Ces radiol. 2025, 79(1):57-60 | DOI: 10.55095/CesRadiol2025/008

FDG-positive Warthin's tumor in the parotid gland mimicking the neck cervical lymph node metastasis of the malignant melanoma on 18F-fluorodeoxyglucose PET/CT imagingCase report

Jiří Doležal1, Dagmar Kalousová2, Jiří Grim3, Jaroslav Růžička4
1 Oddělení nukleární medicíny, Fakultní nemocnice Hradec Králové a Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové
2 Radiologická klinika, Fakultní nemocnice Hradec Králové a Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové
3 Klinika onkologie a radioterapie, Fakultní nemocnice Hradec Králové a Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové
4 Klinika otorinolaryngologie a chirurgie hlavy a krku, Fakultní nemocnice Hradec Králové a Univerzita Karlova v Praze, Lékařská fakulta v Hradci Králové

Aim: To present a rare case report of the 18F-FDG avid Warthin's tumor (papillary cystadenolymphoma) in the parotid gland mimicking a neck cervical lymph node metastasis of the malignant melanoma on the 18F-fluorodeoxyglucose PET/CT imaging.

Method: The 71-year-old man with positive history of the malignant melanoma underwent 18F-FDG PET/CT for finishing of the staging. The whole body PET/CT scan was obtained 60 minutes after intravenous injection of 18F-FDG (4.5 MBq/kg). The PET scan acquisition time was 2.5 minutes per bed position for whole body imaging and fourteen bed positions were necessary. Contrast-enhanced CT (venous circulation phase) provided both full CT evaluation (including intravenous and oral contrast) and PET attenuation correction.

Results: The examination revealed 18F-FDG avid lesion in the tight contact with the left glandula parotis. The PET/CT finding was suspected for the neck lymph node solitary melanoma metastasis. The patient underwent surgery and Warthin's tumour (papillary cystadenolymphoma) in the left glandula parotis was proven by histopathology.

Conclusion: Benign Warthin's tumour shows an increased 18F-FDG uptake in the neck lesion and mimics a solitary malignant melanoma metastasis on 18F-FDG PET/CT imaging and can cause potential pitfall in the PET/CT evaluation.

Keywords: Warthin's tumor, melanoma, PET/CT, 18F-FDG.

Accepted: January 31, 2025; Published: April 22, 2025  Show citation

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Doležal J, Kalousová D, Grim J, Růžička J. FDG-positive Warthin's tumor in the parotid gland mimicking the neck cervical lymph node metastasis of the malignant melanoma on 18F-fluorodeoxyglucose PET/CT imaging. Ces radiol. 2025;79(1):57-60. doi: 10.55095/CesRadiol2025/008.
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