Salivary Gland Tumors Research Articles

Parotid cancer: analysis of preoperative parameters for adaptation of the therapeutic strategy.

To establish typical clinical and radiological profiles of primary low-grade parotid cancers in order to tailor therapeutic strategy. Retrospective study of 57 patients operated on for primary parotid cancer between 2010 and 2021, with review of preoperative MRI and histopathology according to a standardized scoring grid. To study prognostic factors and determine the preoperative clinical and radiological profile of low-grade cancers. Good prognostic factors for specific survival were: staging ≤ cT3 (p = 0.014), absence of adenopathy on cN0 MRI (p < 0.001), superficial lobe location (p = 0.033), pN0 (p < 0.001), absence of capsular rupture (p = 0.004), as well as the absence of peri-tumoral nodules (p = 0.033), intra-parotid adenopathies (p < 0.001), vascular emboli (p < 0.001), peri-neural sheathing (p = 0.016), nuclear atypia (p = 0.031), and necrosis (p = 0.002). It was not possible to define a reliable clinical and radiological profile for low-grade cancers (sensitivity 38%, specificity 79%). Our study demonstrated multiple factors of good prognosis, but it was not possible to define a clinical and radiological profile of patients likely to benefit from more limited surgery, nor to diagnose, a priori, low-grade cancers.

Molecular analysis using SalvGlandDx improves risk of malignancy estimation and diagnosis of salivary gland cytopathology: An exploratory multicenter study.

Diagnosis of salivary gland neoplasms is challenging, especially on cytological specimens acquired by fine-needle aspiration. The recently implemented standardized Milan system for reporting salivary gland cytopathology provides an estimated risk of malignancy (ROM); yet, for two of the categories, the diagnosis of the lesion remains unclear. However, a precise diagnosis is desirable for optimal patient management, including planning of surgery and imaging procedures. Cytological specimens (n=106) were subjected to molecular analysis using the SalvGlandDx panel. The risk of malignancy was calculated for each detected alteration based on the diagnosis of the resection specimen. By taking into account the molecular alterations, their associated ROM, the clinical and cytological features, and the current literature, the Milan category was evaluated. Of n=63 technically valid cases, 76% revealed a molecular alteration. A total of 94% of these molecularly altered cases could be assigned to a different Milan category when additionally taking molecular results into account. In only 2% of the salivary gland neoplasms of uncertain malignant potential, in which a molecular alteration was detected, the classification remained salivary gland neoplasms of uncertain malignant potential. Molecular analysis of cytological specimens provides a benefit in classifying salivary gland neoplasms on fine-needle aspiration. It can improve the ROM estimation and thus help to assign cases of formerly unknown malignant potential to clearly benign or malignant categories.

Case Series: Pleomorphic adenoma in minor salivary gland

Abstract* Pleomorphic adenomas (PA) are the most prevalent benign salivary gland neoplasms. They may occur at any age, with a peak incidence between 40 and 60 years of age. They are more commonly observed in females (60%). These tumors can arise in both the major and minor salivary glands. Approximately 80% of these tumors are diagnosed in the parotid gland, whereas 10% arise in the minor salivary glands, mainly affecting the palates, followed by the lips and cheeks. This report describes two cases of unusual lesions that were diagnosed as (PA) in the minor salivary glands in our department via a review of the relevant literature. The first case involved an 83-year-old man who presented with a slow-growing swelling on the right side of the upper lip, and the second case involved a 45-year-old woman who presented with a slow-growing lesion on the palate. The presence of PA was confirmed histopathologically after surgical resection. Although relatively rare, PA is a benign lesion, the diagnosis of which must be known for appropriate therapeutic management.

Clinical-pathological Correlation of CD68 and CD8 in Tumor Immune Microenvironment of Salivary Gland Neoplasms

Clinical-pathological Correlation of CD68 and CD8 in Tumor Immune Microenvironment of Salivary Gland Neoplasms

Rare Sites and Presentations of Pleomorphic Adenoma – A Case Series

Abstract Pleomorphic adenoma is the most frequently occurring benign salivary gland neoplasm, commonly in the major salivary gland. Sometimes, it can also occur in the minor salivary glands, the common site being the palate, the lips, and the cheeks. Rarely, it can also be seen in locations such as on the tongue, floor of the mouth, pharynx, retromolar area, tonsil, and nasal cavity. We discuss some interesting cases of uncommon locations of pleomorphic adenoma involving minor salivary glands and its clinical, diagnostic, and treatment aspects. Here, we present four rare presentations of pleomorphic adenoma treated in our department. The patient details and clinical pictures were taken after informed consent.

Unique Presentation of Rare Cervical Sympathetic Chain Schwannoma

We describe a unique case of a cervical sympathetic chain schwannoma that presented as an ambiguous oropharyngeal mass with a differential of a benign or malignant salivary gland tumor or neurogenic tumor. Consideration of a malignant salivary gland mass led us to modify our diagnostic approach so as not to risk seeding a potential malignancy and harming the patient. This article also highlights the distinct imaging findings of neurogenic tumors of the neck that are helpful in appropriately diagnosing these tumors.

Preoperative cytopathological investigatory aids in the diagnosis of salivary gland lesions.

Salivary gland lesions are a group of heterogeneous lesions inclusive of non-neoplastic and neoplastic lesions. History, clinical examination and preoperative investigations attempt to minimise the challenges faced in diagnosing these diverse lesions. Preoperative investigations include imaging and cytopathology. The advent of onsite evaluation methods to ensure sample adequacy and newer reporting systems that assign risk of malignancy has improved the sensitivity and specificity of cytopathology. The scope of this review is limited to the preoperative cytopathological investigations and the diagnostic challenges met in reporting salivary gland tumours.

The puzzle of diagnosing salivary gland tumors with immunohistochemistry

The puzzle of diagnosing salivary gland tumors with immunohistochemistry

Machine learning-based survival prediction nomogram for postoperative parotid mucoepidermoid carcinoma

Parotid mucoepidermoid carcinoma (P-MEC) is a significant histopathological subtype of salivary gland cancer with inherent heterogeneity and complexity. Existing clinical models inadequately offer personalized treatment options for patients. In response, we assessed the efficacy of four machine learning algorithms vis-à-vis traditional analysis in forecasting the overall survival (OS) of P-MEC patients. Using the SEER database, we analyzed data from 882 postoperative P-MEC patients (stages I–IVA). Single-factor Cox regression and four machine learning techniques (random forest, LASSO, XGBoost, best subset regression) were employed for variable selection. The optimal model was derived via stepwise backward regression, Akaike Information Criterion (AIC), and Area Under the Curve (AUC). Bootstrap resampling facilitated internal validation, while prediction accuracy was gauged through C-index, time-dependent ROC curve, and calibration curve. The model’s clinical relevance was ascertained using decision curve analysis (DCA). The study found 3-, 5-, and 10-year OS rates of 0.887, 0.841, and 0.753, respectively. XGBoost, BSR, and LASSO stood out in predictive efficacy, identifying seven key prognostic factors including age, pathological grade, T stage, N stage, radiation therapy, chemotherapy, and marital status. A subsequent nomogram revealed a C-index of 0.8499 (3-year), 0.8557 (5-year), and 0.8375 (10-year) and AUC values of 0.8670, 0.8879, and 0.8767, respectively. The model also highlighted the clinical significance of postoperative radiotherapy across varying risk levels. Our prognostic model, grounded in machine learning, surpasses traditional models in prediction and offer superior visualization of variable importance.

Analysis of pattern of salivary gland cancers: Descriptive analysis from a single center

Salivary gland carcinomas are the malignant tumours arising from major or minor salivary glands, accounting for 5% of all head and neck cancers. There is scarce data available regarding pattern of presentation and clinical outcome of salivary glands in Pakistan. Thus this retrospective analysis of the patients presenting with salivary gland tumours was designed. A total of 305 patients were diagnosed with salivary gland cancers from 2008 till 2023, including 127 (41.6%) of females and 178 (58.4%) of male patients. There were 191 (62.6%) patients with parotid gland cancer and 114(37.4%) with submandibular and other minor glands. Mucoepidermoid carcinoma was the most prominent histological type followed by Adenoid Cystic carcinoma. Grade 2 (44.1%) was most frequently reported followed by Grade 1 (33.9%) and 3 (22.0%). These cancers did not show any significant association with age or gender. Salivary gland cancers are relatively rare cancer. Further studies to explore biological characteristics and long term clinical outcome are recommended.

Warthin’s Tumor in Submandibular Salivary Gland: An Uncommon Extra Parotid Location

Introduction: Salivary gland tumors are complex to diagnose both on histopathology and cytology. Majority of these tumours arise in the parotid glands, followed by submandibular glands, and rarely in minor salivary glands. Warthin’s tumor (WT), also known as papillary cystadenoma lymphomatosum, is characterized by a dense lymphoid stroma and a double layer of oncocytic epithelium with papillary and cystic architecture. Only 6-10% cases have been reported in the extra-parotid locations i.e. cervical lymph nodes, submandibular gland and larynx. Case Report: Our patient presented with painless bilateral submandibular swellings for 1.5 months with history of chronic smoking of two bundles of biddis per day for 32 years. Conclusion: Hereby, this case was unique in its presentation as it was located in an extra parotid region with bilateral origin, as these locations carry clinical significance in diagnosing and ruling out conditions like lymphoma.

Cystadenoma of the Tongue: A Case Report

Cystadenoma is a rare benign salivary gland neoplasm characterized by a predominantly multicystic growth pattern. The parotid gland is involved in about 45–50% of cystadenoma cases, with the minor glands of the lip and buccal mucosa being the next most common sites. The tongue is rarely involved. We report the case of a 56 year-old patient who presented a cystadenoma of the base of the tongue.

Early Recurrence Adenoid Cystic Carcinoma of Paranasal Sinus, A Case Report

Introduction: Adenoid cystic carcinoma (ACC) of the head and neck is a rare salivary gland tumor. It grows and spreads in silence until causing a symptom. Surgery is still the main treatment of choice although complete resection is hard to achieve most of the time. Case Presentation: This report presents an adult female with ACC of the left hard palate and left maxillary sinus, this patient also had slight lymph nodes enlargement. She underwent sub-total maxillectomy followed by locoregional radiotherapy. The tumor spreads out to vertebral bones within one year and keeps on progressing despite bone radiation. It recurred locally and appeared in the neck lymph node 2 months after bone metastasis. Lung metastasis happened 3 months later and soon she passed away. Mortality happened in less than two years after initial treatment. Conclusion: : High tumor grade, advanced T stage, lymph node involvement, perineural invasion, and paranasal sinus location clearly define poor prognostic factors. In this case, adjuvant radiotherapy for poor prognostic factors ACC doesn’t give any benefit in locoregional control or overall survival.

Salivary gland tumors: an audit from a tertiary care centre in Northern India.

Salivary gland tumors are relatively rare and can exhibit various clinical behaviors. The study aims to understand the natural history, pathology, diagnostic workup, and treatment strategies for these tumors to improve patient outcomes. The audit included patients with salivary gland tumors detected through radiology or cytology. Patients underwent surgery, with some receiving adjuvant treatment. Demographic information, treatment interventions, and survival outcomes were analyzed using SPSS software. A total 89 as malignant salivart gland tumours were audited Malignant tumors were predominantly found in the parotid gland, with fewer cases in the minor salivary gland and submandibular gland.The median age of presentation was 47 years, and the majority of patients were male. The study examined various pathological and clinical factors, including tumor stage, nodal status, and the presence of facial palsy. Surgical procedures and histological types of tumors were documented. Adverse histological features like positive margins, lymph node positivity, lympho-vascular invasion, extracapsular spread, and perineural invasion were noted. POSTOP RT was administered to high-risk patients. Most malignant salivary gland tumors were found in the parotid gland, while minor salivary gland tumors were underrepresented in the audit. Surgical practices were diverse. Radiotherapy protocols were relatively standardized. The study found that certain histological features, such as lymph node positivity, margin positivity, lympho-vascular invasion, perineural invasion, and extracapsular spread, were associated with adverse effects on DFS and OS. The findings suggest that specific histological features, including LVI and ECE have emerged as independent prognostic factors for DFS and OS.

A Comparison of Clear Cell Sarcoma to Jaw and Salivary Tumors Bearing EWS Fusions.

To review tumors identified as "clear cell sarcoma" in order to determine similarities to the rare EWS fusion positive jaw and salivary gland tumors clear cell odontogenic carcinoma (CCOC) and clear cell carcinoma of the salivary gland (CCC). PubMed was used to collect all reports of clear cell sarcoma (CCS). Search parameters were "clear cell sarcoma" and "CCS." References in the publications were screened and cross-referenced. Data extracted included demographic characteristics, presenting signs and symptoms, radiographic findings, histological and immunohistochemical features and known molecular/genetic aberrations. Clear cell sarcoma has several similarities to CCOC and CCC. All three tumor types have similar histologic appearances including the presence of clear cells, as well as similar genetic profiles in that all harbor an EWSR1-CREB family fusions. Additionally, these tumors appear in soft tissue as well as bone, and can have a prolonged clinical course. CCS can appear anywhere in the body, including the head and neck region. All three tumors appear to have a predilection to women, although CCS may have a slight younger age of onset as compared to CCOC and CCC (3rd vs 5th decade of life, respectively). Gaining a better understanding of the similarities and differences between these three tumors may lead to a better understanding of each one.

Fast neutron therapy in Tomsk: 40-year experience in cancer treatmnet

The purpose of the study was to evaluate the efficacy of neutron therapy (NT) for salivary gland cancer and recurrent breast cancer. Material and Methods. The study included 130 patients with salivary gland cancer and 125 patients with recurrent breast cancer. Fast neutron therapy using U-120 cyclotron was given to the patients of the study group. Patients of the control group received standard radiotherapy (external beam radiotherapy). Results. Among patients with salivary gland cancer, a recurrence rate was significantly lower in patients who received a postoperative course of NT compared to patients of the control group (21.1 vs 45 %, p&lt;0.05). The five-year overall survival rates were 73.8 ± 9.5 % and 43.2 ± 9.4 % in the study group and the control group, respectively (p&lt;0.05). The five-year disease-free survival rates were 65.6 ± 7.5 % and 34.8 ± 9.1 % in the study and control groups, respectively (p&lt;0.05). In patients with recurrent breast cancer, a significant increase in the frequency of complete regression in the study group compared to the control group was observed (91.8 vs 51.3 %, p&lt;0.05). Ten-year survival rates in patients with no evidence of re-recurrence were 77.4 ± 8.7 % and 44.7 ± 8.8 % in the study group and the control group, respectively (p&lt;0.05). Conclusion. The study demonstrated efficacy of fast neutron therapy in patients with salivary gland cancer and recurrent breast cancer. Neutron therapy did not result in serious complications, improved survival of the patients and decreased the recurrence rate compared with standard radiotherapy.

Abstract 1076: Single nucleus RNA-sequencing using normal human salivary glands revealed a potential etiologic relationship between each salivary gland cell and salivary gland malignancies

Abstract Salivary glands are composed of several types of cells, and each cell type is predicted to be involved in the carcinogenesis of different types of cancers including Adenoid cystic carcinoma (ACC), Acinic cell carcinoma (AciCC), salivary duct carcinoma (SDC), myoepithelial carcinoma (MECA) and other histology. In this study, we performed single nucleus RNA-seq on three human salivary gland samples to clarify the gene expression profile of each complex cellular component of the salivary glands and related these expression patterns to expression found in salivary gland cancers (SGC) to infer cell of origin. By single nucleus RNA-seq, total 13,643 salivary gland cells were stratified into four clusters: acinar cells, ductal cells 1, ductal cells 2, and myoepithelial cells/stromal cells, with differentially expressed genes of each group. The localization of each cell group was anatomically validated by IHC of each cluster marker gene, and one group of ductal cells was found to represent intercalated ductal cells labeled with HES1. Gene ontology analysis for this group included “epithelial cell differentiation” confirming the intercalated duct. Furthermore, to elucidate the potential etiologic relationship between normal salivary glands cell type and salivary gland carcinoma histology, we compared the expression of each cluster marker to SGC public RNA-seq data. In comparison between AciCC and ACC, we used normalized RNA-seq data of 54 ACC and 21 AciCC. ACC had significantly less expression of acinar cells markers (STATH, CST2, and LPO) compared to other markers expression(***P = 4 × 10−51), unlike AciCC (P = 0.54), suggesting a possible contribution of acinar cells to the carcinogenesis of AciCC. In another cohort, we compared 16 SDC, and 38 MECA with publicly available RNA-seq data. Remarkably, HES1 and ELF3, each of two different ductal cell markers, were significantly upregulated in SDC consistent with origin of SDC from ductal cells (P=0.001, P=0.0007, respectively). Consistent with bulk RNA-seq results, expression of HES1 in IHC using clinical human SDC and MECA samples was higher in SDC than MECA, suggesting that the expression of the derived cells is involved in salivary gland carcinogenesis. Cell type expressions in specific SGC histology are similar to those found in normal salivary gland populations, indicating a potential etiologic relationship. On the other hand, there was no significant difference in myoepithelial marker ACTA2 expression between SDC and MECA, suggesting that the markers of origin are not always highly expressed, depending on cancer subtypes. Although publicly available SGC RNA-seq data used in this study are limited, the results remarkably reflect the diverse modes of carcinogenesis of SGC. These findings might provide a better understanding of the molecular basis of SGC and treatment strategies for SGC. Citation Format: Takuya Nakagawa, Chanond Nasamran, Jingjing Hu, Prakriti Sen, Theresa Guo, Kathleen Fisch, Joseph Califano. Single nucleus RNA-sequencing using normal human salivary glands revealed a potential etiologic relationship between each salivary gland cell and salivary gland malignancies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 1076.

Abstract 6450: High mobility group protein 2 (HMGA2) is highly expressed in a broad range of human cancers

Abstract The high mobility group protein 2 (HMGA2) is an essential component of the enhanceosome. It can attach to AT-rich binding sites in the DNA minor groove, affect the conformation of the DNA, and thereby modify the transcription of numerous genes. HMGA2 is preferentially expressed during organogenesis. Aberrant expression of HMGA2 in adult tissues is commonly associated with tumor formation and cancer aggressiveness. Accordingly, HMGA2 represents a potential drug target. To better comprehend the role of HMGA2 expression in cancer, a tissue microarray containing 8,344 samples from 115 different tumor entities and 608 samples of 76 different normal tissue types was analyzed. In normal tissues, a strong nuclear HMGA2 staining was limited to few cell types from the amnion, placenta, seminal vesicle, endocervix, fallopian tube, and respiratory epithelium. HMGA2 expression was generally markedly higher in cancer than in corresponding normal tissues. HMGA2 staining was found in 2,695 (42.7%) of the 6,313 interpretable tumor samples, including 701 (11.1%) with weak, 769 (12.2%) with moderate, and 1,225 (19.4%) with strong positivity. A total of 93 of 115 tumor categories showed HMGA2 expression in at least one case, and 69 tumor categories included at least one case with strong HMGA2 staining. The frequency of HMGA2 positivity was particularly high in cancers of the ovary and the endometrium (52.6-92.6%), pancreatico-biliary cancers (48.1-75.5%), thyroidal neoplasms (53.4-95%), salivary gland neoplasms (66.7-98%), nonseminomatous testicular germ cell tumors (73.5-93.5%), colorectal adenocarcinoma (81.6%), papillary renal cell carcinoma (68.2%), and in squamous cell carcinomas (36-81.5%). Tumor entities with a particularly low expression of HMGA2 included prostatic adenocarcinomas (1.3-4%), non-invasive urothelial carcinomas (1.8-4.3%), hepatocellular carcinoma (3.2%), and non-Hodgkin’s lymphomas (0%) It is concluded, that HMGA2 is highly expressed in a very broad range of tumor entities. These findings emphasize a potential role of HMGA2 as a drug target and demonstrate utility for HMGA2 IHC for the distinction of neoplastic from non-neoplastic tissues in several organs. Citation Format: Katharina Möller, Florian Lutz, Florian Viehweger, Martina Kluth, Claudia Hube-Magg, Christian Bernreuther, Guido Sauter, Andreas H. Marx, Ronald Simon, Till Krech, Stefan Steurer, Christoph Fraune, Sarah Minner, Natalia Gorbokon, Maximilian Lennartz, Eike Burandt, Anne Menz. High mobility group protein 2 (HMGA2) is highly expressed in a broad range of human cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6450.

Abstract 2414: Feasibility and clinical utility of blood based NGS in head and neck carcinomas: A single center experience from precision medicine program

Abstract Background: While blood-based next-generation sequencing is increasingly integral to clinical practice across various malignancies, the routine assessment of circulating tumor DNA (ctDNA) in head and neck cancer remains underexplored, with limited supportive data. Methods: This study focused on head and neck cancer patients enrolled in the Gustave Roussy precision medicine program (STING, NCT04932525), undergoing liquid biopsy (LB) with the FoundationOne Liquid CDX panel. The Molecular Tumor Board discussed cases, calculating Tumor Fraction (TF) based on aneuploidy, categorizing it as high or low with a 10% cutoff. Results: The analysis encompassed 239 LBs from 214 patients with relapsed or metastatic head and neck cancers. Of these, 59 LBs were from 57 patients showing stability or positive response (SD/R), while 180 were from 167 patients at diagnosis or disease progression (BL/PD). Notably, 156 (73%) were male, with a median age of 61 years. Within the cohort, 65% of LBs were from patients with squamous cell carcinomas (SCC), 15% adenoid cystic carcinomas (ACC), and 20% other histologies mainly adenocarcinomas. The anatomical distribution included 59 LBs from salivary gland (SG) cancers, 49 oropharynx (OP), 48 oral cavity (OC), and others including larynx, hypopharynx, sinus and nasopharynx. Among LBs performed at BL/PD, 72% were informative, while only 36% were so at SD/R. The proportion of informative biopsies varied across anatomical sites. For SCC, TP53 mutations were most prevalent (71%), followed by TERT and PIK3CA variants, and FGF19 and FGF3 amplifications. ACCs showed NOTCH1 mutations (6/19, 32%) as the most common, followed by TP53 and various other variants. In the entire cohort, clonal hematopoiesis-related variants were identified, with 40% showing at least one of DNMT3A, CHEK2, or ASXL1. Patients with low TF at BL/PD exhibited significantly improved overall survival (21.6 vs. 7.6 months, HR 0.35, 95% CI 0.23 - 0.53, p &amp;lt; 0.0001), consistent across subgroups except for OP.Conclusion: This study demonstrates the feasibility of liquid biopsy in HNSCC and rare head and neck tumors, providing valuable therapeutic and prognostic insights. The findings underscore the potential of liquid biopsy as a valuable tool in clinical decision-making for head and neck cancer patients. Citation Format: Filippo Gustavo Dall'Olio, Damien Vasseur, Lea Loriguet, Francois Regis Ferrand, Antoine Moya-Plana, Yungan Tao, Mariana Iacob, Karim Benihoud, Odile CASIRAGHI, Catherine Brenner, Pierre Busson, Philippe Gorphe, Santiago Ponce, Pierre Blanchard, Etienne Rouleau, Yohann Loriot, Ludovic Lacroix, Antoine Italiano, Ingrid Breuskin, Caroline Even. Feasibility and clinical utility of blood based NGS in head and neck carcinomas: A single center experience from precision medicine program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2414.

A Rare Synchronous Existence of Warthin’s Tumour and Oral Cancer

Oral squamous cell carcinoma (OSCC) is one of the most common malignancies worldwide while Warthin’s tumor (WT) is a common type of benign salivary gland neoplasm mostly seen in the parotid gland but rarely involves extra parotid tissues. Extra parotid WT is itself a rare entity and its synchronous occurrence with OSCC is an unusual phenomenon. It is vital to accurately identify the pathology as confusion may arise due to its rare occurrence and an intriguing presentation of resembling metastasis in lymph nodes. In the present review, a systematic literature search was performed and case reports and series in which synchronous existence of WT and OSCC were included. Total 13 papers have been included with 17 cases of synchronous WT and OSCC. Quality assessment for cases was done based on the CARE guidelines. The given results describe the histological features and site of WT in individuals who also had OSCC. Most of the studies described the histological findings of WT, which were seen involving the lymph nodes. More than 50% of the included cases had a history of tobacco chewing or smoking. The cases that have reported for follow up showed no evidence of any recurrence. WT with OSCC synchronous occurrence at a different site from the primary tumor can mimic a metastatic lesion from a primary lesion. It is a diagnostic challenge and could alter the management of these patients if not identified accurately. Awareness about this synchronous occurrence can avoid the overtreatment in such cases. Majority of the WTs described were seen in cervical lymph nodes.&#x0D; Keywords: Oral cancer; Warthin tumor; Benign Neoplasm; Mixed salivary gland tumor; Synchronous neoplasm; metastasis; Second malignancy; Prognosis.