Radiotherapy for a cystadenolymphoma of the parotid gland (Warthin's tumor)

Background: With 17.6% of all primary parotid neoformations the benign Wart hin's tumor (cystadenolymphoma) is the second common parotid gland tumor. M ales > 50 years are affected predominantly. After surgery the recurrence ra te is Less than 5%. Histomorphologically the tumor is characterized by cyst oid ducts Lined by epithelial cells as well as Lymphoid stroma. The Lymphoi d component has been described as radioresponsive whereas the epithelial pa rts are Less radiosensitive. Since 1960 only one patient treated by primary radiotherapy has been published. Case report: A 77-year-old woman suffered from cystadenolymphoma (maximal d iameter 7 cm). Because of its extension and the reduced performance status of the patient surgery was no option. Radiotherapy was performed with a tot al dose of 50 Gy. Clinically, the tumor regressed completely after 30 Gy, w hich was confirmed by CT at 6 weeks after completion of radiotherapy. After 6 and 12 months the patient stayed free of tumor. Epicrisis: In our case the cystadenolymphoma was unusually Large (7 cm). Ra diotherapy with 50 Gy induced complete tumor regression. The good clinical response after 30 Gy suggests that the necessary dose may be Lower for Less extended cystadenolymphomas. Conclusion: We present a case of cystadenolymphoma treated by radiotherapy with 50 Gy resulting in a complete remission. Due to missing published expe riences no common recommendation for the total dose can be given, in the fo llowing situations radiotherapy should be considered: 1. high surgical risk of damage to the facial nerve, 2. unfavorable cosmetic outcome after surge ry, 3. inoperability for internal risks, 4. refusal of operation.