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Conservative management of warthin tumour.

BACKGROUND
Warthin tumour (WT) is usually treated by surgery to establish a histologic diagnosis. Conservative management is considered appropriate for patients with significant comorbidities, making anesthesia high risk. Preoperative fine-needle aspiration cytology (FNAC) is useful in diagnosing WT, making conservative management an option. In our institution, patients with an FNAC diagnostic of WT have the option of conservative management.


METHOD
Retrospective review of cases of WT over 10 years (1996-2006) to study the demographics of patients treated conservatively and surgically and to establish the accuracy of FNAC.


RESULTS
Eighty-six cases of WT were identified during the study period for which FNAC was diagnostic, of which 58 cases (67.4%) were treated conservatively and 28 cases (32.6%) were treated by superficial parotidectomy. A further seven cases of WT were diagnosed on histology as the corresponding FNAC was incorrect in two cases and nondiagnostic in five cases. With regard to WT, FNAC in our unit had a sensitivity of 80% and a specificity of 100%. Females accounted for 54.7% of cases, which is much higher than previously reported and likely reflects the high prevalence of smoking among females in Liverpool.


CONCLUSION
Conservative management for WT on the basis of a diagnostic FNAC was employed in 67.4% of cases. This included young patients who preferred to avoid surgery. Conservative management is a viable option if reliable cytologic reporting is available.