Gontarz Michał, Gałązka Krystyna, Gąsiorowski Krzysztof, Bargiel Jakub, Marecik Tomasz, Szczurowski Paweł, Wyszyńska-Pawelec Grażyna
Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 30-688 Cracow, Poland.
Department of Pathology, Jagiellonian University Medical College, 30-688 Cracow, Poland.
Diseases. 2024 Jul 1;12(7):140. doi: 10.3390/diseases12070140.
Warthin tumors (WTs) are the second most common salivary gland tumors, most commonly found in the tail of the parotid gland. The lymphoid components of a WT may also serve as a site for tumor-to-tumor metastasis. This report describes the metastasis of cutaneous squamous cell carcinoma (cSCC) from the preauricular region to a parotid WT. A 68-year-old male patient was admitted to the Department of Cranio-Maxillofacial Surgery of the Jagiellonian University in Cracow, Poland, with a two-year history of a growing, painless skin tumor of the right preauricular region. The patient was eligible for surgical treatment with elective neck dissection at the Va, III, II, I levels with parotidectomy and the excision of the cSCC. In the histopathological examination of the components of the surgical specimen beside the primary cutaneous squamous cell carcinoma (cSCC), a parotid WT was found; in the majority, it was occupied and destroyed by the metastatic cSCC and radically removed. After a tumor board consultation, due to the advanced stage (pT3N2b LVI2 PNI0 R0), with three intraparotid lymph node metastases and LVI2, the patient was authorized for postoperative radiotherapy. In conclusion, tumor-to-tumor metastasis is an extremely rare entity. Surgery is the standard of care for both WTs and head and neck cSCC. In most cases, metastasis into the parotid gland can be successfully treated with superficial parotidectomy with facial nerve preservation. Dissemination into the parotid gland requires elective neck dissection, as well as adjuvant treatment.
沃辛瘤（WTs）是第二常见的涎腺肿瘤，最常见于腮腺尾部。WT的淋巴成分也可能成为肿瘤间转移的部位。本报告描述了皮肤鳞状细胞癌（cSCC）从耳前区域转移至腮腺WT的情况。一名68岁男性患者因右侧耳前区域有一个逐渐增大、无痛的皮肤肿瘤，有两年病史，入住波兰克拉科夫雅盖隆大学颅颌面外科。该患者符合手术治疗条件，可进行选择性颈部清扫术，清扫颈V、III、II、I区，并进行腮腺切除术及切除cSCC。在对手术标本中除原发性皮肤鳞状细胞癌（cSCC）外的成分进行组织病理学检查时，发现了一个腮腺WT；大多数情况下，它被转移性cSCC占据并破坏，已被彻底切除。经过肿瘤多学科会诊，由于处于晚期（pT3N2b LVI2 PNI0 R0），有三个腮腺内淋巴结转移且LVI2，该患者被批准进行术后放疗。总之，肿瘤间转移是一种极其罕见的情况。手术是WTs和头颈部cSCC的标准治疗方法。在大多数情况下，腮腺转移瘤可通过保留面神经的浅叶腮腺切除术成功治疗。腮腺转移需要进行选择性颈部清扫术以及辅助治疗。
