Basal Cell Adenoma Research Articles

Efficacy of computed tomography features in the differentiation of basal cell adenoma and Warthin tumor in the parotid gland

The aim of this study was to identify computed tomography (CT) features that differentiate basal cell adenoma (BCA) from Warthin tumor (WT). Histopathologically confirmed parotid gland tumors (57 BCAs and 83 WTs) were retrospectively reviewed. CT images were evaluated to determine location, distribution, cyst formation, size, the new vessel facing sign (VFS), and enhancement behavior including the CT attenuation of solid portions of the tumor (AST), the vessel near the tumor (AVT), and maxillary artery (AMA) on early stage 2-phase contrast CT. Tumor CT attenuation ratios (AST/AVT and AST/AMA) were calculated. Chi-square tests, independent t-tests, and receiver operating characteristic curve analysis were conducted. Male:female ratio, patient age, posteroinferior location, tumor size, and presence of VFS were significantly lower for BCA than WT. The average AST/AVT was significantly higher for BCA than WT. The threshold value for AST/AVT on early stage 2-phase contrast CT was 0.72 between BCA and WT, and sensitivity and specificity were 94.7% and 98.8%, respectively, as calculated by receiver operating characteristic analysis. Gender ratio, age, location, size, presence of VFS, and AST/AVT value may help to differentiate BCA from WT in parotid glands on CT examination.

Differential challenges in salivary gland neoplasms

Salivary gland tumors are neoplasms characterized by a high level of pleomorphism and histological overlap. One tumor may contain several cell types; therefore, it is necessary to include immunohistochemical staining, as well as morphometric analysis of tumor cells as prerequisites for an appropriate diagnosis. Our research included 120 tumors, such as pleomorphic adenoma, Warthin tumor, basal cell adenoma, myoepithelioma, adenoid cystic carcinoma, mucoepidermoid carcinoma, salivary duct carcinoma, polymorphous low-grade carcinoma and myoepithelial carcinoma. The aim of the study was to differentiate benign and malignant tumors based on the characteristics of nuclei. The expression of Ki67 and the morphometric nuclear parameters ? area, perimeter, Feret diameter, integrated optical density, circularity, and roundness, were analyzed. It was observed that the Ki67 proliferative index was statistically significantly higher in malignant tumors (P<0.001). Adenoid cystic carcinoma exhibited the highest value, whereas the lowest value was exhibited in basal cell adenoma. Morphometric analysis showed statistically significantly increased values of integrated optical density (P<0.001) and nuclear size parameters (P<0.05) in malignant tumors. The determination of the Ki67 proliferative index and morphometric analysis of the integrated optical density and area can differentiate benign from malignant tumors with high precision. The presented values suggest the obtained results as cut-off values.

A rare basal cell adenoma (BCA) of the parotid gland ina male patient

Basal cell adenoma (BCA) is an uncommon, benign salivary tumor comprising 1-3% of salivary tumors. These tumors occur more commonly in women and patients older than 50 years of age. Patients typically present with a slow growing, well circumscribed mass. Overall BCA has a good prognosis with low rates of recurrence and malignant transformation. However, BCA membranous subtype undergoes malignant transformation at increased rates compared with the solid, tubular and trabecular forms. We present a rare case of a basal cell adenoma in a 57 year old male as well as a literature review.

Management of Basal Cell Adenoma of Accessory Parotid Gland Through Transoral Approach: Report of a Rare Case With Review

Diagnosis of mid-cheek mass has always been a diagnostic dilemma for clinicians. The incidence of the accessory parotid gland (APG) has been well documented in the literature. However, a diverse spectrum of pathologies can arise from this accessory parotid tissue. Basal cell adenoma is a rare benign tumor that predominantly affects the parotid gland. Its occurrence in the accessory parotid gland has been documented in 9 cases till date. Surgical approaches for the management of such APG lesions have been in debate. This report documents a case of Basal Cell Adenoma arising in accessory parotid tissue in a 55-year-old woman who was treated by transoral excision. This paper also reviews previously documented cases of all APG lesions and attempts to elucidate the rationale for selecting an appropriate surgical approach.

Basal Cell Adenoma of the Parotid Gland

Basal Cell Adenoma (BCA) known as monomorphic adenoma is a rare type of benign epithelial salivary neoplasm that mostly occurs in the parotid gland. Clinically BCA appears as a firm, mobile, slow-growing mass and is usually diagnosed during the histopathological examination of the resected surgical specimen. Histological differential diagnosis ranges from benign to malignant neoplasms such as pleomorphic adenoma, basal cell adenocarcinoma, adenoid cystic carcinoma and basaloid squamous cell carcinoma. The treatment of BCA is surgical excision, due to its varied prognosis with the different histological subtypes; a regular long term follow up of the patient postoperatively is mandatory. We report a rare and interesting case of basal cell adenoma of the parotid gland in a 52 year old female. We review the literature; discuss the diagnosis and management of this rare histological entity.

Monomorphic Adenoma: A Diagnosis or a Misnomer? A Review of Literature on Terminologies, Features and Differential Diagnosis of Basal Cell Adenoma

Monomorphic Adenoma: A Diagnosis or a Misnomer? A Review of Literature on Terminologies, Features and Differential Diagnosis of Basal Cell Adenoma

Homeobox transcription factor engrailed homeobox 1 is a possible diagnostic marker for adenoid cystic carcinoma and polymorphous adenocarcinoma.

Diagnostic utility of a homeobox transcription factor, engrailed homeobox 1 (En1) in the histopathology of salivary gland neoplasms was studied. The expression of En1 was immunohistochemically examined in 51 cases of adenoid cystic carcinoma (AdCC) and 143 cases of other salivary gland neoplasms. In all 51 AdCCs, En1 was expressed in 30-100% of tumor cells. In eight of nine polymorphous adenocarcinomas (PACs), En1 was expressed in 40-100% of tumor cells. Less than 5% of tumor cells expressed En1 in three of 12 epithelial-myoepithelial carcinomas, one of 17 basal cell adenomas (BCAs), and one of 34 pleomorphic adenomas (PAs). Among 55 other carcinoma cases, 1-30% of tumor cells expressed En1 in three salivary duct carcinomas (SDCs) ex PA. None of the myoepitheliomas and Warthin tumors expressed En1. When the cut-off value of the percentage of En1-expressing cells was set to 25%, all 51 AdCCs, eight of nine PACs and one SDC ex PA were En1-positive and the others were En1-negative. En1 is expressed consistently in AdCCs, frequently in PACs, but rarely in other salivary gland neoplasms. En1 is a possible diagnostic marker for AdCC and PAC in the histopathology of salivary gland neoplasms.

Study of histomorphological patterns of salivary gland tumors

Introduction: Salivary gland neoplasms though relatively rare, have a varied histological spectrum both in the benign and malignant tumors and hence, are of interest to pathologists. Aim of the study: To study the histomorphological patterns of salivary gland tumors. Materials and Methods: This was a two year four month prospective study from January 2015 to April 2017. The salivary gland specimens received in histopathology section of Department of Pathology, Government Medical College, Nizamabad, Telangana were studied for light microscopy. Results: Present study included 80 cases, with patient age ranging from 11 to 78 years and the male to female ratio was 3:1. In the present study 62.5% cases were benign and 37.5 % were malignant. Pleomorphic adenoma was the commonest benign tumor followed by Warthin’s tumor, monomorphic adenoma and basal cell adenoma. Mucoepidermoid carcinoma was the most common malignant tumor followed by adenoid cystic carcinoma, acinic cell carcinoma and carcinoma ex pleomorphic adenoma. Conclusion: Of all salivary glands, Parotid glands are most commonly affected by tumors. Pleomorphic adenoma is the most common benign tumor and Mucoepidermoid carcinoma is the most common malignant tumor in salivary glands. Keywords: Mucoepidermoid Carcinoma, Pleomorphic adenoma, Salivary gland tumors.

Endoscopic Transoral Approach for Resection of Basal Cell Adenoma Arising in Parapharyngeal Space.

Objectives The clinical and radiological characteristics of the basal cell adenoma (BCA) and its association with the internal carotid artery (ICA) in the parapharyngeal space (PPS), have not been sufficiently explored. This study aims to analyze the characteristics of patients with BCA arising in the PPS and to evaluate the feasibility of a total resection via an endoscopic transoral corridor. Design and Main Outcome Measures The clinical, radiological, and histopathological characteristics of four patients with BCA arising in the PPS were retrospectively analyzed. The endoscopic transoral approach was performed for resection of BCA. Its technical nuances, perioperative comorbidities, and outcomes are introduced. Results The clinical presentation, symptoms, and signs of patients with BCA are variable. The tumor was lateral to the ICA in two patients and anterior to the ICA in the remaining two. All four BCA were successfully removed en bloc ( n = 3) or by piecemeal ( n = 1) via an endoscopic transoral approach. The ICA was not injured, and no additional nerve damage, venous bleeding, postoperative infection, or salivary gland fistula were encountered in any of the four patients. Cystic degeneration is the predominant appearance of BCA on MRI; however, they are difficult to differentiate from other lesions arising in the PPS. No recurrence was detected at the time of the study analysis. Conclusion BCA of the PPS could have variable relationships with the ICA. An endoscopic transoral approach can provide an adequate corridor for total resection of BCA in PPS with seemingly low morbidity.

Expression of NR4A3/NOR-1 in acinic cell carcinoma of the salivary gland

Objective: To investigate the diagnostic role of NR4A3/NOR-1 immunohistochemistry in acinic cell carcinoma (AciCC) of the salivary gland. Methods: A total of 142 tumors were collected from 2004 to 2020 at Nanjing Jinling Hospital, including 24 cases of AciCCs, 12 salivary gland secretory carcinomas,14 salivary duct carcinomas,16 adenoid cystic carcinomas,3 basal cell carcinomas,13 mucoepidermoid carcinomas,7 myoepithelial carcinomas,15 pleomorphic adenomas,15 warthin tumor, 8 myoepithelioma,8 basal cell adenomas, and 7 oncocytomas; 28 normal salivary gland tissues and 2 pancreatic AciCC were also included. Results: NR4A3/NOR-1,a nuclear marker,was positive in 91.7% (22/24) of AciCC of the salivary gland,while DOG1,a membranous and cytoplasmic marker, demonstrated a sensitivity of 95.8% (23/24);there was no significant difference in the overall positive rates(P=0.551), but the stain pattern was different. NR4A3/NOR-1 was negative in normal salivary gland tissues and any other types of tumors in the salivary gland; however,DOG1 showed apical staining in the acinar cells in the salivary gland,as well as salivary gland secretory carcinomas,adenoid cystic carcinomas,basal cell carcinomas,mucoepidermoid carcinomas,myoepithelial carcinomas and basal cell adenomas(P<0.001). NR4A3/NOR-1 showed a high sensitivity(91.7%) and specificity(100%) to identify AciCC of the salivary gland,and in combination with DOG1, the sensitivity increased to 100%. Furthermore, NR4A3/NOR-1 were only positive for AciCC arising from salivary glands but not pancreas(0/2)(P=0.018). Conclusion: NR4A3/NOR-1 is a special and sensitive biomarker for AciCC of salivary glands; combined NR4A3/NOR-1 and DOG1 can be an ideal diagnostic immunohistochemical panel for AciCC.

Comparison of Diagnostic Reliability of p63 and Smooth Muscle Actin in Salivary Gland Neoplasms.

Salivary gland neoplasms pose considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants & similar histological features with other tumor entities. Myoepithelial and basal cells play a significant role in the pathogenesis of salivary gland neoplasm. p63 and smooth muscle actin are more reliable markers for identifying these cells and not studied much comparing their reliability in the diagnosis of salivary gland neoplasms. Hence, the aim of this study is to evaluate and compare the diagnostic reliability of immunohistochemical markers such as p63 and smooth muscle actin (SMA) in the diagnosis of various benign and malignant salivary gland neoplasms. The study comprises of 18 samples categorized into two groups: Group I comprised 9 cases, of which 4 cases were Pleomorphic adenoma, 2 cases were Myoepithelioma, 2 cases of Basal cell adenoma and 1 case was Warthin's tumor; and Group II consisted of 9cases, of which 3 was Mucoepidermoid carcinoma, 1 cases were Myoepithelial carcinoma and 5 cases were Adenoid cystic carcinoma. The selected cases were subjected to immunohistochemistry (IHC) procedure to assess the expression pattern of p63 and smooth muscle actin. The obtained data was analysed statistically by using Mann-Whitney test. In SMA, strong positivity for epithelial and connective tissue components of benign salivary neoplasm is about 22.2%respectively. In malignant salivary neoplasm, SMA was strongly positive for the epithelial and connective tissue component of about 77.7% and 88.8% cases respectively. The difference in the connective tissue components was found to be statistically significant (U = 24, P = 0.032). P63 was strongly positive for the epithelial and connective tissue component of benign salivary neoplasm of about 33.3% and 11.1% cases respectively.In malignant salivary neoplasm, p63 was strongly positive for the epithelial component of about 66.6% cases and connective tissue is completely negative. Alpha-SMA can be utilized as reliable IHC markers for salivary gland neoplasms due to its diagnostic importance in tumors with myoepithelial origin indicative of the histogenesis of salivary gland tumors and even p63 can be used as specific markers for differentiation of malignant salivary gland tumors.

A PROSPECTIVE STUDY ON CLINICOPATHOLOGICAL &amp; RADIOLOGICAL EVALUATION OF PAROTID TUMOURS IN A TERTIARY CARE CENTRE

Background: Salivary gland tumours are relatively rare clinical entities encountered in the frequent day-to-day clinical practice. They exhibit a wide variety of behaviour and widely diversified histology. Proper management of these tumours require an accurate diagnosis by the pathologist, correct clinical correlation by the surgeon. With this background, we have conducted a study on the incidence, age, gender, clinical features of parotid swellings, histological distribution, the efficacy of FNAC as a diagnostic modality, the role of ultrasound and MRI in the diagnosis and various treatment modalities in the management of parotid swellings and their outcome in our institute. Methods: Our study was a prospective study conducted on 60 patients over a period of 20 months from August 2018 to March 2020. All patients were evaluated by taking proper history, thorough clinical examination, routine laboratory investigations and specific investigations like FNAC, MRI, USG and biopsy. Results: The mean age of presentation in our study was 35.73 years. Seventy percent of tumours were pleomorphic adenoma, malignant mixed tumours constituted 13%, Warthin's neoplasm constituted 7.01%, Basal cell adenoma, Oncocytoma and Acinic cell carcinoma each of these tumours constituted 3.33%. All the patients presented with swelling (100%) in the parotid region, 46.67% patients presented with pain in swelling, out of which majority were benign. Pain occurred in 100% of the patients with malignant tumours and only in 36% of the patients with benign tumours. No patient presented with features of facial nerve paralysis, fungating mass or cervical lymphadenopathy. On FNAC, 56 were reported as benign (50 cases were reported as benign and remain six were reported as malignant on HPE) remaining 4 cases were reported as malignant. Similar results were obtained on ultrasound. Fifty-one cases were reported as benign and remaining 9 cases were reported as malignant on MRI. Superficial parotidectomy was done in 83.33% of cases, the remaining were treated with conservative total parotidectomy. No radical parotidectomy and radical neck dissection (RND) were done. Conclusion: Parotid tumours were commonly noticed in the 5th decade of life, males were predominantly affected. Pleomorphic adenoma is the most common tumour encountered. Malignant mixed tumours were most commonly observed malignant tumour followed by Acinic cell carcinoma. Parotid swelling is the most common presenting complaint followed by pain. Histopathological examination was more accurate when compared to FNAC. Superficial parotidectomy was the most commonly performed procedure.

Basal cell adenocarcinoma of the parotid gland: Comparison with basal cell adenoma for preoperative diagnosis

ObjectiveTo summarize the diagnosis and treatment outcomes of basal cell adenocarcinoma (BCAC) of the parotid gland, a rare low-grade malignancy, at a single institution, and to investigate the treatment approach for this rare malignancy. MethodsWe conducted a retrospective analysis of 9 patients with BCAC during 20 years from September 1999 to December 2019. Forty-five patients with basal cell adenoma (BCA), who were treated during the same time period, were used for comparison. The clinical characteristics of BCAC, diagnostic imaging, the usefulness of fine-needle aspiration cytology (FNAC) and frozen section biopsy (FSB), histological assessment of malignancy, and treatment outcomes were investigated. ResultsThere were no marked differences in sex, age, tumor diameter, or tumor location between BCAC and BCA cases. Among the 9 patients with BCAC, one patient was noted with pain/tenderness, and two patients were observed with adhesion to the surrounding tissues. Only one patient was diagnosed as malignant based on MRI/US. FNAC for BCAC was suspicious for malignancy in 6 of the 9 cases, which included one patient with the correct grade of malignancy, one patient with malignancy only, and 4 patients suspicious for malignancy. FSB was suspicious for malignancy in 8 of the 9 cases. Malignancy grade was determined based on infiltration to the surrounding tissues and expression of Ki-67, p53, and bcl-2. One patient with infiltration to the surrounding tissue was diagnosed as intermediate-grade malignancy, while the remaining 8 patients were diagnosed as low-grade malignancy. The BCAC cases included 7 patients with T2 and 2 patients with T1. Conservative resection was performed for all patients, and all cases are surviving cancer-free. ConclusionThe malignancy of BCAC can be suspected before surgery based on symptoms/signs, diagnostic imaging, and FNAC. FSB enables the diagnosis of not only malignancy but also the grade of malignancy, which may help determine the appropriate surgical resection. Although all 9 patients with BCAC are surviving free from cancer, a long-term follow-up is warranted.

The diagnostic value of Superb Microvascular Imaging in identifying benign tumors of parotid gland

BackgroundWe compared the ultrasound features, superb microvascular imaging (SMI) and micro vessel density (MVD) of pleomorphic adenoma (PA), Warthin’s tumor (WT) and basal cell adenoma (BCA) to explore the clinic value of SMI in differential diagnosis of benign tumors of parotid gland.MethodsThe vascular distributions and grade by color doppler flow imaging (CDFI) and SMI, as well as vascular index (VI) of 249 parotid gland masses from 217 patients were analyzed.ResultsThe internal echogenicity of BCA are more homogeneous in comparing with WT and PA(P < 0.05). By SMI, the vascular distribution and vascular grade in PA were mainly peripheral (33.1%) and avascular (25.7%), Grade 1 (27.8%) and Grade 0 (25.7%). WT were mainly central (31.3%) and mixed distribution (34.9%), in Grade 3 (37.3%) and Grade 2 (36.2%). BCA was mainly peripheral (33.3%) and mixed distribution (33.3%), in Grade 2 (33.3%) and Grade 3 (33.3%). The overall detection rate of SMI for vascular Grade 2 and 3 was significantly higher than that of CDFI (P < 0.05). Both VI and MVD were lowest in PA, highest in WT (P < 0.001). The VI by SMI was correlated with MVD (P < 0.001). The correlation index between vascular distribution and grade by SMI and MVD were significantly higher than CDFI.ConclusionSMI can provide low-velocity blood flow information, which is helpful for the differential diagnosis of common benign tumors of parotid gland, and is expected to be more widely used.

A retrospective study of 30 basal cell adenomas of the salivary gland in a Brazilian population and literature review.

The present study aimed to provide the clinicopathological data of Brazilian patients with basal cell adenoma (BCA). Records of BCA cases were retrospectively gathered from the Brazilian National Cancer Institute database between 1996 and 2006. All cases were histopathologically reviewed, and the clinicopathological data were collected from the patients' medical files. In addition, an English literature review about this tumor is also presented. Of 1127 salivary gland tumors identified, 30 were BCAs (2.7%). Women were more affected than men (70.0% vs. 30.0%), and the majority (60.0%) were elderly (> 65years old). The parotid gland was the most frequent location affected (93.3%), followed by the upper lip (3.3%) and submandibular gland (3.3%). Fine-needle aspiration was the main procedure applied to establish a preoperative diagnosis of tumor; however, the results were not always consistent. Histopathologically, the trabecular pattern was the most common type seen (50.0%) among our BCA samples. Most patients underwent superficial or partial parotidectomy. Frey's syndrome was reported only in one case during the follow-up. No recurrence was noted in the present series. The literature review revealed a total of 213 reported cases of BCA in the period investigated. This is the first case series of BCA reported in Brazil. As occurred in other previously reported series, the clinicopathological data of BCAs are similar and confirm that this type of tumor is rare, develops predominantly in the parotid gland, frequently affects older women, has an indolent behavior, and the affected patients have an excellent prognosis.

INTRAORAL SALIVARY GLAND TUMORS: A RETROSPECTIVE STUDY OF 15 YEARS IN A BUCOMAXILLOFACIAL SURGERY SERVICE

Objective: To identify the relative frequency and distribution of salivary gland tumors (SGTs) diagnosed at a Oral and Maxillofacial surgery service over a 15-year period. Study design: A retrospective study was carried out by recording the biopsies of SGTs performed in the service, with histopathological analysis, between 2004 and 2018. Results: Among the 2829 biopsies of oral lesions, 27 (0.95%) were SGTs; 18 (66.7%) were benign and 9 (33.3%) were malignant. Females were more affected (74.1%). The mean age ± standard deviation (SD) was 54.3 ± 17.1 years, ranging from 16 to 79 years. The hard palate was the site more affected (66.7%), followed by the soft palate (11.1%). Nine different types of tumors were diagnosed: pleomorphic adenoma (48.2%), adenocarcinoma (14.8%), adenoid cystic carcinoma (7.4%), canalicular adenoma (7.4%), myoepithelioma (7.4%), mucoepidermoid carcinoma (3.7%), basal cell adenoma (3.7%), clear cells carcinoma (3.7%) and ex-pleomorphic adenoma carcinoma (3.7%).Conclusion: These findings suggest that SGTs have a low incidence in the population, and pleomorphic adenoma is the most common type of tumor followed by adenocarcinoma with the hard palate being the more prevalent site. Objective: To identify the relative frequency and distribution of salivary gland tumors (SGTs) diagnosed at a Oral and Maxillofacial surgery service over a 15-year period. Study design: A retrospective study was carried out by recording the biopsies of SGTs performed in the service, with histopathological analysis, between 2004 and 2018. Results: Among the 2829 biopsies of oral lesions, 27 (0.95%) were SGTs; 18 (66.7%) were benign and 9 (33.3%) were malignant. Females were more affected (74.1%). The mean age ± standard deviation (SD) was 54.3 ± 17.1 years, ranging from 16 to 79 years. The hard palate was the site more affected (66.7%), followed by the soft palate (11.1%). Nine different types of tumors were diagnosed: pleomorphic adenoma (48.2%), adenocarcinoma (14.8%), adenoid cystic carcinoma (7.4%), canalicular adenoma (7.4%), myoepithelioma (7.4%), mucoepidermoid carcinoma (3.7%), basal cell adenoma (3.7%), clear cells carcinoma (3.7%) and ex-pleomorphic adenoma carcinoma (3.7%).Conclusion: These findings suggest that SGTs have a low incidence in the population, and pleomorphic adenoma is the most common type of tumor followed by adenocarcinoma with the hard palate being the more prevalent site.

BASAL CELL ADENOMA: A CASE REPORT

Basal cell adenoma is a benign neoplasm of salivary gland with 1% to 2% of tumors of that order. The nomenclature derives from the basaloid appearance of its tumor cells formed by the combination of salivary duct epithelium and myoepithelial cells. The present study aims to report the case of a 70-year-old male leucoderm patient admitted by the department of maxillofacial surgery presenting clinically a tumor lesion in the left buccal region with hardened consistency on palpation, painless, mobile, with 1-year evolution. In the cranial computed tomography with a soft profile window, we observed a hypodense mass image, well delimited and approximately 2 cm in its largest diameter. In view of these characteristics, the diagnostic hypothesis was pleomorphic adenoma. Excisional biopsy was performed with local anesthesia at the outpatient operating room. The specimen was referred for histopathologic analysis, defining diagnosis for basal cell adenoma. The patient is in periodic postoperative follow-up.

BASAL CELL ADENOMA: A RARE CASE WITH AN UNUSUAL PRESENTATION

Basal cell adenoma is a benign salivary gland neoplasm that mainly affects the parotid gland and rarely occurs in minor salivary glands. It is more common in older adults, with peak prevalence in the seventh decade of life, and clinically appears as a slowly growing mass. A 25-year-old white woman presented with a 6-mm submucosal nodule around the upper lip area. The lesion was asymptomatic and was covered with normal-looking mucosa. Based on the location, a clinical diagnosis of dermoid cyst was established, and an excisional biopsy was performed. Histopathologic examination showed a proliferation of cells with 2 phenotypes forming a tubular pattern within a fibrous stroma. Luminous cells exhibited oval and pale nuclei and eosinophilic cytoplasm, while basaloid cells contained pale or hyperchromatic nuclei and clear cytoplasm. A diagnosis of basal cell adenoma was made, and the patient was considered treated and is currently being followed up.

Myb Immunohistochemical Staining and Fluorescence in situ Hybridization in Salivary Rare Basaloid Lesions.

Objective: Salivary rare basaloid lesions, including cribriform type basal cell adenoma (cBCA), BCA with incomplete capsule (iBCA), sialoblastoma (SB), and intercalated duct hyperplasia (IDH), could easily be misdiagnosed as adenoid cystic carcinoma (AdCC). We aim to identify an approach for differential diagnosis and to establish an optimal workflow concerning the diagnosis of these lesions.Material and methods: A panel of antibodies (MYB, β-catenin, CD117, SOX10, ki67, P63, calponin) and fluorescence in situ hybridization (FISH)-MYB were utilized to distinguish above salivary basaloid diseases from AdCC.Results: Histologically, the striking diagnostic features of cBCA, iBCA, SB, and IDH are composed of basaloid tumor cells, well-defined encapsulation, or lack of destructive invasion. Immunohistochemically, Myb immune-labeling could effectively make a distinction among cBCA, iBCA, SB, and IDH from AdCC, except in SB. cBCA and iBCA typically expressed β-catenin in the nuclei of tumor cells. There was no statistical significance in the ki67 index between SB and AdCC, but their indices were significantly higher than those of iBCA and IDH (p < 0.05, p < 0.05, respectively). P63 and calponin immune-expression were observed in the basaloid or myoepithelial cells. CD117 were observed positively in cBCA, iBCA, SB, and AdCC, except in IDH. SOX10 were observed positively in all cases. No cases had fusion of MYB and NFIB detectable by FISH, except in AdCC.Conclusion: Considering their sensitivity and specificity, FISH-Myb and an immunohistochemical panel of MYB/β-catenin/ki67 would be an optimal choice for the differential diagnosis of these basaloid lesions.Clinical relevance: Some salivary basaloid tumor or tumor-like lesions have overlapping features with AdCC. Through this present research, we suggested that the panel IHC of MYB, βcatenin, and ki67 combined with FISH-Myb should be an optimal choice for differential diagnosis among those lesions.

Retrospective Study of Buccal Mucosal Salivary Neoplasms.

Salivary gland neoplasms of the buccal mucosa are relatively rare and often present with an unusual histopathologic profile when compared with other intraoral locations. We present a series of minor salivary gland neoplasms of the buccal mucosa and discuss demographics, clinical presentation, and histologic findings. An IRB approved retrospective search of University of Florida Oral Pathology Biopsy Service archive from 1994 to 2018 for all salivary gland neoplasms of the buccal mucosa was undertaken. Data related to age, gender, clinical presentation, diagnosis, and category of neoplasm recorded. Review for consensus of diagnosis and immunohistochemical (IHC) testing on current diagnostic standards was performed and diagnoses updated based on results. Of 66 cases identified majority were females (72.7%) and age mean was 63 years. Benign tumors were 56.06% and 43.94% malignant, with Mucoepidermoid carcinoma (MEC) being commonest (26/66, 39.4%), followed by canalicular adenoma (CLA) (14/66, 21.2%), ductal papilloma (DP) (10/66, 15.2%), cystadenoma (CA) (8/66, 12.1%), basal cell adenoma (BCA) (4/66, 6.1%), and 1(1.5%) each for pleomorphic adenoma (PA), secretory carcinoma (SC), adenoid cystic carcinoma (ACC) and adenocarcinoma not otherwise specified (ACNOS). This study with respect to demographics and percentage of benign and malignant buccal mucosal salivary gland neoplasms is in conformity with the literature. It underscores the fact that both benign and malignant salivary gland neoplasms should be included in the differential diagnosis of submucosal buccal masses. Future larger multicenter studies with detailed treatment and outcomes data may aid and assist in further understanding the behavior, diverse histomorphology and prognosis of these neoplasms.