Polymorphous Low-grade Adenocarcinoma Research Articles

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.

Extensive Partial Obturador Oropharyngeal in Class IV Aramany after Oral Adenocarcinoma

When a patient is interrupted by velopharyngeal closure or defects in the hard palate, air escapes inappropriately through the nose in nasal speech sounds. The obturator prosthesis with extension to the oropharynx is currently the best indication for maxillary defects, but it also represents a challenge for manufacturing and oral adaptation. The aim of this study was to report a clinical case of successful prosthetic rehabilitation of a 65-year-old woman who presented with a defect in the maxilla, soft palate, tonsil, and oropharynx after treatment for polymorphous low-grade adenocarcinoma. With her considerable loss of structure and tissue, she reported difficulties with impaired functions such as chewing, swallowing, and speaking and difficulty interacting with people. The oral rehabilitation was performed with an oropharyngeal obturator prosthesis with an extension to the oropharynx and a total mandibular denture. This case demonstrates that the rehabilitation with an oropharyngeal obturator prosthesis with an extension to the oropharynx and a total mandibular denture provides speech, chewing, and phonetics, directly interfering with her social life in the mutilated patient.

Parotid Gland Adenocarcinoma: A Case Report

Adenocarcinoma no otherwise specified (NOS) and polymorphous low-grade adenocarcinoma (PLGA), are malignant tumors of the salivary glands. Both types of malignant tumors have the potential for recurrence and distant metastases. Rare cases of recurrence and metastases lead to the absence of standardized systemic therapy for salivary gland cancer. This case report aims to expand the literature regarding recurrence and distant metastases of parotid gland adenocarcinoma. We report the case of a 54-year-old woman who complained of a recurrent lump in the right mandibular area who had previously undergone chemoradiotherapy, right parothyrodectomy, and left mastectomy. Histopathological examination of the biopsies that were performed gave different results, namely adenocarcinoma and PLGA.

Carcinomas of the minor salivary glands of the oral cavity. A population-based study from the Swedish Head and Neck Cancer Register for 2008–2018

Background and objectives Carcinomas of the minor salivary glands are rare with a heterogeneous pathology. This study explored the demographics, histology, treatment and survival in the Swedish population over 11 years. Material and methods Cases of salivary gland carcinomas in the oral cavity were extracted from the ‘Swedish Head and Neck Cancer Register’ (2008–2018). Statistical analyses with cross tabulation, age grouping, chi-square, the Kaplan–Meier method and log-rank tests were performed. Results Three hundred thirty cases were included (62% female; mean age 60 years; 83% were WHO Performance Status 0). The carcinomas were mostly stage I (57%), and the most common site was the palate with 165 tumours (50%). The most common histology was mucoepidermoid carcinoma (30%), followed by polymorphous low-grade adenocarcinoma (25%) and adenoid cystic carcinoma (24%). The distribution of histology differed between age groups. The five-year predicted overall survival rate was 83%. Most patients (89%) were treated with primary surgery. Conclusion and significance The demographics, histology, and survival of minor salivary gland carcinomas in the oral cavity in the Swedish population correspond well with previously published material. The demographics and histology differ from carcinomas of the major salivary glands in the same population.

Polymorphous low-grade adenocarcinoma: a report of two cases

<p class="abstract">Polymorphous low-grade adenocarcinoma (PLGA) is an infrequent type of malignant epithelial tumor that occurs almost exclusively in minor salivary glands. It commonly presents in women between the sixth and eighth decade of life, usually as an asymptomatic mass of long evolution and slow growth in the oral cavity but can erode and infiltrate adjacent bone. We present 2 case reports and review the literature on the subject. One case presented with a growing mass that developed over the course of 12 years, incorrectly diagnosed in the first incisional biopsy as a benign tumor. The second case presented as a recurring PLGA 19 years after the first, which appeared at an unusually young age. Both cases were managed with the treatment of choice: surgery with wide excision margins. Although prophylactic neck dissection is not the rule, it was part of the postoperative treatment in both cases, along with life-long follow-ups to find recurrences at early stages. A high level of suspicion and knowledge regarding its presentation are essential for correct diagnosis and management.</p>

POLYMORPHOUS LOW-GRADE ADENOCARCINOMA OF THE UPPER LIP: A CASE REPORT

A 49-year-old female patient presented with a nodule in the upper lip lasting 1 year. The patient had diabetes and had a 37-year smoking history (had quit 14 months before). On clinical examination, a firm, well-circumscribed submucosal nodule measuring 0.8 cm in diameter was observed in the upper lip, left side. Because it had mobility, an excisional biopsy was performed, under the clinical hypothesis of a benign neoplasm of salivary gland. Hematoxylin and eosin staining of the specimen was compatible with a malignant neoplasm of salivary gland. Immunohistochemical analysis showed positive staining for p63, S-100, CEA, CK and Ki-67, and a diagnosis of polymorphous low-grade adenocarcinoma was established. An investigation of the anatomical region with magnetic resonance imaging did not evidence remaining lesion. The patient has been under clinical and imaging follow-up for 5 years without any sign of recurrence of the neoplasm. A 49-year-old female patient presented with a nodule in the upper lip lasting 1 year. The patient had diabetes and had a 37-year smoking history (had quit 14 months before). On clinical examination, a firm, well-circumscribed submucosal nodule measuring 0.8 cm in diameter was observed in the upper lip, left side. Because it had mobility, an excisional biopsy was performed, under the clinical hypothesis of a benign neoplasm of salivary gland. Hematoxylin and eosin staining of the specimen was compatible with a malignant neoplasm of salivary gland. Immunohistochemical analysis showed positive staining for p63, S-100, CEA, CK and Ki-67, and a diagnosis of polymorphous low-grade adenocarcinoma was established. An investigation of the anatomical region with magnetic resonance imaging did not evidence remaining lesion. The patient has been under clinical and imaging follow-up for 5 years without any sign of recurrence of the neoplasm.

SOX10 EXPRESSION IN SELECTIVE MALIGNANT SALIVARY GLAND TUMORS OF INTERCALATED AND EXCRETORY DUCTAL ORIGIN

Objective: To determine the level of immunohistochemical expression of SOX10 in malignant tumors of salivary gland of intercalated ductal and excretory ductal origin. Material and Methods: An analytical cross-sectional study was designed. Sample size was 90 and categorised into two groups i.e., intercalated ductal (adenoid cystic carcinoma AdCC and polymorphous low-grade adenocarcinoma PLGA) and excretory ductal (mucoepidermoid carcinoma MEC). Blocks were retrieved from the histopathology lab of Pakistan Institute of Medical Sciences (PIMS), Peshawar Medical College (PMC) and Islamabad Diagnostic Center (IDC) from 2015 – 2020. Hematoxylin & Eosin (H&E) and Immunohistochemistry (IHC) slides were prepared and examined under microscope. Statistical analysis was done using SPSS version 25. Results: The intensity was found weak in 24 (85.7%) and moderate 4 (14.3%) in excretory ductal tumors. Similarly, the intensity was strong and intense in most of the intercalated ductal tumors compared to none in the excretory ductal tumors. The difference was statistically highly significant (p-value,<0.001). Similarly, the proportion of SOX10 was found with no positive cells in 25 (89.3%) and <10% cells in 3 (10.7%) cases of excretory ductal tumors whereas in the intercalated ductal tumor cases almost two third (62.8%) patients had cells between 51- 80% and above 80%. The difference in proportion of SOX10 was found statistically significant (p-value, <0.001). Conclusion: The conclusion of this study is that immunohistochemical expression of SOX10 can help in differentiating the origin of tumors of intercalated ductal and excretory ductal origin. Key Words: Adenoid cystic carcinoma, Polymorphous low-grade adenocarcinoma, Mucoepidermoid carcinoma, SOX1O, Immunohistochemistry, Hematoxylin & eosin.

Polymorphous adenocarcinoma of the parotid – An uncommon site of occurrence

Polymorphous low-grade adenocarcinoma is a neoplasm of the minor salivary glands and is malignant in origin but is indolent in nature. Currently, this neoplasm is documented and known as polymorphous adenocarcinoma (PAC) by WHO Classification of Salivary Gland Tumors (2017). Of all the salivary neoplasms, minor salivary gland neoplasm accounts for 9%–23%. Very rarely, it involves major salivary glands such as parotid, submandibular, and sublingual in <5% cases. It may develop either de novo or from pleomorphic adenoma. PAC mimics some benign as well as malignant neoplasms. Histopathological features alone cannot diagnose PAC due to the overlapping features with other neoplasms, and so immunohistochemistry is essential to confirm the diagnosis and hence aids in the proper management of PAC. We report a case of PAC arising from parotid gland in a 52-year-old male treated with facial nerve preservation.

Lysosomal and cytoskeletal events in epithelial salivary tumours as assessed by imunohistochemistry for CD63 and HSP27

Little attention has been paid to immunohistochemically assessed, lysosomal activities in salivary neoplasia. In an attempt to remedy this, the present investigation applied immunohistochemistry for CD63 antigen (a lysosomal membranous protein) and HSP27 (a molecular chaperone with roles in intracellular homeostasis) to archival paraffin-embedded surgical specimens of 101 benign and malignant, epithelial salivary tumours. Diffuse cytoplasmic CD63 immunoreactivity was seen in serous cells in acinic cell carcinoma, and mucous cells in mucoepidermoid carcinoma, pleomorphic adenoma (PA) and Warthin tumour. Apical rims or bands of CD63 immunoreactivity were also seen in simple cells lining tubular structures in PA, acinic cell carcinoma, mucoepidermoid carcinoma and polymorphous (low-grade) adenocarcinoma; and, occasionally, oncocytic luminal cells in Warthin tumour. HSP27 immunoreactivity was usually seen in non-luminal cells of PA, basal cells of oncocytic tumours, epidermoid cells of mucoepidermoid carcinoma and PA, and cells outlining aggregates or pseudolumina of adenoid cystic carcinoma. Expression of CD63 is preferentially associated with differentiated or simple luminal cell phenotypes in epithelial salivary tumours and possibly reflects autophagy of secretory granules or absorption of luminal material. Expression of HSP27 is preferentially associated with non-luminal cells and possibly reflects remodelling of the cytoskeleton.

LOW-GRADE PAPILLARY ADENOCARCINOMA: A RARE ENTITY

Introduction Low-grade papillary adenocarcinoma (LGPA) of the minor salivary glands is uncommon, which is noted to occur after 40 years of age with a male/female ratio of 2:1. Adenocarcinoma in this site includes salivary and nonsalivary types pathologically. The prevalence of LGPA is 17%, which is often poorly recognized and misdiagnosed, as it has a greater potential for local recurrence with evidence of regional metastasis, and only a few cases are reported in the literature. LGPA represents a relatively rare histologic variant of polymorphous low-grade adenocarcinoma. Case Presentation A 50-year-old female patient reported a complaint of a swelling in the posterior part of the hard palate that was associated with pain of 1-year duration. On examination, a mobile submucosal swelling of 1-cm size was noted in the posterior part of the hard palate laterally on the left side, and wide excision of the lesion was performed. On histologic examination, the lesional tissue exhibited extensive well-defined papillary arrangement of tumor cells that had a columnar appearance. The lesion was interpreted as LGPA on histologic examination, which was followed by immunohistochemistry to confirm the diagnosis. She is disease-free over a period of 2 years, and follow-up is being continued to monitor for development of recurrence. Conclusion A rare case of LGPA is reported for its diagnostic challenge; the lesion has a biological tendency to develop local recurrence and regional metastasis. Low-grade papillary adenocarcinoma (LGPA) of the minor salivary glands is uncommon, which is noted to occur after 40 years of age with a male/female ratio of 2:1. Adenocarcinoma in this site includes salivary and nonsalivary types pathologically. The prevalence of LGPA is 17%, which is often poorly recognized and misdiagnosed, as it has a greater potential for local recurrence with evidence of regional metastasis, and only a few cases are reported in the literature. LGPA represents a relatively rare histologic variant of polymorphous low-grade adenocarcinoma. A 50-year-old female patient reported a complaint of a swelling in the posterior part of the hard palate that was associated with pain of 1-year duration. On examination, a mobile submucosal swelling of 1-cm size was noted in the posterior part of the hard palate laterally on the left side, and wide excision of the lesion was performed. On histologic examination, the lesional tissue exhibited extensive well-defined papillary arrangement of tumor cells that had a columnar appearance. The lesion was interpreted as LGPA on histologic examination, which was followed by immunohistochemistry to confirm the diagnosis. She is disease-free over a period of 2 years, and follow-up is being continued to monitor for development of recurrence. A rare case of LGPA is reported for its diagnostic challenge; the lesion has a biological tendency to develop local recurrence and regional metastasis.

Mast Cells and Proteins Related to Myofibroblast Differentiation (PAR-2, IL-6, and TGFβ1) in Salivary Cancers: A Preliminary Study.

Salivary gland neoplasms represent an important group of cancers in the head and neck and myoepithelial cells play a key role on the development these tumors. This study evaluated the distribution of mast cells and related proteins (PAR-2, TGFβ1, IL-6) to the myofibroblastic differentiation in malignant tumors of salivary glands with and without myoepithelial differentiation. Immunohistochemical assessement for tryptase mast cells, SMA, PAR-2, TGFβ1, IL-6 was performed in 10 cases of polymorphous low-grade adenocarcinoma, 14 cases of mucoepidermoid carcinoma (MEC) and 10 cases of adenoid cystic carcinoma. When the density of mast cells were compared between tumors, their density was significantly higher in MEC (P=0.08). Tumors with high expression of PAR-2 (79.4%) exhibited a high density of mast cells. Myofibroblasts were more frequent in malignant tumors with low expression (<50%) of cell masts. Individual analysis of the tumors showed no significant difference between the expression of PAR-2, IL-6, TGFβ1, and myofibroblasts. When the density of mast cells, myofibroblasts and the expression of PAR-2 protein, IL-6, and TGFβ1 were compared, it was no statistically significant difference between tumors with and without myoepithelial differentiation. The results of present study suggest a possible participation of mast cells and especially of PAR-2 in the development and progression of malignant salivary cancers, regardless of myoepithelial content.

Immunohistochemical Expression of BCL-2 in Malignant Salivary Gland Tumors

Background: Malignant salivary gland tumors (MSGTs) consist of a heterogeneous group of neoplasms with complex clinicopathological features and biological behaviors. The purpose of this study was to determine the expression of Bcl-2 antiapoptotic protein in mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ADCC), acinic cell carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA) of salivary glands and to find out its association with different grades of these tumors.&#x0D; Material and Methods: This descriptive study included 55 cases of MSGTs. Tissue sections were stained with routine hematoxylin and eosin stain as well as Bcl-2 immunostain. MSGTs were graded as low grade (Low grade MEC, ACC, PLGA, and tubular pattern of ADCC), intermediate grade (cribriform pattern of ADCC, and intermediate grade of MEC) and high grade (high grade of MEC and solid pattern of ADCC) tumors on H&amp;E sections. Bcl-2 expression was scored as ‘negative’ (&lt;5% of neoplastic cells), ‘1’ (5-19% of neoplastic cells), ‘2’ (20-49% of neoplastic cells), and ‘3’ (&gt;50% of neoplastic cells), respectively.&#x0D; Results: MSGTs most commonly involved the parotid gland (52.7%), while ADCC (40%) and MEC (38.2%) were the most common tumors. Expression of Bcl-2 was strongly positive in 56.4% cases of MSGTs which included ADCC (71%), MEC (19.4%) and ACC (9.7%), respectively. A significant association was found between Bcl-2 staining and types of MSGTs i.e., MEC, ADCC, ACC (P = .001) as well as between Bcl-2 staining and grades of MSGTs (P = .013).&#x0D; Conclusions: Bcl-2 protein is expressed in malignant salivary gland tumors. Its expression maybe helpful in grading small biopsies, predicting behavior, and planning targeted therapy of MSGTs.&#x0D; &#x0D;

Histopathologic Analysis of Gingival Lesions: A 10-Year Retrospective Study

Background: Lesions of the gingiva account for a significant portion of the diagnostic workload of any oral pathology practice. Biopsy is important in establishing a definitive diagnosis. The aim of this study was to determine the relative frequency and distribution of biopsied gingival lesions in a Nigerian population. Methods: This was a retrospective study of all gingival biopsies performed over a 10-year period. Data on age, gender, site (maxillary or mandibular) and histopathological diagnosis were recorded. The lesions were categorized into two groups: non-neoplastic and neoplastic, with the neoplastic lesions further divided into benign and malignant lesions. Data analysis was done using SPSS version 23. Results: There were a total of 501 orofacial biopsies during the period under review, with gingival biopsies accounting for 73 (14.6%) cases. The mean age of subjects was 29.6 ± 20.1 years. There were 48 (65.8%) females and 25 (34.2%) males. Non-neoplastic lesions were 50 (68.5%), while neoplastic lesions were 23 (31.5%). The non-neoplastic lesions had an average age of 25.9 ± 17.7 years, and were encountered most frequently in the 10-19 years age group. Eighteen (36.0%) cases occurred in males, while 32 (64.0%) cases were seen in females. The maxillary gingiva (56.0%) was affected more often than the mandibular gingiva (44.0%). Pyogenic granuloma was the most frequent non-neoplastic lesion, accounting for 35 (70%) cases, followed by peripheral ossifying fibroma (n=6; 12%). The neoplastic lesions had a mean age of 37.1 ± 22.9 years, and consisted of 20 (87%) benign and 3 (13%) malignant lesions. The mean age for benign lesions was 35.3 ± 21.6 years, with a peak occurrence between 20 – 49 years. Females were almost twice more frequently affected than males. The mandibular gingiva accounted for 55% of the benign lesions. The most common benign lesion was fibroma (n=8; 40%) followed by ameloblastoma (n=3; 15%). Malignant lesions accounted for 4.1 % of the biopsied gingival lesions, with a mean age 48.7 ± 33.2 years. There was one case each of Kaposi’s sarcoma, polymorphous low-grade adenocarcinoma and mucosa-associated lymphoma. Conclusion: There is need for histologic examination of all excised gingival swellings.

Role of elective neck dissection and adjuvant radiation therapy in patients with polymorphous adenocarcinoma.

To evaluate the role of elective neck dissection (END) and of adjuvant radiation (aRT) in polymorphous adenocarcinoma (PAC), previously known as polymorphous low-grade adenocarcinoma (PLGA). Retrospective cohort study of patients in the National Cancer Database with a histology of PAC (coded as PLGA) at a head and neck site diagnosed between 2004 and 2015. Multivariable Cox proportional hazard modeling was used to assess overall survival in the overall population, and in sub-analyses of clinically N0 disease, positive resection margins, and late stage disease. A total of 922 patients [66.8% female; mean (SD) age, 60.9 (13.9) years] met inclusion criteria. 74.7% of patients received surgery alone, and 18.0% received surgery and aRT. Only 7.6% of patients with clinically N0 disease received an END, with 10.6% of these having at least one positive node. END did not have a survival benefit compared to no END [HR 1.28 (0.61-2.68)]. Compared to surgery alone, aRT did not have significantly increased survival in the overall population or in late stage [HR 0.68 (0.39-1.19) and HR 0.46 (0.18-1.22), respectively]. On sub-analysis of patients with positive resection margins, aRT had a significant survival benefit compared to surgery alone [HR 0.37 (0.14-0.99)]. PAC is a rare, slow-growing malignant tumor typically treated with surgical excision, with undefined indications for END or aRT. Our findings show END to not have a benefit to overall survival. In patients with positive resection margins, there was a survival benefit for aRT.

Polymorphous Low-Grade Adenocarcinoma in the Nasopharynx: A Case Report and Review of the Literature

Polymorphous low-grade adenocarcinoma (PLGA) is a neoplasm that usually occurs in the minor salivary glands located in the mucosa of the soft and hard palates, the buccal mucosa, and the upper lip. It rarely occurs in the nasopharynx, and only six cases have been reported. PLGA can be treated by wide local excision and requires no additional treatment if a negative margin is identified in frozen biopsy. Here we describe a case of PLGA originating in the nasopharyngeal mucosa. We were able to completely resect the tumor using simple endoscopic surgery rather than using an open approach, such as a transpalatal resection. Our patient had no local recurrence or distant metastasis at the 24-month follow-up.

Polymorphous Low-grade Adenocarcinoma of Base of the Tongue: A Case Report and Review of Literature of an Orphan Disease

Polymorphous Low-grade Adenocarcinoma of Base of the Tongue: A Case Report and Review of Literature of an Orphan Disease

A Case of Polymorphous Low-Grade Adenocarcinoma of the Nasopharynx

A Case of Polymorphous Low-Grade Adenocarcinoma of the Nasopharynx

PAPILLARY CYSTADENOCARCINOMA: A CASE REPORT

Papillary cystadenocarcinoma (PCC) is a rare malignant tumor of the salivary glands featured by cysts and papillary endocystic projections. The differential diagnosis includes cystadenoma, papillary-cystic variant of acinic cell carcinoma polymorphous low-grade adenocarcinoma (PLGA), salivary duct carcinoma, and adenoid cystic carcinoma (ACC). Nuclear pleomorphism, mitosis, and infiltrative growth pattern affirm the malignancy of PCC. A 66-year-old man presented with a swelling in the upper alveolar ridge and hard palate. Intraorally, an exophytic, friable and ulcerated lesion was observed. Computed tomography scan showed a large soft tissue mass destroying the left maxilla. An incisional biopsy was performed. Based on the histopathologic features of papillary projections extending into the cystic lumen, the diagnosis of PCC was confirmed. The patient was referred to an oncology center where chemotherapy and radiotherapy were chosen as the appropriate treatment. Currently, no signs of recurrence were detected after 2 years of clinical follow-up. Papillary cystadenocarcinoma (PCC) is a rare malignant tumor of the salivary glands featured by cysts and papillary endocystic projections. The differential diagnosis includes cystadenoma, papillary-cystic variant of acinic cell carcinoma polymorphous low-grade adenocarcinoma (PLGA), salivary duct carcinoma, and adenoid cystic carcinoma (ACC). Nuclear pleomorphism, mitosis, and infiltrative growth pattern affirm the malignancy of PCC. A 66-year-old man presented with a swelling in the upper alveolar ridge and hard palate. Intraorally, an exophytic, friable and ulcerated lesion was observed. Computed tomography scan showed a large soft tissue mass destroying the left maxilla. An incisional biopsy was performed. Based on the histopathologic features of papillary projections extending into the cystic lumen, the diagnosis of PCC was confirmed. The patient was referred to an oncology center where chemotherapy and radiotherapy were chosen as the appropriate treatment. Currently, no signs of recurrence were detected after 2 years of clinical follow-up.

CLINICO-PATHOLOGICAL SIGNIfiCANCE OF B-CATENIN AND E-CADHERIN EXPRESSION IN SALIVARY GLAND TUMOR AT UCH IBADAN

Objectives β-catenin (B-Cat) is a cell adhesion molecule associated with the invasion and metastasis of carcinomas of the head and neck, esophagus while reduced expression of E-cadherin (E-cad), a transmembrane glycoprotein, is associated with loss of differentiation, acquisition of an invasive phenotype, and an unfavorable prognosis in carcinomas from several sites. B-Cat & E-Cad complex are involved in cell adhesion, signal transduction & motility. Aim is to identify the clinical / pathological significance of B-Cat & E-Cad expressions in salivary gland tumors (SGTs) presenting at the University College Hospital, Ibadan. Findings The expressions of β-cat & E-Cad were analyzed in 46 SGTs (10 pleomorphic adenomas PSA, 3 basal cell adenoma, 12 adenoid cystic carcinoma ADCC, 10 mucoepidermoid carcinoma MEC, 5 acinic cell carcinoma ACC, 4 polymorphous low grade adenocarcinoma PLGA & 2 papillary cystadenocarcinoma PCADCA) by immunohistochemistry in formalin-fixed, paraffin embedded specimens (Rabbit monoclonal; Satacruz biotechnology). Result shows immunostaining of B-cat & E-Cad were membranous & cytoplasmic without nuclear involvement, staining was more severe in the ductal areas especially in PSA, there was significant loss of membranous stain in ACC on multivariate analysis. E-Cad staining loss was significantly associated with tumour stage in ACC & MEC. Conclusion loss of β-catenin adhesion molecule may be involved in the development of ACC. E-cad expression is an independent indicator of clinical aggressiveness in patients with ACC.& MEC.

MASPIN EXPRESSION IN PLEOMOPHIC ADENOMA, POLYMORPHOUS LOW GRADE ADENOCARCINOMA AND ADENOCYSTIC ADENOCARCINOMA OF SALIVARY GLANDS SEEN AT THE LAGOS UNIVERSITY TEACHING HOSPITAL, LAGOS, NIGERIA

Objectives To immunostain with Maspin antibody, formalin fixed, paraffin embedded tissues of 41 samples of Pleomorphic Salivary Adenoma [PSA], 10 samples of Polymorphous Low-Grade Adenocarcinoma [PLGA] and 34 samples of Adenoid Cystic Carcinoma [AdCC]. To quantitatively assess Maspin expression in each of the three (3) Salivary Gland Tumours (SGTs) by combining immunostaining intensity scores with scores of proportion of positively stained cells (Total mean scores) in each, using the method described by Reiner et al 1990. To analyze data using Chi square, Fisher's Exact tests and analysis of variance to compare total mean scores of maspin expression among the three (3) SGTs, the statistical significance level being set at p Findings PSA had the greatest proportion of Maspin immunopositivity (73.2%), followed by PLGA (40.0%) and AdCC (35.2%). Mean total Maspin score of PSA (3.5±2.4) was statistically significantly higher than that of PLGA (1.2±1.8) [p=0.005]. and that of AdCC (1.0±1.5) [p Conclusion In this study, there was decreasing expression of Maspin from PSA to PLGA to AdCC, which is consistent with established increased order of clinical aggression of these tumors. It is suggested that Maspin expression could be a useful adjunct diagnostic tool to discriminate between PSA, PLGA and AdCC.