Coexistence of Lung Cancer and Warthin Tumour in a Smoker: Importance of Accurate Interpretation of 18F-FDG-Avid Parotid Lesions

Warthin tumour is a benign salivary gland neoplasm strongly associated with smoking and known for avid 18F-FDG uptake. We report a 53-year-old male chronic smoker presenting with tinnitus and ear pain. A resected brain mass demonstrated metastatic carcinoma (TTF-1 positive, CK7 diffuse). 18F-FDG PET/CT revealed a moderately 18F-FDG -avid left upper lobe pulmonary nodule and a small 18F-FDG -avid intraparotid lesion....

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Audiologists encountering patients with tinnitus and ear pain who have a smoking history should be aware that parotid lesions lighting up on FDG-PET scans are not always malignant; this case does not change audiology practice but reinforces the need for multidisciplinary interpretation of imaging findings.

This case underscores the diagnostic pitfall of assuming FDG-avid parotid lesions represent metastatic disease, which is relevant to any clinician involved in the workup of patients presenting with ear symptoms alongside oncologic imaging.

1. 01Patient presented with tinnitus and ear pain; imaging revealed both lung cancer and a parotid lesion.
2. 02The parotid lesion was a benign Warthin tumour, not a metastasis, despite FDG-PET avidity.
3. 03Warthin tumours are known to be FDG-avid and can mimic malignancy on PET scans.
4. 04Chronic smoking is a shared risk factor for both lung cancer and Warthin tumour.
5. 05Case highlights the need for accurate, multidisciplinary interpretation of PET imaging in smokers.

PMID

42703139

DOI

10.47391/JPMA.26-66.

Journal

Journal of Pakistan Medical Association

Publication type

case_report

Evidence level

4

Sample size

1

Population

Single adult chronic smoker presenting with tinnitus and ear pain, found to have coexisting lung cancer and parotid Warthin tumour

Intervention

18F-FDG PET/CT imaging for oncologic evaluation