Diagnosis Oncocytic Hyperplasia – What′s next?

Introduction Oncocytic tumors account for less than 1% of all salivary gland tumors and therefore are extremely rare. According to the current WHO classification they include oncocytomas, nodular oncocytic hyperplasia (NOH) and oncocytic carcinoma. In everyday clinical practice these terms can cause confusion, especially among younger colleagues.

Case presentations In a 67-year-old female patient during a routine visit, as an incidental finding, a mass of the right submandibular gland was detected. Clinically, there was a palpable, non-pressure-dolent enlargement of the gland, the facial nerve was intact. A submandibulectomy was performed for histologic confirmation. In the histopathological examination the diagnosis of oncocytic hyperplasia was confirmed. In another case, a 63-year-old female patient presented with persistent, painless swelling of both parotideal glands, in this case the facial nerve was also intact. Ultrasound showed intraglandular lymphadenopathy. The patient refused a parotidectomy. Histologic examination of a lymph node also revealed NOH.

Discussion NOH is extremely rare. It affects mainly women in the sixth decade of life. Due to the challenging histological features of the disease, diagnosis by biopsy is very difficult and therefore complete resection is recommended for histologic confirmation.

Conclusion Despite the misleading name – the syllable "onco" suggests a malignancy – oncocytic hyperplasia is a benign, non-neoplastic process without risk of degeneration. Thus follow-up care via clinical examination is recommended and sufficient.

Publication History

Article published online:
12 May 2023