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 Downloads Full Text Article 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 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 76 No. 8 (2026): AUGUST Section IMAGING CORNER License Copyright (c) 2026 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.