Basal Cell Adenocarcinoma - 2 Case Series of a Rare Entity

Introduction: Basal cell adenocarcinoma is a rare well recognized low grade malignant salivary gland tumor often resembles basal cell adenoma. the infiltrating growth pattern and likelihood of vascular and perineural involvement distinguishes basal cell adenocarcinoma with basal cell adenoma. Case presentation: Here we present histopathological and immune histochemical analysis of two such rare cases of basal cell adenocarcinoma and review of literature is discussed. Conclusion: Basal cell adeno carcinoma is a low grade malignancy and doesn’t metastasize. With only few hundreds of cases that has been reported in literature, basal cell adeno carcinoma should be included as differential diagnosis in salivary gland tumors in order not to miss the diagnosis

Cistoadenoma de glándula salival menor en paladar: Reporte de dos casos y revisión de la literatura

El cistoadenoma es un tumor epitelial benigno de baja frecuencia en glándulas salivales, que habitualmente se presenta como una masa de crecimiento lento. En glándulas salivales menores se localiza habitualmente en labio, paladar y mucosa yugal, cuyo diagnóstico diferencial representa un desafío desde el punto de vista clínico. El propósito de este reporte es presentar 2 casos de cistoadenoma en paladar, con énfasis en sus características clínicas y diagnóstico diferencial.

Cystadenoma is an uncommon benign epithelial tumor of the salivary glands, which usually appears as a slow-growing mass. In minor salivary glands, it is usually located in the lip, palate and buccal mucosa, whose differential diagnosis is a clinical challenge. The purpose of this report is to present 2 cases of palate cystadenoma, with emphasis on their clinical characteristics and differential diagnosis.

Carcinoma de células acinares de parótida: reporte de un caso y revisión de literatura / Acinic cell carcinoma of parotid: A case report and review of literature

Resumen Los tumores malignos de glándulas salivales (TMGS) constituyen un grupo infrecuente de cánceres de una gran variedad histológica. Dentro de las neoplasias de estirpe epitelial encontramos al carcinoma de células acinares (CCA), que representa entre un 6%-10% de todos los TMGS. No posee patrones clínicos ni radiológicos específicos, pero comparte características comunes con otros TMGS que serán discutidas a lo largo del reporte. Cabe destacar que en términos generales es un cáncer de bajo grado y poco recidivante, por lo que un tratamiento oportuno y un seguimiento estricto mejoran el pronóstico para este tipo de pacientes. Su diagnóstico se establece con evidencia histopatológica que confirme la presencia de diferenciación epitelial de tipo acinar. El tratamiento consiste en la exéresis tumoral con márgenes libres por parotidectomía suprafacial o total, asociado a vaciamiento cervical si se detecta compromiso nodal. Adicionalmente, se debe sugerir terapia adyuvante ante la presencia de un factor de mal pronóstico. Se presenta un caso y se realiza revisión de literatura.

Abstract Malignant salivary gland tumors (TMGS) constitute an infrequent group of cancers of a wide histological variety. Within the epithelial lineage neoplasms, we find acinar cell carcinoma that represent between 6%-10% of all TMGS. It does not have specific clinical or radiological patterns, but it shares common characteristics with other TMGS that will be discussed throughout the report. It should be noted that in general terms it is a low-grade cancer with low recurrence rates, so timely treatment and strict follow-up improve the prognosis for this type of patient. Its diagnosis is established with histopathological evidence that confirms the presence of acinar-type epithelial differentiation. Treatment consists of tumor excision with free margins by suprafacial or total parotidectomy, associated with cervical lymph node dissection if nodal locoregional metastasis is detected. Additionally, adjuvant therapy should be suggested in the presence of a poor prognostic factor. A case is presented and a literature review is carried out.

Papillary cystadenocarcinoma of the parotid gland: a rare sub-variant of salivary gland adenocarcinoma

Papillary cystadenocarcinoma of the salivary gland is a very rare malignant neoplasm accounting for only 2% of all salivary gland lesions. In 1991 it was first included as a separate entity in the World Health Organization (WHO) classification of salivary gland tumors and in 2017 WHO Classification, the tumor was clubbed as a sub-variant of adenocarcinoma, not otherwise specified. It most commonly occurs in the major salivary glands. Herein we report a case of salivary papillary cystadenocarcinoma in a 54-year-old female, who presented with rapid enlargement of the right parotid swelling. Based on radiology and fine-needle aspiration cytology, a working diagnosis of the malignant tumor involving the superficial lobe of the right parotid gland was made. In view of the malignant nature of the swelling, superficial parotidectomy was done. The histopathology and immunohistochemistry of the mass confirmed the diagnosis of papillary cystadenocarcinoma of the right parotid. With the revised 2017 WHO classification of salivary gland tumors, it is important to report all rare subtypes in order to understand their biology and behavior.

Acinic cell carcinoma of the posterior buccal mucosa: A rare case report

Acinic cell carcinoma (ACC) is a low-grade malignant salivary gland neoplasm that comprises approximately 17% of primary salivary gland malignancies or about 6% of all salivary gland neoplasms. The most common intraoral sites are the buccal mucosa, lips, and palate. The diagnosis of ACC frequently presents difficulties, owing to its great radiological and cytological similarity with benign tumors and with normal acinar component of the salivary gland, respectively. The management of ACC consists of complete surgical excision. Here, we report a case of ACC on the left retromolar trigone, a rare location in a 44-year-old female

Expression of MYB protein in adenoid cystic carcinoma of the salivary gland / 临床与实验病理学杂志

Purpose To investigate the role of MYB in adenoid cystic carcinoma (ACC) of different origins and grades.Methods A total of 103 specimens of salivary gland tumors with complete pathologic data were collected from the Department of Pathology, Affiliated Hospital of Inner Mongolia Medical University. 64 cases of ACC of the salivary gland, which included 19 cases of grade I, 27 cases of grade Ⅱ, and 18 cases of grade Ⅲ were selected as experimental group. 7 cases of exrras-alivary ACC and 32 cases of non-ACC benign and malignant tumor of salivary gland were served as control group. The MYB protein expression was detected by MYB immunohistochemical En Vision two-step staining for both experimental and control group. Results The positive expression rates of MYB in 64 cases of salivary ACC and 7 cases of extrasalivary ACC were 54.69％ (35/64) and 57.14％ (4/7), respectively, with no statistically significant difference (P> 0.05). The positive expression rates of MYB in 64 cases of salivary ACC and 32 cases of non-ACC salivary benign and malignant tumors were 54.69％ (35/64) and 6.25％ (2/32), respectively, which showed statistically significant difference (P < 0.05). The positive expression rates of MYB were 68.42％ (13/19), 66.67％ (18/27) and 14.29％ (4/18) in 64 cases of salivary ACC Ⅰ, Ⅱ and Ⅲ, respectively, and the difference was significant (P <0.05). The difference between grade Ⅰ and Ⅱ was not statistically significant (P> 0.016 7), while compared with grade Ⅲ, there was a statistical increase of positive expression rate of MYB in both grade Ⅰ and Ⅱ (P < 0.016 7). Conclusion MYB is highly expressed in grade I and Ⅱ of the salivary ACC and low expressed in grade Ⅲ. It is speculated that there may be other fusion gene mutation in salivary ACC grade Ⅲ. MYB is lowly expressed in non-ACC benign and malignant tumors of salivary gland, suggesting that MYB protein expression has a certain diagnostic value for the diagnosis of salivary ACC.

Clinicopathological characteristics and prognosis of salivary gland secretory carcinoma / 临床与实验病理学杂志

Purpose To investigate the clinicopathological features and prognosis of salivary gland secretory carcinoma(SC). Methods A retrospective study was performed including reviewing the clinical documents and pathological sections of 10 cases of SC. Immunohistochemical EnVision study and histochemical staining were performed in the 10 cases. Fluorescence in situ hybridization (FISH) was used to detect the ETV6-NTRK3 fusion gene. Results There were 8 men and 2 women included in this study. The mean age was 45 years(ranged from 22 to 62 years).9 cases occurred in the parotid and 1 case in submandibular gland. Local painless masses were common first symptoms. Tumor size ranged from 1 cm to 3.5 cm in maximum diameter (average 1.8 cm) and the cut surface of most tumors was solid with dusty red or grayish yellow color, of which 1 case showed cystic degeneration. Histologically, the tumors usually pushed and were invasive to the adjacent tissues. Sometimes, the tumors showed expansive growth pattern. Tumor cells demonstrated microcystic, cystic papillary and alveolar patterns. Eosinophilic secretions could be observed in both microcysts and lumen of alveolus. Immunohistochemically, 10 cases revealed diffuse positivity of cytokeratin, and 9 cases were diffusely and strongly positive for S-100, Mammaglobin, vimentin and CK7, whereas all cases were negative for CD117, Dog-1, p53, p63, SMA, and GATA3. The tumor cells were positive for PAS staining and negative for mucicarmine staining. The detection ETV6-NTRK3 fusion gene was carried out in 4 cases by FISH analysis, among which 3 cases were positive. Follow-up data were available in the 10 patients (ranged from 2 months to35 years), among which 9 patients were alive, except for 1 patient died of tumor recurrence and metastasis 16 years after surgery. Conclusion SC is a newly recognized rare malignant tumor of salivary gland with a lowgrade malignancy, slow growth pattern and favorable prognosis. The histological structures of microcysts and eosinophilic secretions are (he crucial histological characteristics of SC. Diffusely strong positive expression of S-100 and mammaglobin is helpful for the diagnosis and differential diagnosis of the tumor. The diagnosis of SC could be confirmed when ETV6-NTRK3 fusion gene could be identified.

Clinicopathologic features and prognosis of the young pulmonary primary salivary gland tumor / 临床与实验病理学杂志

Purpose To study the clinicopathologic features retrospectively and to explore the prognosis of 15 cases of young pulmonary primary salivary gland tumor. Methods The 15 cases of young pulmonary primary salivary carcinoma were analyzed respectively. Re-sults The 15 cases showed 7 cases with adenoid cystic carcinoma and 8 cases with mucoepidermoid carcinoma. Cough and bloody sputum were main symptoms, while chest pain, chest distress and fever were less seen. There were 10 cases performed with partial pul-monary lobectomy, 3 cases performed with unilateral total lobectomy, 1 case performed with artery perfusion treatment and bronchial ar-tery embolization and 1 case performed with conservative treatment for pancreatic metastasis after diagnosis. The mean follow-up time was 28 months ( from 4 to 96 months) . Conclusion The primary salivary gland-type lung tumor belonged to benign or low-grade ma-lignant tumor, mainly accompanied with hacking cough and bloody sputum, which was commonly found in trachea and bronchus. Final diagnosis could be made through bronchoscopy and biopsy. Complete surgical excision is the primary method and the prognosis is usual-ly good, especially in the young.

Diagnostic dilemma in myoepithelial carcinoma of cheek.

Myoepithelial carcinoma (MC) is a rare neoplasm of the salivary gland generally occurring in the parotid gland and rarely in the minor salivary glands. It poses a diagnostic challenge on fine-needle aspiration (FNA) cytology because it can show different cell types and lack clear features of malignancy. This can lead to a range of differential diagnosis on cytology. The diagnostic difficulty can be compounded if the lesion is present at an unusual site. A 41-year-old male presented with a recurrent swelling on the check since 2 years with a prior history of pleomorphic adenoma (PA) at the same site 8 years back. FNA was performed and a diagnosis of recurrent PA or myoepithelial cell neoplasm was given. Final diagnosis was made on histology and immunohistochemistry studies and reported as MC of minor salivary gland originating within PA. Pathologist should be aware of the occurrence of MC at the sites of the minor salivary glands in the oral cavity and its wide morphologic spectrum to make a confident diagnosis of MC preoperatively.

Oral and maxillofacial pathologic lesion: retrospective studies on prevalence and sociodemographic features

The aim was to study the prevalence and sociodemographic features of odontogenic, non-odontogenic and salivary glands lesions among patients seen in Hospital Universiti Sains Malaysia. This information is essential to assist clinician in formulating reliable differential diagnosis of such lesion. Data on patient demographics, lesion location, tissue of origin and microscopic diagnosis were extracted from the Laboratory and Diagnosis record registries for biopsy specimen accessioned from year 2000 to 2012. This data was subsequently analyzed based on World Health Organization Classification of Head and Neck Tumours (2005). A total of 748 cases were included in the study. Out of the total number of cases, 367 cases were males and 377 cases were females. Ninety seven cases (13%) were of odontogenic origin, while 90 cases (12%) and 197 cases (26%) were of non-odontogenic and salivary gland origin respectively. Forty five percent of cases involved oral mucosal lesions. The most prevalent odontogenic lesion reported within the twelve years period was radicular cyst and ameloblastoma. Non-odontogenic bone lesion was rarely encountered with it making up less than two percent of total cases reported. Pleomorphic adenoma was the most prevalent benign salivary glands neoplasm reported within similar time period.

A Case of Polymorphous Low Grade Adenocarcinoma in Submandibular Gland / 대한이비인후과학회지

Polymorphous low-grade adenocarcinoma (PLGA) is a distinctive salivary gland neoplasm with a propensity to arise from minor salivary glands, particularly of the palate. Reports of PLGA have increased with the establishment of specific histopathological criteria characterizing the PLGA, but there are only a few reports of major salivary gland origin. PLGA shares histological features with adenoid cystic carcinoma, so histopathologic diagnosis is essential and immunohistochemistry is an important tool when making differential diagnosis. The treatment of choice is wide surgical excision, and long-term follow up is necessary to evaluate local recurrences. We herein report a case of PLGA arising in a submandibular gland with a review of the relevant literature.

CT and MR imaging findings of salivary duct carcinoma / 中华放射学杂志

Objective To evaluate the CT and MR imaging findings of salivary duct carcinoma (SDC) in order to enhance the understanding of this rare disease.Methods A retrospective analysis of CT and MRI images was performed in 20 patients (14 males and 6 females,median age 56 years old) with pathologically proved SDC.CT and MR images were evaluated with respect to the following feature factors:location,size,morphology,margin,CT density/ MR signal intensity and enhancement pattern.Results Thirteen lesions were located in parotid gland,4 lesions in submandibular gland,1 lesion in sublingual gland and 2 lesions in the buccal spaces.The maximum diameter of SDC ranged from 1.5 to 7.0 cm,mean (3.5 ±0.9) cm.Five cases demonstrated round or oval round masses with well-defined margin,15 cases demonstrated irregular masses with ill-defined edge.Among them,the peritumoral fat tissues were infiltrated in 7 cases,the preauricular skin were invaded in 3 cases,the jaw muscles were invaded in 2 cases and the parapharyngeal space,pterygoid muscle,retromandibular vein was invaded in 1 case respectively.Lesions were homogeneous in 4 cases and heterogeneous in 16 cases.Seven lesions showed varied calcifications.Lesions were homogeneous iso-intense in 1 case and heterogeneous iso-intense in 2 cases on T1WI,heterogeneous hyperintense in all cases on T2WI.On post contrast images,lesions demonstrated remarkable enhancement in 17 cases,moderate enhancement in 3 cases.Enlarged cervical lymph nodes were found in 12 cases.Conclusions SDC has nonspecific imaging characteristics.CT and MR examinations can accurately demonstrate the extent of tumor involvement and are helpful to provide more comprehensive information for SDC management.

Tumor de Warthin da glândula parótida: estudo de 70 casos / Warthin's tumor of the parotid gland: study of 70 cases

OBJETIVO: Relatar as características clínicas, tratamento e complicações.dos tumores de Warthin. MÉTODOS: Estudo retrospectivo com 70 pacientes submetidos à ressecção de cistoadenoma papilífero linfomatoso,. Variáveis analisadas: idade, sexo, etnia, presença ou não de tabagismo, sítio primário do tumor, tamanho do tumor em centímetros, presença de bilateralidade, tipo de operação, multicentricidade, complicações do tratamento, presença de recidiva no seguimento e tempo de seguimento.. RESULTADOS: Quarenta e quatro pacientes (62,8 por cento) eram do sexo masculino e 26 (37,2 por cento), do sexo feminino, com média etária de 56,7 anos, O tabagismo estava presente em 55 (78,6 por cento) pacientes, (94,3 por cento) dos tumores eram unilaterais e quatro (5,7 por cento) bilaterais, com tamanho médio de 4,1cm ao exame físico. As complicações foram 14 (19 por cento) casos de paresia e/ou paralisia facial, seroma em 10 (13,8 por cento), síndrome de Frey em três (4 por cento), hematoma em dois (2,7 por cento) e infecção de ferida operatória em um (1,5 por cento) caso. CONCLUSÃO: O tumor de Warthin tem maior incidência no sexo masculino, em tabagistas e localização unilateral predominante na glândula parótida. A parotidectomia superficial com preservação do nervo facial mostrou-se eficaz em 100 por cento casos. As complicações encontradas foram paresias ou paralisias transitórias, seroma, síndrome de Frey, hematoma e infecção de ferida operatória.

OBJECTIVE: To report the clinical characteristics, treatment and complication of Warthin tumors. METHODS: we conducted a retrospective study of 70 patients undergoing resection of papillary lymphomatous cystadenoma. Variables: age, sex, ethnicity, presence or absence of smoking, primary site of tumor, tumor size in cm, presence of bilateral tumor, type of operation, multicentricity, treatment complications, recurrence and follow up. RESULTS: Forty-four patients (62.8 percent) were male and 26 (37.2 percent) female, with a mean age of 56.7; smoking was present in 55 (78.6 percent) patients; 66 (94.3 percent) tumors were unilateral and four (5.7 percent) bilateral, with an average size of 4.1 cm on physical examination. The complications were 14 (19 percent) cases of facial paresis and / or paralysis, seroma in 10 (13.8 percent), Frey's syndrome in three (4 percent), hematoma in two (2.7 percent) and wound infection in one (1.5 percent) case. CONCLUSIONS: Warthin tumors have a higher incidence in male smokers and predominantly unilateral location of the parotid gland. Superficial parotidectomy with preservation of facial nerve was effective in 100 percent cases. Complications were transient paresis or paralysis, seroma, Frey syndrome, hematoma and wound infection.

Central Mucoepidermoid Carcinoma of the Mandible: Case Report

Linfoepitelioma de glândulas salivares maiores: relato de caso / Lymphoepithelioma of major salivary glands: case report

O linfoepitelioma de glândulas salivares maiores é um tumor maligno e raro, principalmente no ocidente. No presente artigo, descrevemos o caso de uma paciente do sexo feminino, com linfoepitelioma de parótida, que recidivou precocemente depois de cirurgia isolada e alcançou remissão depois de quimiorradiação. A paciente encontra-se no 19º mês de seguimento clínico, sem sinais de recidiva ou sequelas do tratamento. A literatura pertinente ao assunto foi revisada.

Lymphoepithelioma of major salivary glands is a rare malignant tumor, affecting mainly the population of Western countries. In the present paper, we report the case of a female patient with parotid lymphoepithelioma, which recurred early after surgery. The patient achieved remission after chemoradiation and has been followed up for 19 months with no evidence of relapse and sequelae of treatment. Additionally, we reviewed the relevant literature related to this topic.

Expressão da proteína p53 em 106 adenomas pleomórficos de glândula salivar maior / p53 protein expression in 106 pleomorphic adenomas of major salivary gland

INTRODUÇÃO E OBJETIVO: O adenoma pleomórfico (AP) é o tumor das glândulas salivares mais comum. A parótida é o sítio anatômico mais frequente. Características clínicas e microscópicas são bem conhecidas, entretanto sua patogênese ainda é incerta, como a expressão de oncogenes e fatores que influenciam a transformação maligna. O objetivo deste estudo foi analisar e correlacionar os aspectos histopatológicos indicativos de transformação maligna de AP de glândula salivar maior, com a expressão da proteína p53 nesses tumores. MATERIAL E MÉTODO: Foram avaliados 106 casos de AP por pesquisa retrospectiva nos prontuários clínicos, revisão das preparações histológicas em hematoxilina e eosina (HE) e realização de técnica imuno-histoquímica, pelo método da estreptoavidina-biotina, utilizando o anticorpo primário anti-p53. RESULTADOS: Alterações histopatológicas relacionadas com a transformação maligna foram incomuns: hialinização extensa (5; 4,7 por cento) e necrose (1; 0,9 por cento). Houve positividade para a proteína p53 em 25 dos 106 casos estudados (23,58 por cento). O arranjo histológico das células dos tumores considerados positivos para p53 foi principalmente dos tipos ductal (92 por cento; 23) e cordonal (88 por cento; 22). Não houve associação estatisticamente significante entre a positividade para o p53 e as variáveis histopatológicas, em comparação com os casos negativos: quantidade e tipo de matriz extracelular; alterações teciduais sugestivas de transformação maligna e metaplasia. CONCLUSÃO: Poucos casos que exibiram expressão para p53 apresentaram algum tipo de alteração morfológica sugestiva de malignidade, e a correlação entre a imunoexpressão da proteína p53 e a presença de alteração sugestiva de transformação maligna não foi estatisticamente significante, sugerindo que a expressão dessa proteína nesses tumores independe dessas características.

INTRODUCTION AND OBJECTIVE: The pleomorphic adenoma is the most common salivary gland tumor. The parotid gland is the most frequent anatomic site. Its clinical and microscopic features are widely known. However, its pathogenesis is still uncertain as well as the expression of oncogenes and other factors that influence malignant transformation. The objective of this study was to analyze the histopathological features of malignant transformation in pleomorphic adenoma (PA) of major salivary gland and correlate them with p53 protein expression in these tumors. MATERIAL AND METHOD: We evaluated 106 cases of PA by researching clinical records retrospectively, reviewing histological preparations in HE and applying immunohistochemical technique through streptavidin biotin method using primary anti-p53 antibody. RESULTS: Histopathological changes related to malignant transformation were unusual: extensive hyalinization (5; 4.7 percent) and necrosis (1; 0.9 percent). There was positivity for p53 protein in 25 out of 106 cases (23.58 percent). The histological cell arrangement of p53 - positive tumors was mainly the ductal type (92 percent; 23) and cordonal (88 percent, 22). There was no statistically significant association between positivity for p53 and histopathological variables in comparison with negative cases: quantity and type of extracellular matrix, tissue changes suggestive of malignant transformation and metaplasia. CONCLUSIONS: A few cases that showed p53 expression had some kind of morphological change suggestive of malignancy and the correlation between p53 immunoexpression and the presence of changes suggestive of malignant transformation was not statistically significant, which suggests that the protein expression in these tumors do not depend on these characteristics.