Management of Warthin Tumor of Parotid Gland.

Study Overview
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Brief Summary
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Comparison between Ultrasound-Guided Ethanol Sclerotherapy (UGES) & surgical excision in management of warthin tumor of parotid gland.

Detailed Description
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Warthin tumor (also known as cystadenolymphoma), is a benign and frequent salivary gland neoplasm. It represents about 2% to 15% of all primary epithelial tumors of the parotid gland. Warthin tumor is histologically characterized by a dense lymphoid stroma and a double layer of oncocytic epithelium with a papillary and cystic architectural pattern. Its etiology: remains controversial. Incidence: It is the second most frequent benign neoplasm of the salivary glands after pleomorphic adenoma. Pathophysiology: Initially, Hildebrand proposed that the lesion may be remnants of the branchial pouches and a variant of the lateral cervical cyst. Later, Albrech and Artz proposed the heterotropic origin of Warthin tumor from the neoplastic proliferation of salivary gland ducts present within intra- or para-parotid nodes. Histopathology: Grossly, Warthin tumor is a well-circumscribed spherical to oval mass. On cut section, there are solid areas and multiple cysts with papillary projections. Cytology: Smears characteristically show oncocytic epithelial cells without atypia admixed with polymorphous lymphocytes and cellular debris. Microscopic Findings: Warthin tumors are composed of varying proportions of papillary- cystic structures lined by oncocytic epithelial cells and a lymphoid stroma with germinal centers. Clinically, Warthin tumor presents as a rounded or an ovoid nodular painless, slow-growing, fluctuant to firm at palpation. It can be unilateral, bilateral, or multicentric and is asymptomatic in 90% of cases. Prognosis: Warthin's tumor has a favorable prognosis and almost never recurs. Malignant degeneration of Warthin tumor is very rare. Complications: Local Recurrence; The local recurrence rate is low; when recurrence does occur, it is probably due to multifocal tumors or inadequate excision. Malignant Transformation; Malignant transformation in a Warthin tumor is extremely rare. The most frequent histological types of malignant transformation in a Warthin tumor are mucoepidermoid carcinoma, squamous cell carcinoma, undifferentiated carcinoma, oncocytic adenocarcinoma, and adenocarcinoma.

Official Title
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Comparison Between Ultrasound-Guided Ethanol Sclerotherapy (UGES) & Surgical Excision in Management of Warthin Tumor of Parotid Gland.

Conditions
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Warthin's Tumor of Parotid Gland

Intervention / Treatment
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* Procedure: Ultrasound-Guided Ethanol Sclerotherapy (UGES)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: All new cases presented with benign parotid cyst and diagnosed as Warthin tumour in the parotid gland. Exclusion Criteria: Other Parotid gland tumours e.g. solid tumours, malignant tumours and other suspicious tumours.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 80 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Intervention Model: Single Group Assignment
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Warthin tumor in parotid tumor<br>Comparison between Ultrasound-Guided Ethanol Sclerotherapy (UGES) & surgical excision in management of warthin tumor of parotid gland. | Procedure: Ultrasound-Guided Ethanol Sclerotherapy (UGES)<br>* Comparison between Ultrasound-Guided Ethanol Sclerotherapy (UGES) & surgical excision in management of warthin tumor of parotid gland.<br>* Other names: Surgical excision;|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Primary (main): | Rate of curability in each group | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Secondary (subsidiary): | Rate of facial nerve injury in each group | 1 week |