% of all salivary gland tumors. (Ref)
• More common in men, typically in the 6th to 7th decades of life.
• Strong association with smoking.

Pathophysiology:

• Composed of two key elements: epithelial and lymphoid stroma.
• Believed to arise from salivary gland ducts.

Clinical Features:

• Painless, Slow-Growing Mass: Usually located in the lower pole of the parotid gland.
• Bilateral in 5-15% of cases.
• Rarely transforms into malignancy.

Diagnosis:

• Fine-Needle Aspiration (FNA) Biopsy: Diagnostic.
• Ultrasound or CT/MRI: To evaluate the extent and to differentiate from other salivary gland neoplasms.

Treatment:

• Surgical Excision: Standard treatment for symptomatic tumors or for definitive diagnosis.
• Observation: For asymptomatic, small tumors.

Mnemonic: “Warthin’s Tumor – WARTS”

• Warthy appearance (cystic, papillary)
• Adult males predominantly
• Repeated (bilateral in some cases)
• Tobacco association (strong correlation with smoking)
• Salivary gland (mainly parotid)

Chart: Warthin’s Tumor Features

Note: On the USMLE, Warthin’s tumor may be presented as a classic case of a painless, slow-growing parotid mass in an older male patient with a history of smoking. Recognizing its benign nature and association with smoking is key. The choice between surgical excision and observation depends on the symptoms, size, and patient preference.

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