Successful surgical removal of rare parotid tumor

On the morning of May 11, Dr. Nguyen Thanh Tien, Head of the Department of Otorhinolaryngology ( Quang Nam General Hospital), said that doctors had just successfully removed a very rare Warthin tumor in the parotid gland for patient LXB (68 years old, in Phuoc Thang commune, Hiep Duc district, Quang Nam).

After removing the tumor and receiving long-term treatment at the hospital, Mr. B's health has now stabilized.

Recently, the ENT department received a patient with LXB in a state of swelling, pain, difficulty speaking, difficulty swallowing, difficulty breathing, and difficulty eating.

Warthin's tumor successfully removed

PHOTO: CX

Through clinical examination, doctors noted a tumor about 2x3 cm in size, located under the skin of the right parotid gland, with normal skin covering, firm to the touch, mobile, and painless.

Parotid ultrasound showed a hypoechoic mass measuring 28×18 mm, with clear boundaries and increased vascularity inside.

Fine needle aspiration cytology (FNA) results suggested chronic sialopharyngitis. However, because the clinical features did not rule out adenoma, the patient was indicated for surgical resection of the parotid gland tumor.

After consultation and preoperative tests, the patient was taken to the anesthesia and resuscitation department, where the surgical team removed the entire tumor for pathological anatomy, preserving the facial nerve (cranial nerve VII) safely without complications during surgery.

After surgery, the patient was closely monitored in the department. No complications such as hematoma, surgical site infection, or facial nerve injury were recorded.

The patient is currently recovering well.

Doctor Nguyen Thanh Tien said that the patient had been examined in many places and was diagnosed with a benign tumor, but the tumor grew very quickly. Therefore, if the surgery is not careful and the expertise is not high, it can easily cause complications such as paralysis of the 7th cranial nerve.

What is Warthin's tumor and what you need to know about it

In addition, postoperative histopathology results showed a characteristic image of Warthin tumor combined with salivary gland tuberculosis (a rare lesion but has been recorded in the literature).

Warthin tumor is a benign tumor composed of papillary glandular epithelium and activated lymphoid tissue. This lymphocyte-rich environment may favor secondary infections, including tuberculosis.

Warthin's tumor is also the second most common benign tumor after mixed tumors, usually occurring in older adults and associated with cigarette smoking.

In contrast, salivary gland tuberculosis is a very rare form of extrapulmonary tuberculosis, difficult to diagnose preoperatively because of its similar manifestations to benign tumors. The simultaneous occurrence of tuberculosis and Warthin tumor in the parotid gland is extremely rare, which can lead to errors in diagnosis and treatment if not detected accurately by histopathology.

Doctor Tien commented that this is a rare case, so surgery not only helps to completely treat the tumor but also contributes to the diagnosis of associated pathologies.

Source: https://thanhnien.vn/phau-thuat-cat-bo-thanh-cong-khoi-u-trong-tuyen-mang-tai-hiem-gap-18525051111473962.htm