Adenocarcinoma Of Minor Salivary Gland Research Articles

A rare case of an aggressive polymorphous adenocarcinoma of minor salivary gland in the retro-maxilla

Abstract Polymorphous adenocarcinoma (PAC) is a low-grade malignant tumour of minor salivary glands of the oral cavity, which rarely presents with invasive features. Low metastatic and excellent survival rates are some of its favorable features. A 36-year-old woman reported with swelling, pain, and mobility of teeth in the left upper inner cheek region. Contrast enhanced computed tomography (CECT) revealed a large, lobulated, heterogenous mass in the left retro-maxillary region with a few enlarged left cervical lymph nodes (levels IB and II). After surgery, the final histopathology report gave a definitive diagnosis of PAC with certain invasive characteristics – perineural invasion, infiltration into skeletal muscle, and depth of invasion of 10 mm, which recurred in a different location 1.5 years later. A few predictable features of PAC include incidence in elderly women, asymptomatic presentation, occurrence in the posterior hard of soft palate, very low incidence of nodal or distant metastases, perineural spread, skeletal muscle infiltration, and low rates of recurrence with good survival outcomes. However, in our case, the patient appeared to present with a relatively aggressive form of PAC, considering her young age, symptomatic presentation, uncommon anatomic location in the retro-maxilla, cervical nodal metastasis, perineural and skeletal muscle infiltration, and local recurrence within a short period. Although PAC is a low-grade tumour with excellent prognosis, it may occasionally present with invasive characteristics, and early diagnosis and prompt management with strict adherence to post-operative regimens and follow-up is of prime importance to prevent any untoward outcomes.

The immunohistochemical expression Ki-67 In Polymorphous Low Grade Adenocarcinoma of the Salivary Glands

Background: Polymorphous Low Grade Adenocarcinoma is a rare malignant tumor of minor salivary glands. It has an unique histopathological, clinical and behavioural features. Most of its incidence has been presented in the palate. It shows a variety of growth patterns within the same one lesion, including cribriform, tubular, and solid areas that may mimic adenoid cystic carcinoma. The tumor cells histologically are characterized by lacking of nuclear atypical and hyperchromatism with rare mitoses. However, the prognosis of this tumor is good because of its low grade, although it has an unpredictable potential to metastasize.
 Objectives: To evaluate the histopathological expression of Ki-67 proliferation antigen in Polymorphous low grade adenocarcinoma and compare the results with the clinicopathological parameters and grading of the tumors.
 Materials and Methods: This study includes 20 cases with Polymorphous Low Grade Adenocarcinoma of minor salivary glands diagnosed histopathologically and treated surgically, were investigated for the immunohistochemical expression of Ki-67 antigen. Immunohistochemical staining was performed using a Labeled Strept- Avidin Biotin method (LSAB) and 0.05 (two-sided) was the level of significance.
 Results: Twenty cases of Polymorphous Low Grade Adenocarcinoma of salivary glands were histologically diagnosed in this retrospective study to evaluate the expression of Ki-67. The mean age for patients with PLGA was nearly (50.6). (12) (60%) cases were males and (8) (40%) cases were females and also male to female ratio was (1.5:1).
 In regarding to site distribution, the most common site was the palate followed by the submandibular gland and floor of the mouth. 
 Conclusions: it was observed that there is a higher rate of cellular proliferation in malignant tumors with high grade, indicating their role in the malignancy and aggressive behavior of these tumors.

BubR1 and cyclin B1 immunoexpression in pleomorphic adenoma and polymorphous adenocarcinoma of minor salivary glands

The immunoexpression of BubR1 and cyclin B1 in pleomorphic adenoma (PA) and polymorphic adenocarcinoma (PAC) in minor salivary glands is poorly studied. Thus, a retrospective and observational study was performed to provide a better understanding of the role and immunopositivity patterns of these proteins in these lesions. Sixteen cases of PA and 16 cases of PAC were selected. Parenchyma cells were submitted to quantitative immunohistochemical analysis through the labeling index. Cytoplasmic immunoexpression of BubR1 was observed in neoplastic cells from all analyzed PA and PAC cases. All PA cases and 93.7% of PAC exhibited nuclear immunoexpression of BubR1. Higher cytoplasmic and nuclear immunoexpression of BubR1 was observed in PAC (p = 0.001 and p = 0.122, respectively). Cytoplasmic immunoexpression of cyclin B1 was observed in all cases of PA and PAC, with a higher labeling index in the latter (p < 0.001). There was a significant positive correlation between nuclear and cytoplasmic BubR1 immunoexpressions (p < 0.001) in PA and a significant negative correlation between BubR1 and cyclin B1 cytoplasmic immunoexpressions (p = 0.014) in PAC. The higher cytoplasmic and nuclear immunoexpression of BubR1 in PACs suggests the continuous maintenance of neoplastic cells in the cell cycle and migration. Higher immunoexpression of cyclin B1 supports this lesion's enhanced proliferative and migration ability.

Oropharyngeal cancer diagnosis and treatment in actual clinical practice in the Republic of Bashkortostan: analysis for 2020

Introduction. Th e growing incidence of oropharyngeal cancer is driven by an increase in frequency of HPV-associated oropharyngeal cancer. Th e morbidity pattern of oropharyngeal cancer is area-specific.Aim. To analyze the oropharyngeal cancer diagnosis and treatment in the Republic of Bashkortostan for 2020.Materials and methods. Th e authors carried out a 2020 retrospective analysis of the diagnosis and treatment results of patients with oropharyngeal cancer. 79 patients were identified with this diagnosis. 84.8% (67/79) among them were males and 15.2% females (12/79). Th e mean age of the patients was 59.1 years. Th e site of primary tumor was on the oropharynx lateral wall in 37.8% cases (30/79), in the tongue root area — 24.1% (19/79), in the tonsils area — 17.7% (14/79), on the soft palate — 16.5% (13/79), on the oropharynx posterior wall — 3.8% (3/79).Results. Examination of tumor morphological types revealed squamous cell carcinoma (SCC) with various degrees of differentiation in 92.4% cases (73/79), adenocarcinoma of minor salivary gland — in 6.3% (5/79) and sarcoma in 1.2% (1/79). 57.5% of 73 patients with SCC (42/73) underwent protein (p16) immunohistochemistry, while 42.5% of the patients (31/73) did not. According to a surrogate marker for HPV, the following results were obtained for 42 patients: p16-positive in 23.8% cases (10/42), p16-negative in 76.2% (32/42). Stage distribution according to TNM-7: stage I — 11.4% (9/79), stage II — 17.7% (14/79), stage III — 36.7% (29/79), stage IV — 46.8% (37/79). Stage distribution according to TNM-8 (patients who underwent p16 immunohistochemistry): stage I — 11.9% (5/42), stage II — 23.8% (10/42), stage III — 19% (8/42), stage IV — 45.2% (19/42). In 2020, 72% of patients (57/79) received definitive treatment, 10.1% (8/79) — palliative care, 15.2% (12/79) — supportive care, and 2.5% (2/79) refused medical treatment.Discussion. Th e various types of radiation therapy were used as the main defi nitive treatment for patients with oropharyngeal cancer in 69.2% cases (45/65). Only 18.5% of patients (12/65) underwent surgery, 58.3% of which (7/12) received post-surgery radiation therapy.Conclusion. 57.5% of patients (42/73) were detected with HPV status, 23.8% (10/42) revealed surrogate markers for HPV association. 69.2% of patients (45/65) received radiation therapy as the definitive treatment. 18.5% of patients (12/65) underwent surgery, 58.3% of which (7/12) received postsurgery radiation therapy.

CRIBRIFORM ADENOCARCINOMA OF MINOR SALIVARY GLANDS: A CASE REPORT WITH FOCUS ON RADIOGRAPHIC APPERANCE

Cribriform adenocarcinoma of minor salivary gland (CAMSG) is currently classified as a subtype of polymorphous adenocarcinoma. CAMSG differs from polymorphous adenocarcinoma in that it has a distinct histopathologic appearance and clinically CAMSG has higher rate of lymph node metastasis at initial presentation. Panoramic radiograph shows an ill-defined radiolucent lesion in the right maxilla that extends from the distal of maxillary right canine to the mesial of maxillary second molar. The lesion has invasive borders and causes destruction and loss of the lamina dura and periodontal ligament space in the mesial of the second molar and distal of the canine. The lesion has also invaded into the right maxillary sinus destroying the floor of sinus. CBCT images show a low attenuation lesion involving the right maxillary alveolar bone at the premolars and first molar area. This report describes the radiographic appearance of a case of CAMSG on panoramic radiograph, cone-beam computed tomography (CBCT), multi-detector computed tomography (MDCT) and on magnetic resonance imaging (MRI).

Cribriform Adenocarcinoma of the Minor Salivary Gland (CAMSG); A Separate and Malignant Entity

Abstract Introduction/Objective Cribriform adenocarcinoma of the minor salivary gland (CAMSG) is a recently described salivary gland neoplasm (SGN) that WHO includes under the polymorphous adenocarcinoma (PAC) subheading. CAMSG is reported to occur mostly in the base of the tongue and lingual tonsils. Methods We present a case of CAMSG of buccal mucosa in a 48-year old woman who presented with pain and swelling on the left side of the face that started after tooth extraction. Imaging revealed a large expansile mass (5.8 x 4.3 x 6.1 cm) originating in the left mandibular angle extending into masticator space, maxillary sinus, pterygopalatine fossa, sphenoid, middle cranial fossa, orbit and skull base. Ameloblastoma, primary intraosseous carcinoma, and squamous cell carcinoma were considered. Incisional biopsy revealed a tumor comprised of round to ovoid cells with clear to vesicular nuclei (ground-glass appearance) and occasional mitosis present in irregular solid, cribriform, and microcystic patterns in a hyalinized stroma with the presence of abundant mucin within lobules and stroma. Results Differential diagnosis of secretory carcinoma, hyalinizing clear cell carcinoma, and less likely PAC and mucoepidermoid carcinoma were considered, all inconsistent with the imaging findings. The tumor cells were positive for S100 and negative for CD117, ki67, p63, CD117, and TTF-1. Based on a prominent cribriform pattern, vesicular nuclei, and S-100 expression, a diagnosis of cribriform adenocarcinoma of minor salivary gland origin was rendered. The patient subsequently underwent left partial maxillectomy, left partial mandibulectomy, and resection of the skull base and left neck dissection and was staged as pT4bN0, with negative margins and vascular invasion. The patient underwent radiation therapy and at 6- month follow up was alive and healthy. Clinically and histologically CAMSG overlaps with tumors of both salivary and non-salivary gland origin. Conclusion Recognition of CAMSG as a distinct entity will help in accurate diagnosis and categorization in the WHO classification of SGNs.

Fine needle aspiration cytology of cribriform adenocarcinoma of minor salivary gland, a recently defined entity

Cribriform Adenocarcinoma of Minor Salivary Glands (CAMSG) is a recently recognized, distinct neoplasm of minor salivary gland origin. Its histological and cytological features show considerable overlap with other head and neck cancers like papillary thyroid carcinoma (PTC). Presence of cribriform and glomeruloid structures, metachromatically staining matrix, and a lack of colloid can help distinguish CAMSG from PTC.

Polymorphous adenocarcinoma of salivary glands

ObjectivePolymorphous adenocarcinoma of salivary gland (PAC) is rare. Despite being described as a low risk histology, some patients develop regional and distant metastasis. More aggressive behavior has been attributed to a PAC subcategory called cribriform adenocarcinoma of minor salivary glands (CAMSG). We examined oncological outcomes of PAC. Patients and methodsFifty-seven patients with PAC were identified from an institutional database of 884 patients surgically treated for salivary gland malignancies from 1985 to 2015. Detailed histopathological analysis was performed. Survival outcomes were calculated using the Kaplan-Meier method. Factors predictive of recurrence were identified using the Cox proportional hazard method. ResultsFifty-four (95%) had tumors of minor salivary gland origin; the most frequent location was the oral cavity in 41 (76%), specifically the hard palate in 32 (55%). Forty-six patients (81%) were clinical T1-T2; 3 (5%) had a clinically positive neck. Thirty-two patients (56%) were classified as PAC and 14 (25%) as CAMSG. Forty-four patients (77%) had surgery alone; 13 (23%) had surgery and postoperative radiotherapy. The 5- and 10-year overall survival and disease-specific survival were 88% and 79% and 98% and 94%, respectively (median follow up 84 [1–159] months); 5- and 10-year recurrence-free survival were 93% and 88%, respectively. Univariate analysis showed male sex, III/IV stage, and CASMG variant had increased incidence of recurrence but were not statistically significant. ConclusionPAC of the salivary glands is an indolent disease with good survival outcomes. Recurrence is uncommon and tends to occur late. Long-term follow-up is indicated in patients with this disease.

Polymorphous adenocarcinoma of the salivary glands: reappraisal and update.

Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancyof the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumourshas also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy,predominantlybecauseof possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.

Newly Described Entities in Salivary Gland Pathology.

Salivary glands may give rise to a wide spectrum of different tumors. This review concentrates on 4 salivary gland tumors that have been accepted in the recent literature as new neoplastic entities: mammary analog secretory carcinoma, cribriform adenocarcinoma of minor salivary glands (CASG), sclerosing polycystic adenosis/adenoma (SPA), and the mucinous/secretory variant of myoepithelioma. Mammary analog secretory carcinoma is a distinctive low-grade malignant salivary cancer that harbors a characteristic chromosomal translocation, t(12;15) (p13;q25), resulting in an ETV6-NTRK3 fusion. Cribriform adenocarcinoma (CASG) is a distinct tumor entity that differs from polymorphous low-grade adenocarcinoma by location (ie, most often arising on the tongue), by prominent nuclear clearing, differing alterations of the PRKD gene family, and clinical behavior with frequent metastases at the time of presentation of the primary tumor. Early nodal metastatic disease is seen in most cases of CASG; yet, they are still associated with indolent clinical behavior, making it a unique neoplasm among all low-grade salivary gland tumors. SPA is a rare sclerosing tumor of the salivary glands characterized by the combination of cystic ductal structures with variable cell lining including vacuolated, apocrine, mucinous, squamous, and foamy cells, by prominent large acinar cells with coarse eosinophilic cytoplasmic zymogen-like granules, and by closely packed ductal structures, surrounded by a peripheral myoepithelial layer and stromal fibrosis with focal inflammatory infiltrates. SPA frequently harbors intraductal epithelial dysplastic proliferations ranging from mild dysplasia to severe dysplasia/carcinoma in situ. Moreover, SPA has been proven to be a clonal process by HUMARA assay and is associated with considerable risk of recurrence. Therefore, on the basis of all these newly recognized findings, we believe that SPA is likely a neoplasm, and we suggest the name "sclerosing polycystic adenoma." The mucinous variant of myoepithelioma is a myoepithelial tumor with foci of prominent cytoplasmic clearing frequently containing intracellular mucin material and having signet-ring morphology.

SYNCHRONOUS POLYMORPHOUS LOW-GRADE ADENOCARCINOMA AND CANALICULAR ADENOMA ON THE UPPER LIP: AN UNUSUAL PRESENTATION

Multiple salivary gland tumors (MSGTs) can be classified by topographic distribution (unilateral or bilateral) and chronologic appearance (synchronous or metachronous). Oral presentation of these tumors is rare, and have been reported as either benign or malignant. To our knowledge, synchronous occurrence of adenoma and adenocarcinoma of minor salivary glands has not been reported in the literature. Herein we present a case of synchronous polymorphous low-grade adenocarcinoma (PLGA) and multifocal canalicular adenoma (CA) affecting a 61-year-old female patient who exhibited, in the oral examination, 9 discrete firm to fluctuant submucosal nodules (ranging from 0.2 to 0.8 cm in diameter) on the upper lip, with a 12-month evolution. The histopathologic analysis showed focal area containing PLGA and multiple CAs. After 1 year of follow-up, no recurrence was observed. After review of the English-language literature and different from our case, only 11 intraoral MSGTs (either benign or malignant) have been identified to date.

Cribriform Adenocarcinoma: A Tumor of Minor Salivary Gland Orgin with Distinct Immunohistochemical and Histologic Features

Cribriform adenocarcinoma of minor salivary gland (CATMSG) is a low grade malignant salivary gland tumor described by Skalova et al. This tumor occurs in the minor salivary glands of the oral cavity and has the potential to metastasize to cervical lymph nodes. The histomorphology of CATMSG is similar to that of papillary thyroid carcinoma in that both contain papillary structures and clear to vesicular nuclei with an open chromatin pattern. Other histological features seen are cribriform areas, tubular pattern and solid islands which show an artefactual splitting of the basal layer of cells. Cribriform, solid and tubular areas are commonly seen in other malignant salivary gland tumors such as adenoid cystic carcinoma (ACC) and lobular carcinoma (LC). The aim of this study was to assess whether tumors originally classified as Adenocarcinoma NOS (Adca,NOS), ACC and LC could be reclassified as CATMSG. Tumors diagnosed between 1992 and 2014 at Oral Pathology Laboratory, Inc (New York Hospital Queens) were selected. Each lesion was review by 3 pathologists to confirm the morphological features seen in CATMSG. After review, 11/79 Adca,NOS, 5/38 ACCs, and 5/23 LCs met the histological criteria of CATMSG. One case diagnosed as CATMSG in 2014 was used as a control and the following stains were completed: EMA, HBME-1, p16, and CAM 5.2. Eleven Adca,NOS, 2-ACC, and 5-LC underwent immunohistochemical (IHC) staining to support reclassification as CATMSG. Positive HMBE-1, p16 and CAM 5.2 staining along with negative staining for EMA were considered supportive of a diagnosis of CATMSG. 7-Adca,NOS, 0-ACC and 2 -LC fulfilled the IHC criteria. Based on strict histologic and ICH features, we were able to reclassify 9 tumors as CATMSG.

Polymorphous Low-Grade Adenocarcinoma

Polymorphous low-grade adenocarcinoma (PLGA) is a low-grade malignant epithelial tumor that is the second most common malignant neoplasm of minor salivary glands. Diagnosis on biopsy remains challenging owing to histological similarities with other salivary glands, including benign and malignant neoplasms. The most important differential diagnoses to consider include pleomorphic adenoma, adenoid cystic carcinoma, low-grade papillary adenocarcinoma, cribriform adenocarcinoma of minor salivary glands, and mucoepidermoid carcinoma. Recently, a PRKD2 rearrangement was described in PLGA. The definitive treatment is complete surgical excision with negative clear margins. These tumors typically follow an indolent course and rarely metastasize but have a propensity to recur. The focus of this review is on the histopathologic features of PLGA and findings that might allow differentiation from histologically similar–appearing salivary gland neoplasms.

Novel PRKD gene rearrangements and variant fusions in cribriform adenocarcinoma of salivary gland origin.

Polymorphous low-grade adenocarcinoma (PLGA) and cribriform adenocarcinoma of minor salivary gland (CAMSG) are low-grade carcinomas arising most often in oral cavity and oropharynx, respectively. Controversy exists as to whether these tumors represent separate entities or variants of one spectrum, as they appear to have significant overlap, but also clinicopathologic differences. As many salivary carcinomas harbor recurrent translocations, paired-end RNA sequencing and FusionSeq data analysis was applied for novel fusion discovery on two CAMSGs and two PLGAs. Validated rearrangements were then screened by fluorescence in situ hybridization (FISH) in 60 cases. Histologic classification was performed without knowledge of fusion status and included: 21 CAMSG, 18 classic PLGA, and 21 with "mixed/indeterminate" features. The RNAseq of 2 CAMSGs showed ARID1A-PRKD1 and DDX3X-PRKD1 fusions, respectively, while no fusion candidates were identified in two PLGAs. FISH for PRKD1 rearrangements identified 11 additional cases (22%), two more showing ARID1A-PRKD1 fusions. As PRKD2 and PRKD3 share similar functions with PRKD1 in the diacylglycerol and protein kinase C signal transduction pathway, we expanded the investigation for these genes by FISH. Six additional cases each showed PRKD2 and PRKD3 rearrangements. Of the 26 (43%) fusion-positive tumors, there were 16 (80%) CAMSGs and 9 (45%) indeterminate cases. A PRKD2 rearrangement was detected in one PLGA (6%). We describe novel and recurrent gene rearrangements in PRKD1-3 primarily in CAMSG, suggesting a possible pathogenetic dichotomy from "classic" PLGA. However, the presence of similar genetic findings in half of the indeterminate cases and a single PLGA suggests a possible shared pathogenesis for these tumor types.

Cribriform adenocarcinoma of minor salivary gland: A report of two cases with an emphasis on cytology

Cribriform adenocarcinoma of minor salivary gland (CAMSG) is a recently characterized low grade salivary gland malignancy that most commonly presents as a mass in the base of the tongue, frequently with regional lymph node metastasis. Given its relative rarity and overlapping cytomorphology, CAMSG may be confused with polymorphous low grade adenocarcinoma (PLGA) in minor salivary gland sites and papillary thyroid carcinoma (PTC) in cervical metastasis, in both fine-needle aspiration and excisional specimens. As there are no cytology reports in the literature, we present two new cases of CAMSG and describe the aspiration cytology of the tumor taken from bench top aspirates, compare it with the histomorphology, and discuss the features that may help one avoid misdiagnosis of PTC in the setting of cervical lymph node metastasis. We found that like PTC, aspirates of CAMSG contain polymorphic fragments of epithelial cells arranged in monolayer sheets, papillary fronds and tips, and occasional cribriform configurations, and metachromatic stromal fragments, which may be misinterpreted as colloid. A background of myxoid/mucoid material also reminiscent of colloid was prominent. Differentiation from PLGA is more difficult based strictly on cytology. A review of the most current literature in relation to the molecular and immunohistochemical profiles, therapeutic options, and prognosis is also presented. It is critical for pathologists and clinicians to be aware of this tumor when presented with patients having a cervical lymph node mass in the absence of a primary tumor.

Cribriform adenocarcinoma of minor salivary glands may express galectin-3, cytokeratin 19, and HBME-1 and contains polymorphisms of RET and H-RAS proto-oncogenes

The aim of the study was to further elucidate the immunohistochemical and genetic characteristics of cribriform adenocarcinoma of minor salivary glands (CAMSG). The study comprised five CAMSG from two males and three females, aged 21-72 years. Four tumors were localized at the base of tongue and one in the floor of mouth. At the time of diagnosis, four tumors had metastasised to regional lymph nodes. After tumor resection, two patients were treated by radiotherapy and one by chemoradiotherapy. During the follow-up (median 14 months), two patients developed lymph node metastasis. Microscopically, all tumors showed cribriform, papillary, follicular, and microcystic growth patterns. The tumor cells displayed vesicular nuclei with intranuclear grooves. Immunohistochemically, all tumors showed expression of cytokeratin (CK) 7, CK8, CK18, vimentin, smooth muscle actin, calponin, S-100 protein, and p16 protein. In addition, we observed expression of galectin-3, CK19, and HBME-1, but not of thyroglobulin and TTF-1. No mutations of RET, BRAF, K-RAS, H-RAS, and N-RAS proto-oncogenes were detected. However, in RET proto-oncogene, we found polymorphisms Gly691Ser (exon 11) and Ser904Ser (exon 15) in one case, p.Leu769Leu (exon 13) in one case, and variant p.IVS14-24 G/A of intron 14 in two cases, and in H-RAS proto-oncogene we found polymorphism 81 T-C (exon 1) in three cases. Thyroglobulin and TTF-1 are the only useful markers in the differential diagnosis between CAMSG and papillary thyroid carcinoma as both tumors may express galectin-3, CK19, and HBME-1. The RET, H-RAS, and N-RAS proto-oncoogenes are not mutated in CAMSG.

Mucinous Adenocarcinoma of Minor Salivary Gland: Case Report and Literature Review

Mucinous adenocarcinoma (MAC) is a glandular tumor characterized by large pools of extracellular mucin. The tumor can arise as a primary tumor of the major salivary glands. However, its occurrence is exceedingly rare and has only recently been recognized. Only few cases in the major salivary glands have been reported. This report is an additional case of MAC with origin in minor salivary gland at the oral floor. Immunohistochemical analysis of the tumor for cytokeratins 7, 8, 10, 13, 14, 18 e 20, vimentin, SMA, CEA, EMA, p53, ki-67 e histochemical analysis for PAS, Alcian blue e mucicarmin was performed. Predominantly, the tumor expressed cytokeratins 7, 18 and 20 that are commonly found in simple epithelia. Therefore, was observed positivity to PAS, Alcian blue and mucicarmin. No other cancer has been detected. The tumor is considered to be a primary mucinous adenocarcinoma, being the twenty-third case in minor salivary gland reported in the literature and the fourth MAC located in the mouth floor.

Signet-ring cell (mucin-producing) adenocarcinoma of minor salivary glands: report of a case

Salivary gland tumors account for a significant group of head and neck neoplasms. Signet-ring cell (mucin-producing) adenocarcinoma of minor salivary glands was described by Ghannoum and Freedman in 2004. We report a case of this extremely rare minor salivary gland neoplasm in an 18-year-old male. To our knowledge, this patient is the youngest to ever be reported having this tumor.

Basal cell adenocarcinoma of a hard palate minor salivary gland: case report and review of the literature

ObjectiveBasal cell adenocarcinoma of a minor salivary gland is extremely rare. The goal of this report is to increase awareness of this rare disease and to review and discuss the differential diagnosis and important considerations in treatment.Study DesignCase report and review of the literature.MethodsCase report of a basal cell adenocarcinoma of a hard palate minor salivary gland and review of the literature of basal cell adenocarcinoma.ResultsBasal cell adenocarcinomas are slow-growing tumours that most commonly involve the parotid gland and very rarely involve minor salivary glands. Although recurrence rates for these tumours are high, mortality rates are low. Histological diagnosis is important to distinguish this tumour from adenoid cystic carcinoma given the significant difference in disease prognosis.ConclusionsDiagnosis of these tumours must be made histologically. Recommended treatment options include wide local excision with radiotherapy reserved for close surgical margins or for local recurrence.

Tumeurs des glandes salivaires. État des lieux en 2009

Histologic grade is a significant predictor of outcome in salivary gland carcinomas. We underlined some newly recognized findings in grading: (i) evidence of high grade anaplastic transformation, occurring either at initial presentation or at relapse, is correlated with the clinical outcome; (ii) extracapsular invasion of carcinoma ex pleomorphic adenoma should be measured because it is now a known prognostic marker; (iii) the MIB-1 proliferative index is the most useful immunohistochemical marker for prognosis of all salivary gland carcinomas. In recent years, specific chromosomal translocations have been reported in some salivary glands tumors. The PLAG1 and HMGA2 gene translocations have so far been identified only in pleomorphic adenomas, and their detection may potentially aid in diagnosis. The mucoepeidermoid carcinoma translocated 1--mastermind like gene family (MECT1-MAML2) translocation, characterizing mucoepidermoid carcinoma, is also a prognostic marker. Newly recognized entities are summarized with special interest on differential diagnosis pitfalls: oncocytic mucoepidermoid carcinoma, sclerosing mucoepidermoid carcinoma with eosinophilia, sclerosing polycystic adenosis, lymphadenoma, lipoadenoma, newly recognized morphological variants of epithelial-myoepithelial carcinoma, cribriform adenocarcinoma of the tongue, signet ring adenocarcinoma of minor salivary gland. Specific chromosomal translocations and latest knowledge of the molecular mechanisms responsible for salivary glands oncogenesis (Epidermal Growth Factor Receptor [EGFR], phosphorylated AKT, topoisomerase II alpha, p27, Stat 3, maspin) should pave the way toward future targeted therapies.