Malignant Gland Research Articles

A case of Bartholin's gland malignancy: A rare diagnosis

Objective: Bartholin’s gland carcinoma is rare. It may arise from the duct or gland proper and thus may be a squamous cell carcinoma (SCC) or adenocarcinoma. Delays in treatment are not uncommon because of misdiagnosis as a cyst or abscess. Bartholin’s gland cancers have a poorer prognosis than SCC vulva, and thus timely and appropriate treatment is key.

Çocuk ve Gençlerde Tükürük Bezi Kanserleri

Aim: This report aimed to present up-to-date information about early symptoms, intraoral findings and treatment options for gland tumours in children. Materials-Methods: The key words salivary gland, malignancy and were searched by using the search engines PUBMED AND GOOGLE SCHOLAR. The titles and summaries of the literatures were evaluated, the suitable ones were included and analysed. Results: In children, the most common benign gland tumour is pleomorphic adenoma and the most common malignant tumour is mucoepidermoid carcinoma. In benign tumours, the symptom could be only swelling, while in malignant ones’ pain and paralysis can be involved. While the parotid gland tumours can cause the facial nerve paralysis, the submandibular and sublingual gland tumours can affect alveolar, lingual and hypoglossal nerves. Treatment of gland neoplasms is the surgical treatment in children same as in adult patients. In addition to surgical removal, postoperative radiotherapy and chemotherapy may be required. Asymmetrical face growth, dental problems, trismus and osteoradionecrosis can be observed after radiation therapy, so radiation therapy option should be carefully evaluated especially in children and adolescents. The prognosis of gland cancers in children and adolescents is quite good. The 5-year and 10-year survival rate differ from 80% to 100%. The recurrence rate is very low. Conclusions: Although the incidence of gland tumours in children is considerably lower than in adults, it is important that malignant gland tumours are more common in children.

CYSTIC ADENOID CARCINOMA OF LARGE EXTENSION IN THE MAXILLA: A CASE REPORT

Cystic adenoid carcinoma (CAC) is a slow-growing, malignant gland neoplasm, with predominance in the palate region. A 54-year-old female patient presented with an extensive ulcerated lesion, with bleeding, painless, endophytic growth, affecting the hard and soft palate, with evolution of 8 months. Image examination showed a hypodense lesion with indefinite limits, involving the palate, the entire nasal cavity, and the left maxillary sinus. After facial clinical and imaging findings were reviewed, incisional biopsy was performed in the peripheral regions of the lesion, and the patient was instructed to suspend the use of the total prosthesis. The histologic examination concluded CAC diagnosis. Because it was a malignant lesion, the patient was referred to a state referral center to continue the treatment. The role of the dentist is of paramount importance in diagnosing and conducting the primary treatment of lesions in the maxillofacial region. Cystic adenoid carcinoma (CAC) is a slow-growing, malignant gland neoplasm, with predominance in the palate region. A 54-year-old female patient presented with an extensive ulcerated lesion, with bleeding, painless, endophytic growth, affecting the hard and soft palate, with evolution of 8 months. Image examination showed a hypodense lesion with indefinite limits, involving the palate, the entire nasal cavity, and the left maxillary sinus. After facial clinical and imaging findings were reviewed, incisional biopsy was performed in the peripheral regions of the lesion, and the patient was instructed to suspend the use of the total prosthesis. The histologic examination concluded CAC diagnosis. Because it was a malignant lesion, the patient was referred to a state referral center to continue the treatment. The role of the dentist is of paramount importance in diagnosing and conducting the primary treatment of lesions in the maxillofacial region.

Aberrant integrin αv and α5 expression in prostate adenocarcinomas and bone-metastases is consistent with a bone-colonizing phenotype.

BackgroundCollaborative signaling between fibronectin-binding αv and α5 integrins has been implicated in the lethal dissemination of prostate cancer in the bone-metastatic niche, the major source of morbidity and mortality in the disease.MethodsWe assessed the frequency and pattern of expression of these integrins in primary high-grade adenocarcinomas and bone metastases compared to the physiological gland. Formalin-fixed paraffin-embedded (FFPE) radical prostatectomy (RP) samples (n=25) containing ≥ Gleason grade 4 cancer and decalcified surgical or diagnostic bone metastatic samples from 10 patients were stained for integrin αv (ITGAV) and integrin α5 (ITGA5) expression. Antibody optimization and antigen-retrieval was performed beforehand.ResultsITGAV was exclusively expressed in the basal layer of physiological prostate glands whereas αv expression was invariably recapitulated in the malignant gland and bone metastases (100%) in multiple distinct patterns: epithelial membranous, basilar/luminal membranous, punctate cytoplasmic, intense foci as single cells or clusters, and rim stromal layers. The luminal/basilar layer of ITGAV expression was striking in cribriform carcinomas, suggestive of a role in molecular pathogenesis. ITGA5 infrequently highlighted the basal layer of the physiological gland, was absent in primary adenocarcinoma, but was expressed with ITGAV exclusively in bone metastases (71%).ConclusionsWe conclude that ITGAV expression is aberrantly expressed in high frequency in high-grade prostatic adenocarcinomas in patterns suggestive of recapitulated basal cell functions, consistent with a stem-regulatory role that has been proposed. Co-expression and enrichment of αv and α5 in osseous metastases supports their proposed collaborative role in colonization of the bone microenvironment and as candidate targets for therapy.

Value of diffusion weighted and ADC value - magnetic resonance imaging in differentiation between benign and malignant solid parotid gland masses

Background: magnetic resonance imaging (MRI) is becoming an essential tool for assessment of parotid gland pathology. Diffusion weighted imaging (DWI) provides quantitative and qualitative information reflecting the changes in tissue cellularity and integrity of cell membranes. Objective: To evaluate the diagnostic accuracy of diffusion weighted -MRI in the differentiation between benign and malignant solid parotid gland masses using 1.5 Tesla MRI scanner and to obtain the best cutoff value of apparent diffusion coefficient (ADC) to differentiate between benign and malignant masses. Patients and methods: prospective cross-sectional analytic study was conducted in Al Imamein Al Kadhumein Medical City, at the period between January 2019 and January 2020, 50 patients were included in the study. DWI was acquired at following b-values [50, 1000 millimeter (mm) 2/second (sec)], in this study the results were obtained and depending on b-value 1000 mm2/sec. Results: The mean level of ADC value of malignant masses (0.599 ± 0.117 SD x 10-3 mm2/sec), while for benign masses (1.590 ± 0.363 SD x10-3 mm2/sec); According to Receiver operating characteristic (ROC) curve the optimal cutoff point of ADC value was (0.914x10-3 mm2/sec) with sensitivity 100%, specificity 97%. The association between MRI diagnosis and histopathological diagnosis was significant (P value< 0.001). Conclusion: Diffusion weighted- MRI and ADC values are highly sensitive and specific to differentiate between benign and malignant solid parotid gland masses and the best ADC cut off value was (0.914x10-3 mm2/sec).

Severe deep neck infections successfully treated with negative pressure wound therapy with instillation - a case report

Background: Deep neck infection (DNI) is a life-threatening complication associated with significant mortality and morbidity rates. The most common causes of DNI are the tonsilitis, dentitis, salivary glands inflammation, malignancies, and foreign bodies. As a result of neck infection, patients are at high risk of potential secondary complications which include: descending mediastinitis, pleural empyema, septicemia, jugular vein thrombosis, pericarditis. We presented a case of successful management of DNI with the utility of negative pressure wound therapy with instillation (iNPWT).&#x0D; Method: A 37-year-old male with deep neck infection due to dentitis was qualified for iNPWT. Due to previous incisions and drainage of the neck abscesses, some undermined wounds drained towards each other’s were revealed with an excessive amount of purulent content. Standard NPWT dressing was placed and polyurethane foam was covered with contact layer dressing. Additionally, an inflow drain was placed within one of the wounds in regard to instill an antimicrobial solution. The wound was instilled four times daily.&#x0D; Results: The patient underwent a total of eight iNWPT sessions. Locally, a reduction in purulent content was achieved with a decrease of wounds’ dimensions and improvement of wound bed granulation. Moreover, improvement of the patient’s general condition and decrease of inflammatory markers was achieved.&#x0D; Conclusions: iNPWT may play an important role in the management of combined, complicated wounds due to DNI. The instilled antimicrobial solution facilitates dissolving and removing of the purulent content that impairs the wound healing.

Management of malignant submandibular gland tumour: 20‐year experience in a single institution

AbstractAimOur primary objective is to establish the epidemiology of submandibular gland malignant tumour in Hong Kong. Our second objective is to investigate the correlation of positive surgical margin and survival in patients with primary malignant submandibular gland tumour. Our third objective is to review the accuracy of fine needle aspiration in histological diagnosis.Patients and MethodsA retrospective study was conducted. Patients who underwent surgery and were discharged from Queen Mary Hospital and Tung Wah Hospital from December 31, 1997‐December 31, 2017 were included. Data was analysed by Microsoft Excel and IBM SPSS Statistics 25.ResultThere were 239 patients with submandibular gland removal between 1997‐2017 in the Queen Mary and Tung Wah Hospitals. Among this group, 32 patients were diagnosed with malignant submandibular gland. Data of these 32 patients were reviewed and analysed. The male‐to‐female ratio was 3:1. The median age at diagnosis was 55.5. Mean follow up time was 44.8 months. Patients presented with various histological subtypes of submandibular gland tumour, the most common being lymphoepithelioma‐like carcinoma and adenocystic carcinoma (28.1% each), followed by carcinoma ex pleomorphic adenoma (12.5%), mucoepidermoid carcinoma (9.4%), salivary duct carcinoma (9.4%), undifferentiated carcinoma (6.3%) and squamous cell carcinoma (6.3%). The tumour histological subtype was unknown in 40.6% of patients at the time of surgery. The positive surgical margin rate was 50%. The overall 5‐year locoregional control rate, disease‐free survival and overall survival were 81.83%, 75.14% and 76.57% respectively.ConclusionLack of preoperative histological diagnosis is identified as the only predictor of positive surgical margin, OR 7.22, P &lt; 0.0163. It is concluded that TNM staging and lymphovascular invasion are the two significant prognostic factors in management of malignant submandibular gland tumour. However, we cannot draw a statistically significant conclusion on whether positive surgical margin would affect the overall survival or locoregional control or disease‐free survival. (P &lt; 0.997, P &lt; 0.74, P &lt; 0.950 respectively).

Sublingual Gland Tumors Worldwide: A Descriptive Retrospective Study of 839 Cases

Sublingual gland tumors are rare. We sought to define the general features of sublingual gland tumors for clinical reference. In addition, we evaluated whether it would be safe to speculate that ∼90% sublingual gland tumors will be malignant and that ∼90% of those malignant tumors will be adenoid cystic carcinoma. In the present study, we have reported data from a pleomorphic adenoma case of the sublingual gland and a case series of sublingual gland tumors. Global data of sublingual gland tumors were retrieved. The cases pathologically identified as either benign or malignant tumors of the sublingual gland were included. The demographic, pathologic, and treatment features were analyzed. Data from 1 recent case of pleomorphic adenoma of the sublingual gland and a 21-case series of sublingual gland tumors were retrieved. A total of 839 cases of sublingual gland tumors were analyzed in the present study. The most commonly encountered age group was 40 to 59years (47.6%). Of the 367 patients with gender specified, 178 were men (48.5%) and 189 were women (51.5%). Malignant tumors predominated (n=722 cases; 86.1% of 839). Most malignant tumors were adenoid cystic carcinoma (n=376), just greater than one half (52.1%) of all malignant tumors. Surgery was the only reported treatment method for the benign tumors. The most common treatment methods for the 164 explicit malignant tumors were surgery plus radiotherapy for 82 patients (50%), followed by surgery alone for 70 patients (42.7%). To date and to the best of our knowledge, the present study is the most comprehensive study on the demographic, pathologic, and treatment features of global sublingual gland tumors. These findings have shown that ∼90% of sublingual gland tumors will be malignant. However, the assumption that ∼90% malignant sublingual gland tumors will be adenoid cystic carcinoma is incorrect, which could be a new critical clinical reference.

Recurrent DICER1 Hotspot Mutations in Malignant Thyroid Gland Teratomas: Molecular Characterization and Proposal for a Separate Classification.

Thyroid gland teratomas are rare tumors that span a wide clinicopathologic spectrum. Although benign and immature teratomas arise in infants and young children and generally have good outcomes, malignant teratomas affect adults and follow an aggressive course. This divergent behavior raises the possibility that benign/immature and malignant teratomas are separate entities rather than different grades of a single tumor. However, the histogenesis and molecular underpinnings of thyroid gland teratomas are poorly understood regardless of grade. In this study, we performed next-generation sequencing on 8 thyroid gland teratomas, including 4 malignant, 3 benign, and 1 immature. We identified DICER1 hotspot mutations in all 4 malignant cases (100%) but not in any benign/immature cases (0%). No clinically significant mutations in other genes were found in either group. We also performed immunohistochemistry to characterize the primitive components of malignant teratomas. Not only did all cases consistently contain immature neural elements (synaptophysin and INSM1 positive), but also spindled cells with rhabdomyoblastic differentiation (desmin and myogenin positive) and bland epithelial proliferations of thyroid follicular origin (TTF-1 and PAX8 positive). Although DICER1 mutations have previously been implicated in multinodular hyperplasia and well-differentiated thyroid carcinomas, these findings demonstrate the first recurrent role for DICER1 in primitive thyroid tumors. The combined neural, rhabdomyoblastic, and homologous epithelial elements highlighted in this series of malignant thyroid gland teratomas parallel the components of DICER1-mutated tumors in other organs. Overall, these molecular findings further expand the differences between benign/immature teratomas and malignant teratomas, supporting the classification of these tumors as separate entities.

Skin reconstruction of the temporo parotid region

bjectives: To determine the result of reconstruction with local or regional flaps of skin defects in the temporo-parotid region, after resection of malignant parotid gland and ear tumors, and to establish a reconstruction algorithm according to the size of the defect. Methods: The electronic medical records of the patients who underwent surgery for malignant tumors of the parotid gland and ear with invasion of the skin of the region, and who had reconstructions of the skin defect with local and regional flaps, were selected. The surgeries were performed by the surgical team of the Otorhinolaryngology service of the Italian hospital in Buenos Aires between 2005 and 2018. Results: Five patients were included.There were two malignant parotid gland tumors with histology of adenoid cystic carcinoma and squamous cell carcinoma, and three temporal bone tumors: squamous cell carcinoma, basal cell carcinoma in another and adenoid cystic carcinoma. The reconstructions were made with local or regional flaps. In skin defects smaller than 8cm the reconstructions were made with cervical and scalp flaps. In skin defects larger than 8cm the pectoralis major musculoctaneous flap were used. No patient had partial or total necrosis of the flaps. Conclusions: The results of the reconstructions with local and regional flaps of the skin defects caused by the resection of malignant tumors of the ear and the parotid gland were very good, since they allowed the repair of the defect with a good aesthetic result, without the need to perform grafts in the donor area and with few minor complications. In patients with advanced malignant tumors of the ear and parotid gland with infiltration of the surrounding skin, it is better to do the reconstruction with local or regional flaps due to the greater simplicity and speed of the surgical technique, similar aesthetic results and few complications.

Evaluation of Preoperative Fine Needle Aspiration Accuracy in Diagnosis of Malignant Parotid Tumors

Objective: To evaluate the diagnostic accuracy of fine needle aspiration (FNA) in detecting malignant parotid tumors. Design: A retrospective study of cases series. Setting: Salmaniya Medical Complex, Otorhinolaryngology Department, Kingdom of Bahrain. Methods: A retrospective study was carried out, between January 2009 and December 2018, for all patients diagnosed with parotid tumors at the Department of Otorhinolaryngology, Head and Neck Surgery at Salmaniya Medical Complex, Manama, Kingdom of Bahrain. Data collection was made from medical records, I-seha and laboratory information system (LIS). 87 patients underwent parotidectomy, of which 30 were excluded due to unsatisfactory diagnoses or missing data. The results of fine needle aspirations were analyzed and compared with the corresponding histopathologic diagnosis. Estimation of sensitivity, specificity, negative predictive value, positive predictive value and accuracy of FNA were calculated. Results: Among the 57 evaluated cases, four cases were further excluded from the final analysis due to unsatisfactory FNA results, therefore only 53 cases remained. The mean age of patients was 48.6 ± 17.2 years. A concordance with histopathology results was observed. 47 cases were diagnosed as benign and five cases were malignant, however, 1 case was diagnosed as malignant by FNA, but not in histopathology. The overall diagnostic accuracy was 98.1% and the prevalence of parotid malignancy was 9.4%. Sensitivity and specificity were 100% and 97.9%, respectively. Positive predictive value was 83.3% while negative predictive value was 100%. Conclusion: Fine needle aspiration is a highly sensitive and specific test in evaluating malignant parotid gland tumors. It is useful and accurate, especially when used hand by hand with the clinical assessment and radiological findings.

Identification of p53 gene alterations in canine mammary tumours using polymerase chain reaction and direct sequence analysis

Mammary tumours are mentioned as the most common tumours in female dogs and approximately half of them are detected malignant. p53 gene mutations are demonstrated to be the most common genetic alteration in canine mammary tumours. The present study was conducted to evaluate exon-1 of p53 gene mutations in tissue samples of canine mammary tumours by PCR and direct sequence analysis. After histopathological confirmation of the tissue sections by haematoxylin and eosin staining (10/26), deparaffinised samples were used for DNA extraction by silica gel method. Subsequently, p53 exon 1 was amplified through PCR assay using specific oligo nucleotide primers designed according to the canine DNA sequence available online. Microscopically, 10 out of 26 suspected tissue samples were recognised as malignant mammary gland tumours with various grades of malignancy. Surprisingly, one insertion of mutation was found in exon 1 of all examined samples corresponding to a sequence comprising 27 amino acids, between amino acids 30 to 57 in the p53 protein. Taken together, it seems that alteration of exon 1 p53 gene may lead to malignancy beha­viour, poor prognosis and short survival time in dogs with mammary carcinomas.

Parotid gland neoplasms presenting as discrete infra-auricular swellings

Background: Parotid gland neoplasms usually present as pre-auricular swellings. Sometimes, they present as solitary infra-auricular swellings which make their localization difficult as they may be confused with submandibular gland or other lateral upper neck masses. Clinicopathological reports of discrete infra-auricular parotid lesions and their surgical managements are few. Objectives: To describe the clinical features and management of discrete infra-auricular parotid masses in a series of Nigerian patients seen during a surgical outreach mission. Methodology: This is a retrospective study of all infra-auricular swellings managed by a Nigerian surgical mission over 6 years. Patients' demographics, duration of swelling, symptoms, treatment, histopathological diagnosis, postoperative complications were retrieved from patients' records. Results: A total of 124 facial tumors were seen, of which 15 (12.1%) were parotid tumors. Eight cases (53.3%) of parotid tumors presented as discrete infra-auricular masses. Age range was 13–57 years (mean = 40.9 ± 15.4 years) with male predilection. Duration of swelling was between 1 and 15 years. All lesions were treated with extracapsular dissection. One patient had postoperative facial nerve paresis, but no facial palsy and sialocele. The histopathological results were 5 (62.5%) pleomorphic adenomas, 1 (12.5%) Warthin's tumor, and 2 (25%) low-grade mucoepidermoid carcinomas. Conclusion: Discrete infra-auricular swellings may present as benign and malignant parotid gland neoplasms.

Sweat Gland Tumor Microenvironment.

Malignant sweat gland tumors are rare cutaneous neoplasms and associated with poor prognosis. The process of tumorigenesis originating from sweat glands is complex and dynamic. The tumor is surrounded by an extracellular matrix (ECM) and stromal cells, as well as physiological state from the tumor microenvironment (TME). Various types of evidence suggest a variety of vital components of TME that interact with each other, ranging from fibroblasts, immune and inflammatory cells, vascular and lymphatic networks, and ECM. This chapter provides a comprehensive overview of sweat gland tumor microenvironment based on current studies of TME and describes the function of each component of TME in cancer initiation, progression, and invasion.

Assessment of parotid gland masses with B-mode ultrasonography and strain elastography findings: Does ultrasound elastography improve accuracy in differential diagnosis between benign and malignant masses?

Aim: Ultrasound elastography (USE) has been found useful in differentiation between malignant and benign lesions of various tissues, such as the thyroid, breast, lymph node and prostate, however, there is limited data on the parotid gland. The aim of this study is to assess the diagnostic performance of B-mode ultrasonography (US) and USE findings in differentiating between benign and malignant parotid gland masses. A secondary goal is to evaluate results for the most frequent benign lesions. Methods: In this cross-sectional study, 57 masses in 48 patients were evaluated. 2 radiologists examined each patient. B-mode US (size, contour, skin depth, internal structures, calcification, cystic component) and USE (a semiquantitative value strain index (SI)) findings were noted. We considered each feature individually. All patients underwent fine needle aspiration cytology (FNAC) and surgical resection.Results: 50 masses were benign and 7 were malignant. Among B-mode US results, contour irregularity was found to have the highest accuracy (85.7%) in differentiating malignant lesions. When USE findings were considered, intra-observer agreement was moderate to fair and interobserver agreement was moderate. Malignant masses had mildly high SI scores. There was a wide range overlap between malignant and benign lesions. There was no statistically significant difference (P=0.422) and we could not attain a reliable SI cut-off value.Conclusion: Despite the promising results of USE in breast and thyroid lesions, conventional US findings and FNAC are still the primary diagnostic tool to evaluate parotid lesions.

Clinical features and pathological analysis of lacrimal gland occupying lesions in 91 cases

Objective: To analyze the pathogenesis, histopathological classification and clinical features of lacrimal gland occupying lesions. Methods: This was a retrospective case series study. Clinical data of 91 patients (102 eyes) with lacrimal gland area occupying diseases who received ophthalmic surgery in the Second People's Hospital of Yunnan Province from January 2014 to November 2018 were retrospectively analyzed, including patients' age, reasons for treatment, gender, imageological examination data and pathological diagnosis results. All patients had more than one medical imaging examination results and histopathological diagnosis results. Results: Among 91 cases, 46 patients (50.5%) were male and 45 (49.5%) were female. The age distribution ranged from 1.1 years to 72 years old, with an average age of 43 years. All of benign tumors added up to 58 cases (63.7%). Pleomorphic adenoma (43 cases, 47.3%), dermoid cyst (6 cases, 6.6%), and inflammatory pseudotumor (6 cases, 6.6%) were the most common cases in the benign lacrimal gland occupying tumors. There were 33 cases (36.3%) of malignant tumors. Adenoid cystic carcinoma (15 cases, 16.5%), adenocarcinoma (6 cases, 6.6%) and lymphoma (5 cases, 5.5%) had the highest incidence among the malignant lacrimal gland occupying tumors. The most common reason for seeking medical treatment was exophthalmos (50 cases, 54.9%; 30 cases were pleomorphic adenoma). Brow arch mass (22 cases, 24.2%) and pain in and around the eye (9 cases, 9.9%; 5 cases were adenoid cystic carcinoma) were also major reasons. Conclusions: The most common benign lacrimal gland area occupying lesion in surgery patients of Yunnan is pleomorphic adenoma, which more occurred in patients with exophthalmos as the main symptoms. The most common malignant tumor in the lacrimal gland area is adenoid cystic carcinoma and the most common reason to seek medical advice was pain in and around the eye. (Chin J Ophthalmol, 2019, 55:842-846).

The application of complex assessment of the health status of the population in tasks of the improvement of the socio-hygienic monitoring system

Improvement and unification of information and analytical technologies is the one of the priorities, the solution of which will provide the gain in the efficacy and appropriateness of management decisions, developed preventive and wellness measures. In the article there is explained the use of generalized indices of the real risk as criteria for the comprehensive assessment of the health state of the population at the regional and the municipal levels. The proposed criteria make it possible to increase the objectivity of the assessment of the health state in the sociohygienic monitoring system and in the implementation of the special studies of epidemiological type. There are presented results of a comprehensive assessment of the health state of the population in the cities of Rostov region for the ten-year period and according to socio-hygienic monitoring in 2014 year. In terms of twenty of markers characteristics ofpopulation health there were used indices of the total mortality and morbidity rate. There was executed the complex assessment of the cancer prevalence rate in the urban population on nine priority localizations of the malignant tumors, including stomach, colon, rectum, lungs, skin, mammary gland, corpus uteri, ovary and thyroid gland. There were identified territories of high and elevated real risk to health state of the population. There is presented the result of the application of mathematical modeling used for the assessment and prediction of the impact of environmental factors on the complex assessment of the health staty of the population. Results of research were used for the shaping of information and analytical materials in the Rostov region.

Do not break a sweat: avoiding pitfalls in the diagnosis of sweat gland tumors.

The group of malignant sweat gland neoplasms is characterized by a wide biologic spectrum, including tumors with indolent behavior, low-grade malignant potential with locally destructive tumor growth and high local recurrence rates and high-grade malignant potential characterized by risk for disseminated disease and disease-related mortality. Reliable diagnosis to predict behavior may be challenging for a number of reasons. The clinical presentation is often nonspecific. Many of the tumors are rare, and they are only infrequently encountered in routine diagnostic practice. A significant subset of tumors shows bland and innocuous histologic features. They are easily mistaken for benign tumors despite their potential for destructive growth and aggressive disease course. At the other end of the spectrum the tumors may resemble poorly differentiated carcinoma or adenocarcinoma and recognition relies entirely on sampling and carful histological examination. The tumors may be inseparable from cutaneous metastases from visceral primaries by morphology and immunohistochemistry, requiring careful clinical correlation and work-up. Conversely, cutaneous metastases are readily mistaken for cutaneous primary tumors. While the presence of a myoepithelial layer is a helpful feature in excluding metastatic deposits, it does not imply benign behavior of sweat gland tumors in general. The above issues and challenges are exemplified in the discussion of selected sweat gland carcinoma in this manuscript, with a focus on recently described entities and those with novel findings.

Stability of αB-crystallin gene expression in canine mammary gland neoplasms. Should it be considered as circulating tumor cell genetic marker?

αB-crystallin is a member of a small family of thermal shock proteins that protects cells from stress. Because of lack of its expression in peripheral blood leukocytes, it was proposed as a molecular marker of circulating tumor cells in canine mammary gland tumors. The aim of the present study was to determine if αB-crystallin shows stability of expression, what is the requirement for this type of marker. It was also assessed whether there is co-expression of αB-crystallin with the basal marker, cytokeratin 17. For this purpose, samples of various types of canine mammary gland tumors of epithelial origin, were selected. Using RT-qPCR, we have found αB-crystallin and cytokeratin 17 co-expression in benign and malignant canine mammary gland tumors. It has been demonstrated that the expression of αB-crystallin in tested neoplastic samples is not stable in comparison to the control group. Furthermore αB-crystallin overor down- expression was associated witch the same cytokeratin 17 pattern. αB-crystallin can be a marker of circulating tumor cells in the bloodstream, but for cancers in which basal marker expression occurs and thus not universal for all cancers originating from the mammary gland tissue.

Cytological differentiation between benign and malignant perianal gland proliferative lesions in dogs: a preliminary study.

To evaluate the diagnostic utility of individual cytological criteria and their best combination to differentiate benign from malignant perianal gland proliferative lesions in dogs. Retrospective study of cytological samples of canine perianal gland proliferative lesions that had subsequent histopathological confirmation. Seventy-seven perianal gland nodules from 56 dogs were included. Histologically, lesions were diagnosed as hyperplasia (n=2), adenoma (n=53), epithelioma (n=6) and carcinoma (n=16). Of the 28 cytological criteria assessed, 13 showed promise for distinguishing benign from malignant lesions. A diagnostic algorithm with an 87% accuracy (sensitivity, 90.9%; specificity, 85.4%) was developed from these data. Cytological evaluation can provide useful information for presurgical differentiation between benign and malignant hepatoid gland proliferative lesions. The proposed algorithm must be validated and tested for reproducibility in further, preferably larger, series of cases.