Vol.:(0123456789) 1 3 European Archives of Oto-Rhino-Laryngology https://doi.org/10.1007/s00405-021-06959-3 HEAD AND NECK Experience with follow‑up strategy in selected patients with Warthin tumour diagnosed by ultrasound‑guided fne‑needle aspiration biopsy (FNAB) Alžběta Fíková 1  · Martin Kuchař 1  · David Kalfeřt 1  · Lucie Dostálová 1  · Jan Balko 2  · Michal Zábrodský 1  · Jan Plzák 1 Received: 31 March 2021 / Accepted: 24 June 2021 © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2021 Abstract Purpose Warthin tumour (WT) management options comprise surgery or follow-up. The purpose of this study was to asses our experience with the follow-up strategy in selected patients with an ultrasound-guided fne-needle aspiration biopsy (FNAB) showing WT. Methods We performed a retrospective analysis of patients diagnosed with WT using FNAB between 1.1.2006 and 31.12.2019. Patients were divided into three groups according to the therapeutic approach—immediate surgery, follow-up or surgery and follow-up. Results 323 patients were diagnosed with WT and met the study’s inclusion criteria (154 women, 47.7% and 169 men, 52.3%). 192 patients were operated right after the diagnosis, 109 patients were observed with their frst detected tumour and 22 patients had parotid WT surgery and were in the wait-and-scan protocol with a contralateral tumour, recurrence or both. The growth rate (GR) of observed WT was highly variable (mean GR 1.0 mm/year (5%), median GR 0.8 mm (9%), range − 19.7 to +20.0 mm/year). From 131 patients in the follow-up group, 19 patients underwent surgery and defnitive histology revealed 17 WTs and 2 adenocarcinomas. However, these 2 patients had changes in sonographic fndings at their next control. The mean observation time was 44.7 months (range 12–138 months) in patients followed exclusively at our institution and 50.9 months (range 12–110 months) in patients observed in cooperation with an otorhinolaryngologist at the patients’ place of residence. Conclusion Ultrasound-guided FNAB is an accurate and simple method in WT diagnosis and based on its result a follow-up strategy can be chosen for selected patients with WT. Keywords Warthin tumour · Cystadenolymphoma · Fine-needle aspiration biopsy · Ultrasound · Follow-up strategy Introduction Warthin tumour (WT), or cystadenolymphoma, represents the second most common benign parotid gland tumour [1, 2]. Several centres reported an increased incidence of WT over recent years with WT as the most frequent parotid gland tumour entity [3, 4]. WT mainly afects older males (5th–7th decades of life), tends to be bilateral and multicentric, and is often associated with a history of smoking [5]. The tumour is well encapsulated, with solid and cystic areas mainly found in the inferior pole of the parotid gland. It is formed by oncocytic epithelial cells arranged in double layers and a lymphoid stromal component consisting of B and T cells [6, 7]. WT etiopathogenesis remains unclear and some authors suggest that they should be classifed as tumour-like lesions rather than true neoplasms [8–10]. Malignant transforma- tion of WTs is reported to be rare; it is more common in the lymphoid component (2.2%) than in the epithelial compo- nent (0.3%) [11, 12]. The management options for WT are surgery or observation. The correct preoperative diagnosis * Alžběta Fíková alzbeta.fkova@gmail.com 1 Department of Otorhinolaryngology and Head and Neck Surgery 1st Faculty of Medicine, Charles University, Faculty Hospital Motol, Postgraduate Medical School, V Úvalu 84, 150 06 Prague, Czech Republic 2 Department of Pathology and Molecular Medicine 2nd Faculty of Medicine, Charles University, Faculty Hospital Motol, V Úvalu 84, 15006 Prague, Czech Republic