Basal Cell Adenocarcinoma Research Articles

11q21 Rearrangement is a Frequent and Highly Specific Genetic Alteration in Mucoepidermoid Carcinoma

Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor. Translocation t(11;19)(q21;p13) involving the MECT1 and MAML2 genes has been suggested as a diagnostic marker in these tumors. To determine the specificity of 11q21 locus rearrangements for MEC, fluorescence in situ hybridization analysis with specific MEC-I Dual Color Break Apart Probe was performed on a tissue microarray containing samples from almost 1200 salivary gland adenomas and carcinomas. Rearrangements of 11q21 were observed in 40% of 217 MECs. The frequency of rearrangements decreased with tumor grade and was found in 53% of G1, 43% of G2, and 31% of G3 tumors (P=0.015). There were no 11q21 rearrangements found in other salivary gland carcinomas including 142 adenoid cystic carcinomas, 104 acinic cell adenocarcinomas, 76 adenocarcinoma not otherwise specified, 38 epithelial-myoepithelial carcinomas, 15 polymorphous low-grade adenocarcinomas, 18 basal cell adenocarcinomas, 19 myoepithelial carcinomas, 12 papillary cystadenocarcinomas, 6 salivary duct carcinomas, and 10 oncocytic carcinomas. Furthermore, all analyzed salivary gland adenomas, including 39 cases of Warthin tumor and control samples, either from the salivary gland or from other organs were negative for 11q21 rearrangements. It is concluded that MECT1-MAML2 gene fusion is a highly specific genetic alteration in MEC with predominance in low-grade and intermediate-grade tumors.

Basal cell adenocarcinoma arising in salivary gland metaplasia of the breast: a novel salivary gland–type tumor developing in the breast

A variety of salivary gland-type lesions occur in the breast. Three cases of a novel mammary carcinoma arising in a background of salivary gland metaplasia and morphologically similar to basal cell adenocarcinoma of the salivary gland are presented. The clinical presentation, morphologic features, treatment, and follow-up of these cases are discussed.

Basal cell adenocarcinoma of the minor salivary gland: a case report

Basal cell adenocarcinoma (BCA) is an uncommon salivary gland neoplasm. The majority of salivary gland tumors are located in the parotid gland, while only a few involves the minor salivary gland of the oral cavity. Pathological diagnosis is important to differentiate BCA from other neoplasms, as the prognosis of the diseases is significantly different. In this article, we present a 41-year-old-male with BCA involving the upper labial mucosa.

A Case of Basal Cell Adenocarcinoma of the Parotid Gland

Basal cell adenocarcinoma (BCAC) of the salivary glands is rare low grade malignant tumor. They were categorized in the second version of the classification of salivary gland tumors by WHO in 1991. A 58-year-old female presented with a complaint of a right parotid mass. A benign tumor was suspected, but the histological diagnosis was BCAC by superficial lobectomy of the right parotid gland. Tumor cells were observed near the surgical margin, radiotherapy was given post-operatively. There was neither local recurrence nor metastasis during 8 months of follow-up. In general BCAC is recognized as a low grade tumor with a favorable prognosis, while long-term follow-up is needed because of occasional recurrence.

Case report: parotid basal cell adenoma, membranous type

A52-year-old female withbackgroundofnon-Hodgkin's lymphoma and polymyositis presented with a 4 year history of slow growing, left parotid mass. There were no other associated symptoms. Fine needle aspirate of the mass was performed and the diagnosis of an atypical primary salivary gland neoplasm was made. Subsequent left parotidectomy was performed and the diagnosis of parotid basal cell adenoma, membranous type was made. Basal cell adenoma is a benign epithelial neoplasm of the salivary gland which is characterised by uniform proliferation of basaloid cells. Basal cell adenoma often occurs in the parotid gland followed by the submandibular gland and the upper lip region. Basal cell adenoma accounts for 1–3% of all benign parotid tumours, and the peak incidence is in the 6th to 7th decades of life. There are various subtypes based on morphological features which include solid, trabecular, tubular, and membranous types. The membranous subtype has been associated with the dermal cyclindromas which have similar incidence of chromosomal alteration at 16q12– 13. The membranous subtype is characterised by tumour cells arranged in a jig-saw like pattern with prominent PAS+ eosino-philic, basement-membrane type material. The main differential diagnosis is basal cell adenocarcinoma, and it can be difficult to distinguish between the two. Basal cell adeno-carcinoma is characterised by increased number of mitotic figures, increased nuclear pleomorphism, infiltrative growth, and peri-neural and intravascular invasion. In our case, the proliferative index Ki-67 is low, and there is no significant nuclear pleomor-phism, infiltrative growth pattern, or perineural invasion. However, the lesion extends to the diathermied margin, which is associated with a higher rate of recurrence of approximately 25%.

Lymphadenoma of the salivary gland: clinicopathological and immunohistochemical analysis of 33 tumors

Lymphadenomas (LADs) are rare salivary gland tumors. Their clinicopathologic characteristics and etiopathogenesis are poorly understood. We examined 33 LADs in 31 patients (17 women and 14 men) aged 11–79 years (median 65 years). There were 22 sebaceous LADs in 21 patients (9 women and 12 men) and 11 non-sebaceous LADs in 10 patients (8 women and 2 men). Two patients had synchronous double tumors. Twenty-six tumors (79%) arose in parotid, three in the neck, and two each in submandibular gland and oral cavity. Extraparotid tumors were seen in 2 of 21 (10%) patients with sebaceous and 4 of 10 (40%) patients with non-sebaceous LADs. Seven of twenty-three (30%) patients had immunosuppressive therapy for unrelated diseases. The tumors were well circumscribed, encapsulated (n=28, 84%) painless masses, varying in size from 0.6 to 6 cm (median 2.2). The cut surfaces were gray-tan to yellow, homogeneous and multicystic (n=24, 72%). The epithelial cells were basaloid, squamous and glandular, forming solid nests, cords, tubules, and cysts. Sebaceous differentiation was restricted to sebaceous lymphadenoma. The epithelial cells expressed basal cell markers (p63, 34BE12, and/or CK5/6, 18/18, 100%) and the luminal glandular cells expressed CK7 (12/12, 100%). Myoepithelial cells were absent (n=10/16, 63%) or focal. The lymphoid stroma was reactive, with germinal centers in 28 (84%). There was no evidence of HPV (0/11), EBV (0/7), and HHV-8 (0/8). Malignant transformation to sebaceous and basal cell adenocarcinoma was seen in one patient each. None of the 11 patients with follow-up (1–8 years) recurred. In summary, sebaceous and non-sebaceous LADs are benign, encapsulated, solid and cystic tumors affecting older adults. Non-sebaceous LADs affect women and extraparotid sites more frequently than sebaceous LADs. Altered immune status may have a role in their etiopathogenesis. Multiple synchronous tumors, origin in buccal mucosa, and malignant transformation may rarely occur.

Malignant Transformation in a Mature Teratoma with Metastatic Deposits in the Omentum: A Case Report

Malignant transformation of a mature cystic teratoma (MCT) is a very rare complication with an incidence of 0.17–2%;. The most common form of malignant transformation of the MCT is squamous cell carcinoma. Other tumors arising in MCT include basal cell carcinoma, sebaceous tumor, malignant melanoma, adenocarcinoma, sarcoma, and neuroectodermal tumor. However malignant transformation with metastatic deposits in the omentum is extremely rare. The present case highlights the rarity of the occurrence of an omental deposits in a case of mature cystic teratoma with malignant transformation.

Brooke-Spiegler Syndrome with Multiple Scalp Cylindromas and Bilateral Parotid Gland Adenomas

A 62-year-old female presented with numerous soft tissue lesions of her scalp and bilateral preauricular region. Several of these have been biopsied or removed with a diagnosis of cylindromas. Cylindromas are benign tumors with a differentiation towards apocrine sweat glands that increase in number and size throughout life. Multiple scalp cylindromas may coalesce and cover the entire scalp, resulting in the “turban tumor.” These are often associated with the autosomal dominant Brooke-Spiegler syndrome with coexistent facial trichoepitheliomas and spiradenomas. There is a very rare association between cylindromas and basal cell adenoma and adenocarcinoma of the parotid gland, with only 17 reported cases. Ours is the first CT demonstration of both the scalp and parotid gland findings in this uncommon situation.

Rare Cerebral and Pulmonary Metastases From Low-Grade Basal Cell Adenocarcinoma of the Parotid Gland

Basal cell adenocarcinoma of the parotid gland is a low-grade malignancy that rarely metastasizes. We described a 32-year-old man with history of a right total parotidectomy for basal cell adenocarcinoma of the parotid gland 5 years ago, presenting with severe headache. A brain MRI revealed enhancing brain lesions that were confirmed as metastases from the parotid gland malignancy. A body FDG PET/CT demonstrated 2 mildly hypermetabolic lesions in the lungs, with pathology showing metastatic basal cell adenocarcinoma of the parotid gland.

Spiradenocarcinoma with low‐grade basal cell adenocarcinoma pattern: report of a case with varied morphology and wild type TP53

We present a patient with a 2-cm spiradenocarcinoma of the left arm resembling low-grade salivary gland basal cell adenocarcinoma. In addition to showing attributes of conventional spiradenoma, the benign component showed prominent areas of cystic change with focal apocrine differentiation, glands with and without mucinous differentiation, clear cell change and focal adenoid cystic carcinoma-like areas. The malignant component was composed of nodules of basaloid cells arranged in sheets with variable tendency to luminal differentiation. The nuclear atypia was low-grade, and the mitotic index was high in the malignant component (to 8/10 high power fields). Immunohistochemically, there was diffuse but variable positivity for cytokeratin 7 in both the benign and malignant components. Epithelial membrane antigen was focally positive, highlighting cells with ductal (luminal) differentiation. Expression of p63 was observed in 50 and 80% of the cells in the benign and malignant components, respectively. Calponin was negative. The proliferative index (MIB-1/Ki-67) was <3% in the benign component and up to 10% in the malignant component. Although the malignant component displayed patchy areas with nuclear p53 immunoreactivity with variable intensity, no mutation in the TP53 gene was identified.

A massive basal cell adenocarcinoma of the palatal minor salivary gland that progressed into the pterygopalatine fossa

Basal cell adenocarcinoma (BCAC) is a rare malignant neoplasm in the salivary glands and BCAC of the minor salivary glands is exceedingly rare. Only nine cases of palatal BCACs of the minor salivary gland have been reported. BCAC is a low-grade malignant tumour which shares many histologic characteristics with basal cell adenoma. Histological differentiation between the two is difficult and they are often discriminated only by invasion of local structures or by perineural or vascular invasive figures. The authors describe the case of a 69-year-old man with a massive BCAC of a palatal minor salivary gland that progressed into the nasal cavity and pterygopalatine fossa and was treated by a subtotal maxillectomy. This is a highly locally advanced case which required a wider surgical excision range than other previously reported BCAC cases of the palatal minor salivary glands. In this case, the proper diagnosis could not be made by local biopsy alone. It should be kept in mind that it may be difficult to distinguish BCAC from basal cell adenoma by microscopic examination of biopsy specimens alone.

Basal cell adenocarcinoma of the supraglottic larynx: treatment of recurrent disease with tamoxifen

At the age of 83, a woman presented with an extremely rare cancer, basal cell adenocarcinoma (BCAC) of the supraglottic larynx. Pathology revealed a stage IVA tumor, pathological stage T4N0M0. She was treated with surgery and did not receive any adjuvant chemotherapy or radiation therapy. At the age of 93, during a routine examination, the patient was found to have palpable adenopathy and underwent a fine needle aspiration in June 2010. Pathology revealed similar histologic characteristics of her 2001 BCAC diagnosis, and further IHC stains revealed positive estrogen receptor staining.

Difficulty of the differential diagnosis of basal cell adenoma and basal cell adenocarcinoma of parotid gland by magnetic resonance imaging: case reports and literature review

Objectives The aim of this study was to assess the efficacy of magnetic resonance imaging (MRI) for the differential diagnosis of basal cell adenocarcinoma (BCAC) and basal cell adenoma (BCA) in the salivary gland.

Raki ucha w materiale Kliniki Otolaryngologii Warszawskiego Uniwersytetu Medycznego w latach 2004–2008

Ear carcinoma constitutes 0.5% of all cancers of the head and neck hardly, however with poor prognosis. In the study we use University of Pittsburgh Staging System. This study is retrospective analysis of the surgical treatment outcomes of the patients with external and middle ear carcinomas in the ENT Department at the Medical University of Warsaw in years from 2004 to 2008. Histopatologicallly, there were:18 squamous cell carcinoma, 17 basal cell carcinoma, 2 neuroendocrine carcinoma, basal cell adenocarcinoma and 1 metatypical carcinoma. Tumors were localised: ear concha in 19 patients, external auditory canal in 6 patients, middle ear in 3 patients, temporal bone and skull base in 9 patients. Among 19 tumors of the auricle, basal cell carcinoma occured the most often (12 patients - 63%), following squamous cell carcinoma (6 patients - 31%), in one case (6%) metatypical carcinoma was confirmed. There were 18 tumors of external auditory canal and tumors with temporal bone involvement in stage T1-T4. In this group 8 subtotal temporal bone resection were performed, however in 5 cases tumor was not totally excised. Additional radiotherapy was performed in 5 patients, 5 died of the disease, three had recurrence in the period of the study and 8 had confirmed metastasis into the breast, lung, cervical and mediastinal lymph nodes. Generally, in this group of patients, 6 died (33%) of the disease in the period from one month to 2 years after surgery. In 6 tumors with no evidence of bone involvement resection limited to the tumor was performed. In 2 tumors of external auditory canal the resection was totally and the patients have no recurrence (100%). Squamous cell carcinoma has poor prognosis, but early diagnosis gives the chance for long-term survival.

A Basaloid Squamous Cell Carcinoma of the Supraglottic Larynx

Basaloid morphology is frequently encountered in squamous cell carcinomas (SCC) of the head and neck and is associated with both smoking-related and human papillomavirus-driven tumors. Unlike conventional morphology SCC, the basaloid variant of SCC can mimic a wide variety of other head and neck malignancies including salivary gland tumors (adenoid cystic carcinoma [ACC], basal cell adenocarcinoma), small cell cancers (Epstein-Barr virus-associated nasopharyngeal carcinoma, sinonasal undifferentiated carcinoma, neuroendocrine carcinoma, primitive neuroectodermal tumor, NUT-midline carcinoma), melanoma, and, occasionally, sarcomas (mesenchymal chondrosarcoma, rhabdomyosarcoma, synovial sarcoma). These alternative diagnoses can be excluded with careful attention to morphology and, when necessary, immunohistochemical protein expression patterns. We present a case of smoking-related basaloid SCC and discuss this differential diagnosis.

Metastasis of Parotid Basal Cell Adenocarcinoma to the Hand—A Case Report

Soft tissue metastases to the hand are rare with studies suggesting an incidence of 0.2% among patients treated for cancers [9]. This paper describes the case of a 67-year-old male presenting with hand pain several years after treatment for a primary basal cell adenocarcinoma of parotid gland origin. Investigations confirmed what is believed to be the first documented case of parotid basal cell adenocarcinoma metastasizing to the hand. A description of the challenges faced in the treatment of this aggressive malignancy presents the opportunity to discuss key factors that must be considered when formulating management plans for similar presentations.

Basal cell adenoma: A diagnostic dilemma on fine needle aspiration cytology

Basal cell adenoma (BCA) is a rare neoplasm which is one of the basaloid tumors of salivary gland. Basaloid tumors are the most difficult problem in salivary gland fine needle aspiration cytology (FNAC). There are various benign and malignant tumors such as; cellular pleomorphic adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma, metastatic basal cell carcinoma, metastatic basaloid squamous carcinoma and small cell carcinoma in differential diagnosis. We present a case of BCA, membranous type in a 39-year-old female with right submandibular swelling misinterpreted as adenoid cystic carcinoma (ACC) on FNAC.

Neoplasms of anal canal and perianal skin.

Tumors of the anus and perianal skin are rare. Their presentation can vary and often mimics common benign anal pathology, thereby delaying diagnosis and appropriate and timely treatment. The anatomy of this region is complex because it represents the progressive transition from the digestive system to the skin with many different co-existing types of cells and tissues. Squamous cell carcinoma of the anal canal is the most frequent tumor found in the anal and perianal region. Less-frequent lesions include Bowen's and Paget's disease, basal cell carcinoma, melanoma, and adenocarcinoma. This article aims to review the clinical presentation, diagnostic evaluation, and treatment options for neoplasms of the anal canal and perianal skin.

Nuclear β-catenin expression in basal cell adenomas of salivary gland

Nuclear localization of β-catenin is known in a wide variety of human neoplasms; however, there are few reports in basal cell adenoma of the salivary gland. Our objective was to confirm the nuclear localization of β-catenin in basal cell adenoma and to examine whether nuclear β-catenin expression could be a useful marker in the diagnosis of basal cell adenoma. To evaluate the nuclear localization of β-catenin in basal cell adenomas, immunohistochemistry (IHC) and mutation analysis of CTNNB1 were performed in 22 and 21 cases, respectively. Mutation analysis of CTNNB1 in exon 3 was performed by DNA direct sequencing. In a comparative study, IHC for β-catenin was also performed in 157 other salivary gland tumors. Nuclear β-catenin expression was examined in 22 basal cell adenomas; scores were 2+ in 18 cases (81.8%), 1+ in three cases (13.6%), and 0 in one case (4.5%). Expression was localized in the basaloid myoepithelial cells. CTNNB1 mutation analysis was performed in 21 basal cell adenomas; mutations, including I35T and T41P, were detected in 11/21 (52%) cases. In comparison with other salivary gland tumors, one of three basal cell adenocarcinomas showed nuclear β-catenin expression, whereas there was no nuclear β-catenin expression in 154 other salivary gland tumors. We demonstrated nuclear β-catenin expression and activation of the CTNNB1 gene in basal cell adenoma. Although nuclear β-catenin expression may be unable to distinguish basal cell adenoma from basal cell adenocarcinoma, it should be a helpful marker in the diagnosis of basal cell adenoma.

Basal cell adenocarcinoma of submandibular salivary gland-problems in cytologic diagnosis

Basal-cell adenoma and basal-cell adenocarcinoma of the salivary gland are rare tumors. Fine-needle aspiration cytology of these tumors, particularly those of basal-cell adenocarcinoma, has rarely been described in the literature. In this report, we describe the clinical, cytomorphologic and histopathologic features of basal cell adenocarcinoma in a 48-year-old male patient. Fine-needle aspiration specimen showed abundant cohesive groups of basaloid cells revealing focal anisonucleosis and nuclear atypia. The tumor cells also showed rosette-like arrangement around central eosinophilic globule. Pertinent literature is reviewed and differential diagnosis are discussed.