Warthin's tumor: multicentricity and increasing incidence in women.

Warthin's tumors comprised 14 percent of all parotid tumors operated on. The average patient age in our series was 57.2 years. Eighty-seven percent of the tumors occurred in the parotid tail. The rest were in the deep lobe, or in an extraparotid location. Fifteen patients had multifocal tumors. The maximum number of tumor foci in one patient was six. A significant increase in the female incidence was noted with a 1.5:1 male-to-female ratio as compared with the previous male dominant ratio of 8:1. Eighty-two percent of the female patients in our group were smokers. We correlated a very high incidence of cigarette smoking in our series when compared with age-matched groups in both sexes within the general population. Since it is estimated that one of eight patients with Warthin's tumor will have multifocal disease, we suggest wider exposure and more meticulous operative exploration to avoid overlooked synchronous tumor foci and subsequent recurrence.