Experience with follow-up strategy in selected patients with Warthin tumour diagnosed by ultrasound-guided fine-needle aspiration biopsy (FNAB)

• Published in: European archives of oto-rhino-laryngology 2022-04, Vol.279 (4), p.2049-2055
• Main Authors: Fíková, Alžběta, Kuchař, Martin, Kalfeřt, David, Dostálová, Lucie, Balko, Jan, Zábrodský, Michal, Plzák, Jan
• Format: Article
• Language: English
• Subjects: Head and Neck; Head and Neck Surgery; Medicine; Medicine & Public Health; Neurosurgery; Otorhinolaryngology
• ISSN: 0937-4477; 1434-4726
• DOI: 10.1007/s00405-021-06959-3

Purpose Warthin tumour (WT) management options comprise surgery or follow-up. The purpose of this study was to asses our experience with the follow-up strategy in selected patients with an ultrasound-guided fine-needle aspiration biopsy (FNAB) showing WT. Methods We performed a retrospective analysis of patients diagnosed with WT using FNAB between 1.1.2006 and 31.12.2019. Patients were divided into three groups according to the therapeutic approach—immediate surgery, follow-up or surgery and follow-up. Results 323 patients were diagnosed with WT and met the study’s inclusion criteria (154 women, 47.7% and 169 men, 52.3%). 192 patients were operated right after the diagnosis, 109 patients were observed with their first detected tumour and 22 patients had parotid WT surgery and were in the wait-and-scan protocol with a contralateral tumour, recurrence or both. The growth rate (GR) of observed WT was highly variable (mean GR 1.0 mm/year (5%), median GR 0.8 mm (9%), range − 19.7 to +20.0 mm/year). From 131 patients in the follow-up group, 19 patients underwent surgery and definitive histology revealed 17 WTs and 2 adenocarcinomas. However, these 2 patients had changes in sonographic findings at their next control. The mean observation time was 44.7 months (range 12–138 months) in patients followed exclusively at our institution and 50.9 months (range 12–110 months) in patients observed in cooperation with an otorhinolaryngologist at the patients’ place of residence. Conclusion Ultrasound-guided FNAB is an accurate and simple method in WT diagnosis and based on its result a follow-up strategy can be chosen for selected patients with WT.