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Current Trends and Controversies in the Management of Warthin Tumor of the Parotid Gland

腮腺 医学 硬化疗法 射频消融术 外科 普通外科 病理 烧蚀 内科学
作者
Miquel Quer,Juan C. Hernández-Prera,Carl E. Silver,María Casasayas,Ricard Simó,Vincent Vander Poorten,Orlando Guntinas‐Lichius,Patrick J. Bradley,Wai Tong Ng,Juan P. Rodrigo,Antti Mäkitie,Alessandra Rinaldo,Luiz Paulo Kowalski,Álvaro Sanabria,Remco de Bree,Robert P. Takes,Fernando López,Kerry D. Olsen,Ashok R. Shaha,Alfio Ferlito
出处
期刊:Diagnostics [MDPI AG]
卷期号:11 (8): 1467-1467 被引量:41
标识
DOI:10.3390/diagnostics11081467
摘要

Purpose: To review the current options in the management of Warthin tumors (WTs) and to propose a working management protocol. Methods: A systematic literature search was conducted using PubMed and ScienceDirect database. A total of 141 publications were selected and have been included in this review. Publications were selected based on relevance, scientific evidence, and actuality. Results: The importance of parotid WTs is increasing due to its rising incidence in many countries, becoming the most frequently encountered benign parotid tumor in certain parts of the world. In the past, all WTs were treated with surgery, but because of their slow growth rate, often minimal clinical symptoms, and the advanced age of many patients, active observation has gradually become more widely used. In order to decide on active surveillance, the diagnosis of WT must be reliable, and clinical, imaging, and cytological data should be concordant. There are four clear indications for upfront surgery: uncertain diagnosis; cosmetic problems; clinical complaints, such as pain, ulceration, or recurrent infection; and the patient’s wish to have the tumor removed. In the remaining cases, surgery can be elective. Active surveillance is often suggested as the first approach, with surgery being considered if the tumor progresses and/or causes clinical complaints. The extent of surgery is another controversial topic, and the current trend is to minimize the resection using partial parotidectomies and extracapsular dissections when possible. Recently, non-surgical options such as microwave ablation, radiofrequency ablation, and ultrasound-guided ethanol sclerotherapy have been proposed for selected cases. Conclusions: The management of WT is gradually shifting from superficial or total parotidectomy to more conservative approaches, with more limited resections, and to active surveillance in an increasing number of patients. Additionally, non-surgical treatments are emerging, but their role needs to be defined in future studies.
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