Infarction of parotid gland Warthin tumor following fine needle aspiration: A diagnostic mimicker of malignancy.

Fine-needle aspiration (FNA) induced infarction of Warthin tumor is a rare phenomenon with potential to mimic malignancy both radiologically and histologically. We report the case of a 55-year-old woman who initially presented with a painless left parotid mass. Pre-FNA contrast-enhanced CT demonstrated a well-circumscribed, homogeneously enhancing oval mass of 3 × 2.6 × 2.2 cm, and doppler ultrasound confirmed internal vascularity. FNA cytology confirmed a benign Warthin tumor. Fifteen days later, she developed painful swelling and trismus. A follow-up CT revealed complete loss of internal enhancement with no interval change in size, and doppler ultrasound demonstrated absent internal color flow, new from the pre-FNA exam. This constellation of findings was consistent with infarction. The patient was managed conservatively with marked clinical improvement within ten days. Subsequent surgical excision, performed approximately 4 weeks after FNA, confirmed infarcted Warthin tumor with no evidence of malignancy. This case emphasizes the importance of recognizing infarction as a benign post-FNA complication to avoid misdiagnosis and unnecessary aggressive treatment.