Synchronous Warthin Tumor and Mucoepidermoid Carcinoma: A Case Report and Cytological Challenges

Multiple synchronous tumors can be observed in the parotid gland, either unilaterally or bilaterally. When tumors of two distinct histological types occur together, they may present as collision tumors and can appear radiologically and clinically as a single mass. These cases often present challenges in preoperative diagnosis, both radiologically and cytologically. A 46-year-old male patient presented to the Ear, Nose, and Throat (ENT) department with swelling in the neck. Ultrasonographic examination revealed a cystic neoplasm measuring 32 × 30 mm in diameter in the parotid gland. Fine needle aspiration (FNA) cytology reported "Neoplasm - Benign, Warthin tumor" and the patient underwent superficial parotidectomy. The final pathological diagnosis was mucoepidermoid carcinoma with an adjacent Warthin tumor.The preoperative diagnosis of parotid masses containing tumors of two different histological types can be challenging. Careful consideration is necessary to avoid misdiagnosis, particularly in cases of collision tumors, where the presentation may mimic a single neoplasm.