Oral Pathology Short Case 6 - 60 Years old Male - Lump in the parotid

 Answer : Warthin tumour

Second most common tumour of salivary gland

5-15% of all cases

6th and 7th decades

Male > Female

Linked to cigarette smoking

Table 6 Histopathology

Papillary projections lined by epithelium	Lymphoid stroma
Papillary cystic structures lined by epithelium Epithelium Inner – Columnar Outher - Cuboidal	With germinal centers

After FNAC – necrosis confused with malignancy 

Granulomatous reaction with langerhan type giant cells may seen

Oncocytes – epithelial cells characterized by excessive number of mitochondria

When present in a lower pole metastatic node is a suspicion 

May associate with HIV (P 27 positivity in HIV)

Technetium 99 may appear as hot lesion

Complete surgical excision with adequate margin 

Parotid resection nomenclature
Anatomical	Functional
Extracapsular dissection Partical parotidectomy Superficial parotidectomy Deep parotidectomy	Conservative Semi conservative Radical
Eg : Conservative superficial parotidectomy

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