Bilateral Multifocal Warthin Tumors Mimicking Metastatic Papillary Thyroid Carcinoma

A Rare Case Posing a Diagnostic Challenge

Abstract

Warthin tumor is the second most common benign tumor of parotid gland. It rarely may be multifocal and occur at extraparotid sites, most common being the cervical lymph nodes. Fine-needle aspirate cytology is diagnostic in most cases of parotid Warthin tumors; however, in extraparotid sites, the diagnosis can be challenging. The difficulty can be further amplified if there is a synchronous lesion in a visceral organ on radiology, raising the suspicion of a metastatic carcinoma. We report an unusual diagnostically challenging case of synchronous, bilateral, multifocal intraparotid and extraparotid Warthin tumors mimicking a metastatic papillary thyroid carcinoma. We also highlight the usefulness of intraoperative consultation in guiding appropriate management in such cases.