A progressively enlarging parotid mass has a differential diagnosis that includes neoplastic and inflammatory conditions, but a Warthin tumor should be a top consideration in any patient with an extensive smoking history. Warthin tumors are typically painless and may be bilateral or multifocal. Histopathology characteristically shows bilayered oncocytic epithelium overlying lymphoid stroma. In addition to counseling on smoking cessation, management also generally includes surgical resection, which may be complicated by greater auricular or facial nerve injury, scarring, or Frey syndrome.
Comment
A progressively enlarging parotid mass has a differential diagnosis that includes neoplastic and inflammatory conditions, but a Warthin tumor should be a top consideration in any patient with an extensive smoking history. Warthin tumors are typically painless and may be bilateral or multifocal. Histopathology characteristically shows bilayered oncocytic epithelium overlying lymphoid stroma. In addition to counseling on smoking cessation, management also generally includes surgical resection, which may be complicated by greater auricular or facial nerve injury, scarring, or Frey syndrome.