PRIMARY INTESTINAL-TYPE ADENOCARCINOMA OF THE TONGUE: REPORT OF A RARE CASE

Abstract

Intestinal-type adenocarcinoma of the salivary glands is an exceedingly rare tumor. A 55-year-old male patient presented with an ulcerated mass in the tongue, measuring approximately 5 cm in diameter, with 2 years of evolution. The patient complained of pain. Histopathologically, the tumor presented proliferation of tall columnar cells, presenting basophilic nuclei and eosinophilic cytoplasm. Neoplastic cells were organized in anastomosing cords, showing patterns of papillary and solid growths, with duct-like structures. Cytologic and architectural features resembled those seen in well-differentiated colonic adenocarcinoma. Areas of comedonecrosis and perineural invasion were also identified. A preliminary diagnosis of adenocarcinoma was made, with 2 possibilities: intestinal-type adenocarcinoma of the salivary gland or metastatic adenocarcinoma of gastrointestinal origin. Both morphologic and immunohistochemical profiles are indistinguishable for these entities. Whole-body examination failed to identify any gastrointestinal primary tumor or that of other origins. Therefore, a gastrointestinal origin was clinically excluded. The patient was referred for cancer treatment. Intestinal-type adenocarcinoma of the salivary glands is an exceedingly rare tumor. A 55-year-old male patient presented with an ulcerated mass in the tongue, measuring approximately 5 cm in diameter, with 2 years of evolution. The patient complained of pain. Histopathologically, the tumor presented proliferation of tall columnar cells, presenting basophilic nuclei and eosinophilic cytoplasm. Neoplastic cells were organized in anastomosing cords, showing patterns of papillary and solid growths, with duct-like structures. Cytologic and architectural features resembled those seen in well-differentiated colonic adenocarcinoma. Areas of comedonecrosis and perineural invasion were also identified. A preliminary diagnosis of adenocarcinoma was made, with 2 possibilities: intestinal-type adenocarcinoma of the salivary gland or metastatic adenocarcinoma of gastrointestinal origin. Both morphologic and immunohistochemical profiles are indistinguishable for these entities. Whole-body examination failed to identify any gastrointestinal primary tumor or that of other origins. Therefore, a gastrointestinal origin was clinically excluded. The patient was referred for cancer treatment.