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

Authors

  • Sharjeel Usmani Department of Radiology and Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), University Medical City, Muscat Oman.
  • Anjali Jain Department of Radiology and Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), University Medical City, Muscat Oman.
  • Khulood Al Riyami Department of Radiology and Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), University Medical City, Muscat Oman.
  • Subash Kheruka Department of Radiology and Nuclear Medicine, Sultan Qaboos Comprehensive Cancer Care and Research Center (SQCCCRC), University Medical City, Muscat Oman.

DOI:

https://doi.org/10.47391/JPMA.26-66

Abstract

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. Given the smoking history and imaging characteristics, Warthin tumour was favoured over metastasis. Lung biopsy confirmed moderately to poorly differentiated adenocarcinoma; parotid FNAC confirmed Warthin tumour. This case highlights the diagnostic pitfall of 18F-FDG -avid benign salivary lesions during lung cancer staging

Keywords: 18F-FDG PET/CT; Warthin Tumour; lung cancer; smoking

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Published

2026-07-12

How to Cite

Sharjeel Usmani, Anjali Jain, Khulood Al Riyami, & Subash Kheruka. (2026). Coexistence of Lung Cancer and Warthin Tumour in a Smoker: Importance of Accurate Interpretation of 18F-FDG-Avid Parotid Lesions. Journal of the Pakistan Medical Association, 76(8), 1382–1383. https://doi.org/10.47391/JPMA.26-66

Issue

Vol. 76 No. 8 (2026): AUGUST

Section

IMAGING CORNER

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Copyright (c) 2026 Journal of the Pakistan Medical Association

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This work is licensed under a Creative Commons Attribution 4.0 International License.