Simultaneous nasopharyngeal and parotid gland Warthin's tumo
The present case has been reported in the journal Acta Otorhinolaryngol Ital.

A 63-year-old man was referred for the assessment of a right, non-painful, parotid mass. The lesion had been present for 4-6 months, but was increasing in size very slowly. He was also complaining the onset of snoring since 6 months with occasional nasal discharge.

Apart from a 40-year habit of smoking 20 cigarettes a day and the onset of a non-insulin dependent diabetes mellitus two years ago, his medical history was unremarkable.

ENT examination revealed a mobile 3.5 × 2.0 cm mass just behind the angle of the jaw (right side). Facial nerve function was normal. Nasopharyngeal endoscopy revealed an oval mass (1.0 cm) with a smooth surface in the left side of the nasopharynx. There were no other notable findings on physical examination.

Fine needle aspiration of the right parotid mass was performed. Histological examination revealed mixed lymphoid cells (lymphocytes and macrophages). The exact anatomical location of both lesions was confirmed by MRI.

Under general anaesthesia, the parotid mass was excised, via a superficial parotidectomy; at the same time, the nasopharyngeal mass was removed under FESS guidance. At histological examination, a synchronous parotid and nasopharyngeal WT was diagnosed. There have been no signs of tumour recurrence at 16 months postoperatively.

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