Extracapsular dissection for warthin tumors despite the risk of ipsilateral metachronous occurrence.

OBJECTIVES/HYPOTHESIS: The ideal extent of surgical intervention for cystadenolymphomas of the parotid gland remains a matter of controversy. The aim of our study was to assess the surgical outcome after extracapsular dissection for cystadenolymphomas of the parotid gland. A further purpose of this study was to examine how the number of primary cystadenolymphomas or the size of the primary lesion influences the possibility of an ipsilateral metachronous tumor occurrence.

STUDY DESIGN: Retrospective clinical study.

METHODS: A retrospective evaluation of the records was carried out for all patients treated for cystadenolymphomas of the parotid gland by means of extracapsular dissection at a tertiary referral center between 2000 and 2012.

RESULTS: Three hundred twenty-seven patients were included in the study. Our analysis detected an overall occurrence rate of ipsilateral metachronous tumors of 3.1% (10/327) with a mean follow-up of 108.4 months. A significant difference in the rate of metachronous lesions between unilocular (1.7%) and multilocular (11.6%) tumors could be detected (χ2 (1) = 7.342, P < .001). Our analysis was not able to find any significant influence of the maximal tumor size on the rate of metachronous tumors (χ2 (1) = 0.634, P = .426).

CONCLUSIONS: One of the most controversial issues in the treatment of cystadenolymphomas of the parotid gland concerns the question of which is the best therapeutic approach to be taken in such patients. Our analysis was able to demonstrate the benefits of extracapsular dissection in the management of solitary as well as carefully selected multicentric cystadenolymphomas with a consistently acceptable surgical outcome.

LEVEL OF EVIDENCE: 4. Laryngoscope, 2018.