A 65-year-old woman presents with a slow-growing parotid mass confirmed on FNAC as a Warthin's tumor. She is a heavy smoker. Which of the following statements about Warthin's tumors is CORRECT?
- A They are the most common benign parotid tumor
- B Bilateral occurrence is seen in up to 10% of cases
- C They arise from heterotopic salivary tissue in lymph nodes, are associated with smoking ✓
- D Malignant transformation occurs in approximately 10–15% of cases
Correct answer: C. They arise from heterotopic salivary tissue in lymph nodes, are associated with smoking
Explanation
Warthin's tumor (papillary cystadenoma lymphomatosum) arises from heterotopic salivary gland epithelium entrapped in parotid lymph nodes during embryological development. It is strongly associated with cigarette smoking, which is thought to promote oncocytic metaplasia. Pleomorphic adenoma is the most common benign parotid tumor, not Warthin's. Bilateral or multifocal Warthin's occurs in 7–10% of cases. Malignant transformation is very rare (<1%), not 10–15%.
Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.
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Written and medically reviewed by the StethoPrep medical team.