Multimodality Imaging of Warthin’s Tumor: PET/CT, Scintigraphy, MRI, and CT

TL;DR

This case study shows how combining different imaging techniques can help diagnose a benign salivary gland tumor that looks like cancer on PET/CT scans.

Contribution

The paper highlights the diagnostic value of multimodality imaging in identifying Warthin’s tumor and emphasizes the need for cytologic confirmation.

Findings

A hypermetabolic parotid lesion on PET/CT was confirmed as Warthin’s tumor via fine-needle aspiration.

Multimodality imaging provided complementary data but did not replace the need for cytology.

Recognizing imaging features and modality limitations is crucial to avoid misdiagnosis.

Abstract

Warthin’s tumor is a benign salivary gland neoplasm that can exhibit intense FDG uptake, potentially mimicking malignant lesions on oncologic imaging. We report a case of a 78-year-old man undergoing staging for suspected lung cancer, in whom a hypermetabolic lesion was incidentally detected in the left parotid gland on [18F]FDG PET/CT. Correlation with prior salivary scintigraphy, MRI, and CT supported the likelihood of Warthin’s tumor, which was subsequently confirmed by fine-needle aspiration cytology. This case illustrates how multimodality imaging can provide complementary diagnostic information that helps characterize the parotid lesion, but not replace cytologic confirmation. Recognition of characteristic imaging features, an understanding of each modality’s diagnostic strengths and limitations, and cytologic confirmation when indicated are essential to avoid misinterpretation and optimize patient management.

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