The role of fine-needle aspiration biopsy (FNAB) in Warthin tumour diagnosis and management

Introduction Warthin tumour (WT) represents the second most common benign parotid neoplasm. The aim of this study is to evaluate the utility of the FNAB in the preoperative diagnosis and treatment decision in patients with WT.

Methods This retrospective study included patients treated for parotid gland mass between 2006 and 2016 who underwent surgery with preoperative FNAB. The first group was formed by patients with FNAB showing WT and the second group by patients with definitive histology of WT.

Results 216 patients underwent FNAB with the result of WT. The majority of patients were treated with enucleation (109, 50.5 %) or extracapsular extirpation (53, 24.5 %), 44 (20.4 %) had superficial parotidectomy, 5 (2.3 %) subtotal parotidectomy and 5 (2.3 %) total parotidectomy. A facial nerve palsy was seen in 20 cases (9.3 %) and was statistically more frequent in patients with more extensive surgeries. The definitive histology corresponded with the preoperative diagnosis in 201 cases (93.1 %). The other way round 222 patients were operated with definitive histology showing WT. The result of FNAB corresponded with definitive histology of WT in 201 cases (90.5 %). Counted sensitivity and specificity of the ultrasound guided FNAB for the diagnosis of WT were respectively: 96.63 % (CI 93.19 – 98.64 %) and 96.21 (CI 93.83 – 97.86 %). The accuracy of this method was 96.36 % (CI 94.54 – 97.70 %). All patients with definitive histology of WT are disease free with no recurrence.

Conclusion Ultrasound guided FNAB is a safe, accurate and reliable method in WT diagnosis. The therapeutic approach can be chosen based on FNAB results correlated with other clinical findings. We propose that when WT is suspected, follow up or enucleation of the tumour are appropriate treatments.

Publication History

Article published online:
10 June 2020