The buccal minor salivary glands as starting point for a metastasizing adenocarcinoma – report of a case (original) (raw)
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1991
Sixteen polymorphous low-grade adenocarcinomas were reviewed and compared with 17 adenoid cystic carcinomas and with 21 other histologically similar minor salivary gland neoplasms. The polymorphous low-grade adenocarcinomas were for the most part distinctive in their microscopic appearance. Typically they exhibited infiltrative growth by small uniform cells in single-layered ducts. A syncytium of tumor cells was also characteristic, although solid and cribriform patterns were seen, making definitive diagnosis difficult with some tumors. lmmunohistochemical staining for S-100 protein, glial fibrillary acidic protein, actin, vimentin, and keratins resulted in relatively distinctive antigenic profiles for the tumors studied. Of significance was strong S-100 protein and weak actin staining of polymorphous low-grade adenocarcinomas, moderate actin staining of adenoid cystic carcinomas, moderate glial fibrillary acidic protein staining of monomorphic adenomas and pleomorphic adenomas, and nonreactivity of monomorphic adenomas for vimentin. It is believed that the immunoprofiles could be useful in the microscopic diagnosis of salivary gland tumors. The identification of antigens found normally in myoepithelial and epithelial cells supports the concept that these tumors are derived from pluripotential reserve cells. (ORAL SURC ORAL MED ORAL PATHOL 1991;71:469-75)
Case Reports in Pathology
Secretory carcinoma (SC) of the salivary gland was recently added to the fourth edition of the World Health Organization classification of head and neck tumors. Some salivary tumors, including acinic cell carcinoma, have been reclassified as SC. Most of these tumors are located on the parotid gland with very few cases reported in the minor salivary glands of the buccal mucosa. Herein, we present a case of SC of buccal mucosa, which appeared clinically as a benign lesion in a 54-year-old Japanese female patient. Histopathologically, the tumor cells presented with an eosinophilic cytoplasm with microcytic structure along with eosinophilic secretory material and hemosiderin deposit. Immunohistochemical staining revealed strongly positive staining for S100, vimentin, and mammaglobin and negative staining for DOG-1. The tumor was finally diagnosed as secretory carcinoma of the buccal mucosa. We present a review of the medical literature of SC arising from minor salivary glands. We found ...
Polymorphous low-grade adenocarcinoma of minor salivary gland
Oral Surgery, Oral Medicine, Oral Pathology, 1991
Sixteen polymorphous low-grade adenocarcinomas were reviewed and compared with 17 adenoid cystic carcinomas and with 21 other histologically similar minor salivary gland neoplasms. The polymorphous low-grade adenocarcinomas were for the most part distinctive in their microscopic appearance. Typically they exhibited infiltrative growth by small uniform cells in single-layered ducts. A syncytium of tumor cells was also characteristic, although solid and cribriform patterns were seen, making definitive diagnosis difficult with some tumors. lmmunohistochemical staining for S-100 protein, glial fibrillary acidic protein, actin, vimentin, and keratins resulted in relatively distinctive antigenic profiles for the tumors studied. Of significance was strong S-100 protein and weak actin staining of polymorphous low-grade adenocarcinomas, moderate actin staining of adenoid cystic carcinomas, moderate glial fibrillary acidic protein staining of monomorphic adenomas and pleomorphic adenomas, and nonreactivity of monomorphic adenomas for vimentin. It is believed that the immunoprofiles could be useful in the microscopic diagnosis of salivary gland tumors. The identification of antigens found normally in myoepithelial and epithelial cells supports the concept that these tumors are derived from pluripotential reserve cells. (ORAL SURC ORAL MED ORAL PATHOL 1991;71:469-75)
Clinicopathological analysis of salivary gland carcinomas and literature review
Molecular and Clinical Oncology, 2015
Malignant salivary gland tumors are rare and exhibit a broad spectrum of phenotypic heterogeneity. The objective of this study was to investigate prognostic factors in patients with salivary gland carcinomas and review the results in light of other reports. We retrospectively reviewed 40 patients with primary salivary gland carcinomas who were diagnosed and treated at our institution between 1991 and 2014. Of the 40 tumors, 19 (47.5%) were mucoepidermoid carcinomas, 11 (27.5%) were adenoid cystic carcinomas, 7 (17.5%) were acinic cell carcinomas, 2 (5.0%) were myoepithelial carcinomas and 1 (2.5%) was a squamous cell carcinoma. Clinically positive lymph nodes were present in 4 patients (10.0%). As regards clinical stage, 15 cases (37.5%) were stage I, 13 (32.5%) were stage II, 1 (2.5%) was stage III and 11 (27.5%) were stage IVA. The majority of the patients (97.5%) were treated with surgery, of whom 25 (62.5%) received surgery alone and 14 (35.0%) underwent surgery in combination with chemotherapy or chemotherapy and radiotherapy. The median follow-up time for all the patients was 48 months. The disease-specific survival rate at 5 years was 87.1%. We identified a significant correlation between poor survival rate and histological grade (intermediate/high), tumor size (T3/T4), lymph node metastasis (node-positive) and clinical stage (III/IV) using the Kaplan-Meier method (P<0.05 for each). In addition, the Cox proportional hazards regression analysis confirmed that lymph node metastasis and tumor size were independent prognostic factors for disease-specific survival (hazard ratio = 18.7 and 15.1, respectively; P=0.023 and 0.037, respectively). Furthermore, tumor size was found to be a predictive factor regarding recurrence in the multivariate logistic regression analysis (odds ratio = 8.35; P=0.025). Our results suggest that lymph node metastasis and tumor size are significant prognostic factors for patients with salivary gland carcinomas.
Malignant salivary gland tumors: A short review
Dental, Oral and Maxillofacial Research, 2021
Both major and minor salivary glands can develop benign or malignant tumors. Malignant Salivary Gland Tumors (MSGT) are very rare and they haves a great pathological diversity. It is known that their tumorigenesis is a very complex and dynamic process, which is divided into three stages: initiation, progression and metastasis. In addition to grade and tumor stage, both the presence of lymph node and distant metastases are considered primary factors associated with disease prognosis, recurrence and survival in MSGT patients. The etiopathogenesis and biological behavior of these particular tumors remain unclear, thus, further new investigations involving protein and molecular analysis are needed to have a better understanding of these cancers.
Salivary gland neoplasms: Histomorphological assessment of an enigmatic group of tumours
Introduction: Salivary gland tumours are complex and exhibit varied clinico-pathological features.These tumours are particularly important to the otolaryngologists, head and neck surgeons and oncologists because of their associated morbidity and mortality. Material and methods: The archives of department of histopathology were retrospectively reviewed from January 2011 to January 2016. All cases of salivary gland neoplasms were included in this study. Clinical details were obtained from the medical records. Diagnosis was confirmed on hematoxylin and eosin (H&E) stained formalin fixed paraffin embedded sections from excised specimens. Results: 235 patients with salivary gland tumours were included in the study. The mean patient age at the time of presentation was 45.5 years (range 17-79 years). There were 90 males and 145 females with a male: female ratio of 1:1.6. Parotid gland was most commonly involved (76%) followed by the submandibular gland (22%) and minor salivary glands (2%). Benign tumours (74.4%) exceeded malignant tumours of salivary glands (25.6%). The most common benign salivary gland neoplasm was pleomorphic adenoma (155 cases), followed by 10 cases of Warthin's tumour, 5 cases of basal cell adenoma, 2 cases of myoepithelioma and schwannoma each and a single case of oncocytoma. Adenoid cystic carcinoma was the most frequently reported malignant tumour of the salivary glands (29 cases), followed by 19 cases of muco-epidermoid carcinoma, 2 cases of salivary duct carcinoma, 3 cases each of carcinoma-ex pleomorphic adenoma, and a single case each of acinic cell carcinoma, carcinosarcoma, osteosarcoma and giant cell tumour of salivary gland. Conclusion: Benign tumours are more common than malignant tumours in the salivary glands. Histomorphological assessment is imperative prior to therapeutic intervention. Unusual entities like nerve sheath tumour, osteosarcoma, carcinosarcoma and giant cell tumour must be kept in mind as a differential diagnosis by the clinicians and pathologists.
Current Thinking on Malignant Salivary Gland Neoplasms
Journal of Cancer Treatment and Research, 2013
Malignant salivary gland neoplasms are rare, representing approximately 3% to 7% of all head and neck cancers. Contrasting from the more common mucosal head and neck cancers, which, in general, are ascribed to excessive tobacco, alcohol use, and more recently to viral infection, specific carcinogenic factors for malignant salivary gland growths have not been as clearly identified. Histologically, they represent a heterogeneous group of tumors. Forty histologic types of epithelial tumors of the salivary glands have been reported; some are exceedingly rare and may be the topic of only a few case reports. Salivary tumors can arise in the major salivary glands or in one of the minor salivary glands (predominantly mucus secreting glands), which are distributed throughout the upper aerodigestive. Most patients who develop malignant salivary gland tumors are in the sixth or seventh decade of life. FNA should be considered as part of the diagnostic evaluation but due to its varying sensitivities and specificities imaging modalities such as ultrasound, CT scans, and MRI should also be used as diagnostic adjuncts. Surgery is the primary modality for management of these tumors, nontraditional surgical approaches and instrumentation, as well as facial nerve monitoring, can be selectively utilized to try and decrease the morbidity associated with these surgical procedures. Adjuvant treatment is primarily achieved with radiation therapy. Chemotherapy continues to have a palliative role in the management of salivary gland tumors; however, research in this field is trying to identify a therapeutic role for chemotherapy in order to improve overall survival.
Chapter 11 Malignant Salivary Gland Neoplasms Literature Review
Malignant salivary gland neoplasms represent approximately 3% to 7% of all head and neck cancers making them extremely rare tumors. Contrasting from the more common mucosal head and neck cancers, which, in general, are attributed to excessive tobacco, alcohol use, and more recently to viral infection, speci c carcinogenic factors for malignant salivary gland growths have not been as clearly identified. Histologically, they represent a heterogeneous group of tumors. Salivary tumors can arise in the major salivary glands or in one of the minor salivary glands (predominantly mucus secreting glands), which are distributed throughout the upper aerodigestive. Most patients who develop malignant salivary gland tumors are in the sixth or seventh decade of life. FNA should be considered as part of the di- agnostic evaluation but due to its varying sensitivities and speci cities imaging modalities such as ultrasound, CT scans, and MRI should also be used as diagnostic adjuncts. Surgery is the primary modality for management of these tumors, nontraditional surgical approaches and instrumentation, as well as facial nerve monitoring, can be selectively utilized to try and decrease the morbidity associated with these surgical procedures. Adjuvant treatment is primarily achieved with radiation therapy. Chemotherapy continues to have a palliative role in the management of salivary gland tumors; however, research in this eld is trying to identify a therapeutic role for chemotherapy in order to improve overall survival.