From the Research
The most common benign salivary gland tumor in smokers is Warthin's tumor, as evidenced by a strong association with tobacco smoking, with smokers having a significantly higher risk of developing this tumor compared to non-smokers 1, 2, 3.
Key Characteristics of Warthin's Tumor
- Warthin's tumor predominantly affects the parotid gland and is more common in males, particularly those in their 60s and 70s.
- The tumor is characterized histologically by a double layer of oncocytic epithelial cells forming cystic spaces with lymphoid stroma.
- Warthin's tumors are generally benign with very low malignant potential, and treatment typically involves surgical excision through superficial parotidectomy.
Association with Smoking
- The strong association with smoking is thought to be related to the retrograde flow of tobacco-related substances through the Stensen's duct, causing metaplastic changes in salivary gland tissue.
- Studies have shown that smokers have a significantly higher risk of developing Warthin's tumor, with a relative risk of 7.6 for men and 17.4 for women 2.
- Heavy smoking has also been identified as a significant risk factor for multilocular Warthin tumor development and bilateral Warthin tumors 3.
Clinical Presentation and Treatment
- Warthin's tumor typically presents as a slow-growing, painless swelling in the lower portion of the parotid gland, often near the angle of the mandible.
- Treatment typically involves surgical excision through superficial parotidectomy, with a low risk of recurrence and minimal risk of malignant transformation.
- The use of dynamic MRI has been shown to be a useful tool for preoperative diagnosis of Warthin's tumor, particularly in cases where other examinations indicate malignancy 4.