Abstract:

Warthin's tumor (WT) is the most prevalent monomorphic adenoma of the major salivary glands. It accounts for 2–15% of all parotid tumors. Bilateral occurrences of multifocal WT are considerably less frequent than unilateral occurrences. Most of these bilateral tumors occur metachronously, with only a few synchronous occurrences reported in literature. A 61-year-old male presented with bilateral parotid swelling, with intermittent pain and difficulty opening his mouth. MRI revealed solid lesions in the superficial lobes of both parotid glands, with the largest measuring 3.7x2.3x3.8 cm on the left. FNAC indicated a Category IVA neoplasm, favoring WT. Bilateral parotidectomy and level IB neck dissection were performed. Histology showed multifocal, well-defined tumors with bilayered oncocytic epithelium, papillary and cystic structures, and lymphoid stroma. Reactive hyperplasia in lymph nodes was observed. These findings were consistent with bilateral multifocal WT. This case highlights a rare instance of synchronous bilateral WT in a 61-year-old patient. It emphasizes the need for careful diagnostic evaluation and treatment, as WT is typically metachronous. The report adds valuable insights to the literature, stressing the importance of considering synchronous presentations in salivary gland tumors.

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