A Rare Synchronous Existence of Warthin’s Tumour and Oral Cancer: A systematic review

Abstract

Oral squamous cell carcinoma (OSCC) is one of the most common malignancies worldwide while Warthin’s tumor (WT) is a common type of benign salivary gland neoplasm mostly seen in the parotid gland but rarely involves extra parotid tissues. Extra parotid WT is itself a rare entity and its synchronous occurrence with OSCC is an unusual phenomenon. It is vital to accurately identify the pathology as confusion may arise due to its rare occurrence and an intriguing presentation of resembling metastasis in lymph nodes. In the present review, a systematic literature search was performed and case reports and series in which synchronous existence of WT and OSCC were included. Total 13 papers have been included with 17 cases of synchronous WT and OSCC. Quality assessment for cases was done based on the CARE guidelines. The given results describe the histological features and site of WT in individuals who also had OSCC. Most of the studies described the histological findings of WT, which were seen involving the lymph nodes. More than 50% of the included cases had a history of tobacco chewing or smoking. The cases that have reported for follow up showed no evidence of any recurrence. WT with OSCC synchronous occurrence at a different site from the primary tumor can mimic a metastatic lesion from a primary lesion. It is a diagnostic challenge and could alter the management of these patients if not identified accurately. Awareness about this synchronous occurrence can avoid the overtreatment in such cases. Majority of the WTs described were seen in cervical lymph nodes.

Keywords: Oral cancer; Warthin tumor; Benign Neoplasm; Mixed salivary gland tumor; Synchronous neoplasm; metastasis; Second malignancy; Prognosis.