PMC6295750_01
Axial contrast-enhanced CT images from 2008: An enlarged left intraparotid lymph node with central hypodensity is suspicious for tumor infiltration (a). An additional intraparotid lymph node can be seen, and in retrospect, a left oropharyngeal nodule can also be seen (b).
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His past medical history was significant for hypertension, dyslipidemia, atrial fibrillation, and WT of the left parotid gland in 2008 (Figure 1(a) and (b)) for which he received a left superficial parotidectomy and developed Frey syndrome (Figure 1). He was currently smoking with a history of 27.5 pack years. A more careful review of pre-parotidectomy imaging revealed the presence of the oropharyngeal lesion at that time (Figure 1(b)).
Further evaluation of MRI images from 2014 reveal the left oropharyngeal nodule. Fat-saturated T2 (a), pre-contrast T1 (b), and post-contrast T1 (c) show a peripherally enhancing 8 mm nodule.
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Magnetic resonance imaging (MRI) studies of the head and neck showed a small, submucosal ovoid shaped nodule, 8 mm in diameter, with a peripheral ring of enhancement of the left oropharyngeal airway (Figure 2(a)-(c)) (Figure 2).
Warthin tumor of the minor salivary gland. Microscopic examination (100x) shows bilayered oncocytic columnar epithelium with papillary architecture (a) and supporting fibrovascular stromal core with chronic inflammatory cells (b).
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Surgical pathology of this specimen was reported as WT (Figure 3(a) and (b)) (Figure 3).