Lymphoepithelial Cyst and Warthin Tumor of the Parotid Gland: Is It Really Essential to Distinguish Between Them?

Abstract Warthin tumour and lymphoepithelial cysts are both benign lesions with different risk factors but same same clinical behavior, and due to the similarities between these two entities differential diagnosis can be challenging. A 66 year-old Caucasian male, smoker, came to our attention with a cystic lesion located within the superficial lobe of the left parotid gland. Medical history was negative for other diseases. Warthin tumor was suspected, and patient underwent enucleation with preservation of the peripheral branches of the facial nerve. Definitive histopathological examination was consistent with lymphoepithelial cyst with reactive lymphadenopathy. It has been hypothesized that lymphoepithelial cysts may be an alternative histogenetic pathway of Warthin tumor, and due to the similarities between these two entities differential diagnosis can be challenging. Neverthless, the distinction is not fundamental, since surgical treatment for lymphoepithelial cyst and Warthin tumor is identical. Prospective correlation studies may determine whether FNA can be safely deferred in select cases.