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.

An analysis of current treatment practice in uterine papillary serous and clear cell carcinoma at two high volume cancer centers / 부인종양

OBJECTIVE: Despite the rarity of uterine papillary serous carcinoma (UPSC) and uterine clear cell carcinoma (UCCC), they contribute disproportionately to endometrial cancer deaths. Sufficient clinical information regarding treatment and prognosis is lacking. The aim of this study is to evaluate treatment outcomes in a rare cancer cohort based on the experience at two tertiary care cancer centers. METHODS: Clinicopathologic data were retrospectively collected on 279 patients with UPSC and UCCC treated between 1995 to 2011. Mode of surgery, use of adjuvant treatment, and dissection of paraaoritc lymph nodes were evaluated for their association with overall survival (OS) and progression-free survival (PFS). RESULTS: 40.9% of patients presented with stage I disease, 6.8% of patients presented with stage II disease and 52.3% of patients presented with stages III and IV. Median follow-up was 31 months (range, 1 to 194 months). OS and PFS at 5 years were 63.0% and 51.9%, respectively. OS and PFS were not affected by mode of surgery (open vs. robotic approach; OS: hazard ratio [HR], 0.68; 95% confidence interval [CI], 0.28 to 1.62; PFS: HR, 0.78; 95% CI, 0.40 to 1.56). Adjuvant treatment was associated with improved OS in stages IB-II (HR, 0.14; 95% CI, 0.02 to 0.78; p=0.026) but not in stage IA disease. There was no difference in OS or PFS based on the performance of a paraaoritc lymph node dissection. CONCLUSION: Minimally invasive surgical staging appears a reasonable strategy for patients with non-bulky UPSC and UCCC and was not associated with diminished survival. Adjuvant treatment improved 5-year survival in stages IB-II disease.

The survival outcome and patterns of failure in node positive endometrial cancer patients treated with surgery and adjuvant radiotherapy with curative intent / 부인종양

OBJECTIVE: The purpose of this study was to evaluate the patterns of failure, overall survival (OS), disease-free survival (DFS) and factors influencing outcome in endometrial cancer patients who presented with metastatic lymph nodes and were treated with curative intent. METHODS: One hundred and twenty-six patients treated between January 1996 to December 2008 with surgery and adjuvant radiotherapy were identified from our service's prospective database. Radiotherapy consisted of 45 Gy in 1.8 Gy fractions to the whole pelvis. The involved nodal sites were boosted to a total dose of 50.4 to 54 Gy. RESULTS: The 5-year OS rate was 61% and the 5-year DFS rate was 59%. Grade 3 endometrioid, serous, and clear cell histologies and involvement of upper para-aortic nodes had lower OS and DFS. The number of positive nodes did not influence survival. Among the histological groups, serous histology had the worst survival. Among the 54 patients relapsed, only three (6%) failed exclusively in the pelvis and the rest of the 94% failed in extrapelvic nodal or distant sites. Patients with grade 3 endometrioid, serous and clear cell histologies did not influence pelvic failure but had significant extrapelvic failures (p<0.001). CONCLUSION: Majority of node positive endometrial cancer patients fail at extrapelvic sites. The most important factors influencing survival and extrapelvic failure are grade 3 endometrioid, clear cell and serous histologies and involvement of upper para-aortic nodes.

Tumor ovárico de bajo potencial maligno (borderline): patrón seroso micropapilar / Ovarian serous borderline tumors with micropapillary patterns

Se describen los tumores de bajo potencial maligno (borderline), su importancia clínica y la conducta terapéutica recomendada a partir de los conocimientos actuales. Se destaca la existencia de la variedad micropapilar la que según algunos autores presenta una mayor frecuencia de implantes invasivos y de recurrencias a corto y mediano plazo, lo que requeriría una conducta más activa. Se describe la importancia de los implantes invasivos y la microinvasión. Se presentan dos casos clínicos con su respectiva histología.

The tumours of low malignant potential or borderline, their clinical importance and the recommended therapeutic approach from the present knowledge are described. The existence of a micropapilar variety according to some authors, presents a greater frequency of invasive implant and recurrences to short and medium term, which would require a more active conduct. The importance of invasive implant and the microinvasión is described. Two clinical cases with their respective histology are presented.

Plasma cell leukaemia with papillary serous cystadenocarcinoma of ovary--a case report.

A rare case of plasma cell leukaemia and papillary serous cystadenacarcinoma of ovary in a 58-year-old female is reported.

Papillary cystadenocarcinoma arising in a paratubal mesothelial cyst of the mesosalpinx--a case report.

Primary carcinoma arising from a paratubal cyst in the mesosalpinx in uncommon. Serous tumors of low malignant potential outnumber invasive carcinomas, which are often of endometrioid type. Only five cases of serous papillary cystadenocarcinoma with capsular invasion have been documented. We report a case of invasive papillary cystadenocarcinoma arising in a large paratubal cyst of the mesosalpinx, in an infertile woman. Possible hormonal basis, its link to serous borderline and malignant tumors of the peritoneum, and value of pre/intra operative cyst fluid cytology are discussed. Lack of definitive management protocols, prognostic indicators and possible consequences are briefly reviewed.

Adenocarcinoma gigante de células acinares de tipo quístico papilar en parótida / Giant acinic cell adenocarcinoma with papillary-cystic pattern of the parotid gland

Se presenta el caso de un hombre de 38 años de edad con un adenocarcinoma de células acinares de 22 cm de tipo quístico papilar, originado en la glándula parótida. El interés del caso radica en: 1) el tamaño del tumor que supera en 9 cm al adenocarcinoma de células acinares más grande hasta ahora informado; y 2) la rara variedad histológica quística y papilar demandó estudios de histoquímica, inmunohistoquímica y microscopía electrónica para su diagnóstico