Treatment of Warthin's tumor by enucleation.

Among 162 patients with Warthin's tumor, 113 had removal by enucleation. The others, in whom parotidectomy and facial nerve dissection were performed, were not suspected of having Warthin's tumor preoperatively or had tumor too close to the facial nerve to be safely enucleated. Patients were generally older and more likely to be male than patients with other benign parotid tumors. Fifteen patients had multiple Warthin's tumors at the time of initial presentation; in an additional 12 patients, Warthin's tumor developed in the opposite parotid gland after the initial operation. In only two patients did an additional tumor develop in a gland from which a Warthin's tumor had previously been enucleated. No permanent injuries to the facial nerve occurred. Because of the safety and efficacy with which enucleation can be performed and because the risk of malignant transformation of Warthin's tumors is extremely small, we believe that enucleation is the treatment of choice in most cases.