Warthin's Tumor Demonstrated With Tc-99m Pertechnetate SPECT and CT

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A 55-year-old woman presented with a four-month history of bilateral preauricular swelling. She denied pain, fever, or symptoms of upper respiratory infection. Physical exam revealed bilateral parotid gland enlargement, without inflammatory changes. A contrasted CT demonstrated bilateral parotid hyperdense masses, the largest measuring 3 cm on the right, and a smaller 1.5 cm mass on the left. A planar Tc99m pertechnetate salivary scan demonstrated increased and delayed uptake in the inferior pole of the right parotid, consistent with a Warthin's tumor. Delayed uptake in the left parotid mass was not well defined on planar imaging. Further evaluation with SPECT demonstrated delayed uptake in both parotid lesions. The findings of bilateral Warthin's tumors was confirmed by surgical excision of both lesions.

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