Primary Salivary Gland Tumors Research Articles

Impaired intratumoral dendritic cell function and potential predictive value of dendritic cell markers for metastasis in malignant salivary gland tumors.

The differentiation between primary and metastatic salivary gland neoplasms (SGNs) helps in determining appropriate management strategies, including the need for additional diagnostic tests, surveillance, or aggressive treatment. The purpose of this study was to identify and quantify the immature and mature dendritic cells (DCs) in metastatic and no metastatic SGNs and determine its association with clinicopathological findings. Cross-sectional, observational, and descriptive study that includes 33 malignant salivary gland neoplasms [MSGN (6, 18.1% metastatic)], and 22 pleomorphic adenomas (PA), as a control group. Clinical and histopathological characteristics were obtained. Immunohistochemistry for human leukocyte antigen D-related (HLA-DR), CD1a, CD83, and Ki-67 proteins was done. Positive intra- and peritumoral DCs were counted. Individuals with MSGN had a lower density of intratumoral HLA-DR+ cells than those with PA (p=0.001), Ki-67 immunostaining was significantly higher in MSGN than in PA (6% vs. 1.4%, p<0.001). Metastatic MSGN showed less intratumoral CD1a+ than non-metastatic (3.2 vs. 165.1, p=0.001). No differences in intra- and peritumoral CD83+ cells were found between benign and malignant SGN. These results suggest that the immune-protective function of intratumoral DCs is compromised in MSGNs. DCs markers may represent useful prediction tools for metastases in salivary gland malignancies, with crucial implications in the implementation of appropriate disease management strategies.

Ultrasonography characteristics of cystic components in primary salivary gland tumors

ObjectivesThe present study aimed to characterize the ultrasonography (US) features of cystic components in salivary gland tumors (SGTs).Materials and methodsA total of 207 patients (218 lesions) with pathologically confirmed primary SGTs were analyzed. Preoperative US revealed the presence of cystic components in lesions. Lesion size, shape, margin, and US findings of the cystic components, including number, distribution, margin, occupying rate, and internal characteristics, were evaluated.ResultsSimilarities were observed between the US performance of benign SGTs (B-SGTs) and malignant SGTs (M-SGTs) with cystic components. Differences in sex and age of patients, number, distribution, and internal characteristics of cystic components were statistically significant. For SGTs with cystic components, the proportions of M-SGTs to ill-defined margins (P = 0.002), eccentric distribution (P = 0.019), and none of the internal characteristics (P = 0.019) were significantly higher than those of B-SGTs. Younger age (P = 0.001), eccentric distribution (P = 0.034) and ill-defined margin (P < 0.001) were risk factors for diagnosing M-SGTs. Cystic component features needed to be combined with lesion indicators (border and shape) to improve diagnostic sensitivity.ConclusionsUS features of the B-SGTs and M-SGTs were significantly different. Cystic component is of interest in the US-related differential diagnosis of B-SGT and M-SGT.Clinical relevanceCystic components are potentially valuable in the differential diagnosis of B-SGTs and M-SGTs on US.

Pediatric primary salivary gland tumors

ObjectivesTo characterize the presentation and treatment of children presenting with primary salivary gland neoplasms. MethodsA retrospective review of primary salivary tumor patients presenting to Children's Hospital Colorado between January 2000 and August 2020. ResultsFifty children were identified with primary salivary gland tumors, comprising of 39 (78 %) benign and 11 (22 %) malignant lesions. Pleomorphic adenoma was the most common benign tumor (36/39, 92 %), while acinic cell carcinoma was the most common malignancy (7/11, 64 %). The parotid gland was the most common site, followed by the submandibular gland (66 % vs. 34 %). No tumors were found in the sublingual glands. Benign neoplasms accounted for 70 % of parotid lesions and 94 % of submandibular tumors. No significant differences in age (13.6 years, SD 4 vs. 13.0 years, SD 4.3) were noted between patients with benign and malignant disease, but tumors in females were more frequently malignant (M:F 1:1.3 vs. 1:2.7 for benign and malignant tumors, respectively). Neck dissection and/or facial nerve sacrifice were required in 27 % (3/11) and 9.1 % (1/11) of malignancies, respectively. Local recurrence was observed in 7.7 % (3/39) of benign cases and 9.1 % (1/11) of malignant cases. No salivary malignancies required chemotherapy, though one patient with neurofibromatosis received imatinib prior to resection. Two patients with locoregional malignancy received adjunctive radiation. The average duration of follow up for benign and malignant disease were 12.6 ± 25 and 45.1 ± 32 months, respectively. ConclusionsThis study presents one of the larger single institutional experiences of pediatric primary salivary neoplasms in the past 20 years, identifying pleomorphic adenoma and acinic cell carcinoma as the most common benign and malignant etiologies, respectively. While this review found most neoplasms presented as a localized mass effectively managed with conservative surgical resection, aggressive tumors required multidisciplinary care.

Epidemiological distribution of primary salivary gland tumors. Retrospective analysis in Baghdad Medical City

Epidemiological distribution of primary salivary gland tumors. Retrospective analysis in Baghdad Medical City

Epidemiological distribution of primary salivary gland tumors. Retrospective analysis in Baghdad Medical City

Background: Studies on the incidence of salivary tumors around the world showed variations, including in Iraq. This study was intended to evaluate the relative incidence of these tumors among the Iraqi population. Materials and methods: The current retrospective study encompassed 109 cases retrieved from the file records of the pathology laboratory of Baghdad Medical City over a five-year period from January 2017 to December 2021. Information regarding age, gender, site, and tumor type was assembled and analyzed using a statistical package for social sciences (SPSS version 20). Results: The present study documented that salivary gland tumors represent 1.35% of the total sample studied. Approximately 56% were benign and 44% were malignant, with a ratio of benign to malignant was 1.27/1. The male-to-female ratio was 1/1. The prevalent benign tumor was pleomorphic adenoma, followed by Warthin's tumor. Warthin's tumor showed a predilection for male patients. The most common sites were the parotid gland (50%), palate (29%), and submandibular gland (10%), respectively. Regarding malignant tumors, adenoid cystic carcinoma ranked first followed by mucoepidermoid carcinoma. Conclusions: Salivary gland tumors chiefly arise in major salivary glands without sex predilection, with pleomorphic adenoma and adenoid cystic carcinoma being the most common salivary tumors.

Metastasis to the sublingual gland of metaplastic breast carcinoma – a case report

Metastatic spread to the salivary glands is rare, occurring primarily from head and neck tumors to the parotid gland. So far, only one sublingual gland metastasis has been reported in the literature. We herein report the second case of metastasis to this gland occurring in a woman in her 50s, previously diagnosed with HER2-positive metaplastic breast carcinoma (MpBC) with chondroid differentiation, with lymph node and diffuse organ metastases. The sublingual lesion presented as a tumefaction on the floor of the mouth, causing masticatory discomfort. Histologically it was formed by epithelial cells with high-grade cytomorphological features with a large central area of chondroid differentiation. The case was clinically and pathologically challenging, given the rarity of the primary MpBC and the improbable secondary location. Alternative primary salivary gland tumors with chondroid differentiation were considered, but ultimately the clinical integration was crucial in establishing the diagnosis of MpBC metastasis to the sublingual gland.

Primary salivary gland tumors from a pathology perspective : Morphomolecular peculiarities and diagnostic and therapeutic challenges

Similar to tumors of other organs, salivary gland neoplasms were historically viewed as asingle neoplastic entity and mostly treated as such. Accordingly, only the clinical tumor stage, and not the histological subtype, was considered to be of significant prognostic impact. However, over the years, several distinct sub-entities have been characterized based on morphological features, such as adenoid cystic carcinoma, mucoepidermoid carcinoma, acinic cell carcinoma, and salivary duct carcinoma. Most importantly, the nosology of salivary gland carcinomas has undergone adynamic "splitting" on the basis of morphological, immunophenotypic, and molecular characteristics, so that 21independent carcinomas are now listed in the current World Health Organization (WHO) classification. Moreover, it has become evident that splitting of these carcinoma subtypes no longer represents a"pathologist's hobby," but carries significant prognostic and therapeutic relevance for optimized cancer surgery and potentially systemic therapy. The current review summarizes the major features of salivary gland tumors, both benign and malignant, and gives an account of their classification systems and genetic profiles.

MYB RNA detection by in situ hybridisation has high sensitivity and specificity for the diagnosis of adenoid cystic carcinoma

Adenoid cystic carcinoma (ACC) is one of the most common primary salivary gland cancers. ACC has several benign and malignant mimics amongst salivary gland neoplasms. An accurate diagnosis of ACC is essential for optimal management of the patients and their follow-up. Upregulation of MYB has been described in 85-90% of ACC, but not in other salivary gland neoplasms. In ACC, MYB upregulation can occur as a result of a genetic rearrangement t(6;9) (q22-23;p23-24), MYB copy number variation (CNV), or enhancer hijacking of MYB. All mechanisms of MYB upregulation result in increased RNA transcription that can be detected using RNA in situ hybridisation (ISH) methods. In this study, utilising 138 primary salivary gland neoplasms including 78 ACC, we evaluate the diagnostic utility of MYB RNA ISH for distinguishing ACC from other primary salivary gland neoplasms with a prominent cribriform architecture including pleomorphic adenoma, basal cell adenoma, basal cell adenocarcinoma, epithelial myoepithelial carcinoma, and polymorphous adenocarcinoma. Fluorescent in situ hybridisation and next generation sequencing were also performed to evaluate the sensitivity and specificity of RNA ISH for detecting increased MYB RNA when MYB gene alterations were present. Detection of MYB RNA has 92.3% sensitivity and 98.2% specificity for a diagnosis of ACC amongst salivary gland neoplasms. The sensitivity of MYB RNA detection by ISH (92.3%) is significantly higher than that of the FISH MYB break-apart probe (42%) for ACC. Next generation sequencing did not demonstrate MYB alterations in cases that lacked MYB RNA overexpression indicating high sensitivity of MYB RNA ISH for detecting MYB gene alterations. The possibility that the sensitivity may be higher in clinical practice with contemporary samples as compared with older retrospective tissue samples with RNA degradation is not entirely excluded. In addition to the high sensitivity and specificity, MYB RNA testing can be performed using standard IHC platforms and protocols and evaluated using brightfield microscopy making it a time and cost-efficient diagnostic tool in routine clinical practice.

Huge Recurrent Mucoepidermoid Carcinoma of Parotid - a Rare Presentation.

Mucoepidermoid carcinoma is the commonest primary malignant salivary gland tumor in both children and adults and constitutes around 2.8-16% of all salivary gland tumors. There is a wide age range of 3 to 95 years with a mean age of 47 years. We reported a case of 85 years old female patient, who presented to the department of Surgical Oncology, Srinivasan Medical College and Hospital, Trichy, with history of right parotid swelling for past 25 years, who had undergone Superficial parotidectomy 10 years back, followed by recurrence of tumor with huge increase in size, around 20cm in greatest dimension. Right Completion Radical Parotidectomy with Modified Radical neck dissection type 1 with Cervical Rotation Flap cover was done and histopathological examination of the surgical specimen confirmed as high grade Mucoepidermoid carcinoma. Following surgery, the patient's outcome is better, uneventful with periodic regular follow-up.

TERT Promoter Mutation in Benign and Malignant Salivary Gland Tumors; A Cross-Sectional Study.

Telomere-related tumorigenesis mechanisms in the salivary gland, including mutation in the promoter region of TERT, have been rarely investigated. Therefore, the present study aimed to investigate the mutation in the promoter region of TERT in benign and malignant salivary gland tumors. This was a descriptive-analytical cross-sectional study. Tissue samples of 54 patients with primary salivary gland tumors sent to the pathology department of Rasool-e-Akram Hospital from September 2017 to September 2021 were examined. Fifteen samples including two groups of the most common benign tumors (n=5; 3 pleomorphic adenomas and 2 Warthin tumors) and four groups of the most common malignant tumors (n=10; 3 mucoepidermoid carcinomas, 3 adenoid cystic carcinomas, 2 acinic cell carcinoma, and 2 salivary duct carcinoma) were selected. The promoter region of TERT, including well-known hot spot regions, is sequenced using the Sanger sequencing method. Data were analyzed using statistical software R version 4.1.2. Of 15 salivary gland tumor specimens, consisting of 5 benign tumors and 10 malignant tumors after DNA sequencing, TERT promoter region mutation was only seen in one of the adenoid cystic carcinoma samples, located at -146 bp upstream from ATG (chr5: 1,295,250 C>T). TERT promoter mutation was not different in malignant and benign salivary tumors. Nonetheless, there are a few studies that report TERT promoter mutation in adenoid cystic carcinoma of the salivary gland, necessitating the need for further investigations.

Metastatic salivary gland neoplasms to pleural effusion: diagnostic challenges and prognostic significance in a series with 9 patients.

Pleural effusions can present a diagnostic challenge as they are not always caused by malignancy in patients with a history of typical visceral primaries. At 2 major academic medical centers, we have identified several cases in which salivary gland neoplasms metastasized to pleural effusions in patients who have been aggressively managed with various treatment modalities including chemotherapy, radiation, and/or surgical excision. Herein, we present a range of primary salivary gland tumors that metastasized to serous effusions and characterize their cytomorphology, immunoprofiles, and clinical courses. Our case series shows that many tumor types metastasize to pleural effusions and they present unique diagnostic challenges in each case. We found that metastasis of a salivary gland neoplasm to a pleural effusion is a late-stage event and is often associated with poor prognosis. This series serves as a resource to demonstrate the cytomorphologic and immunohistochemical features of malignant pleural effusions due to salivary gland neoplasms and draws attention to poor prognosis in cases of salivary duct carcinoma, mucoepidermoid carcinoma and adenoid cystic carcinoma.

Outcomes of Patients with Adenosquamous Carcinoma of the Head and Neck after Definitive Treatment

<h3>Purpose/Objective(s)</h3> Adenosquamous carcinoma of the head and neck (ASC-HN) is a rare and aggressive variant of squamous cell carcinoma (SCC). Limited data suggests inferior outcomes compared to conventional SCC. We report one of the largest single institutional experiences of this disease in patients treated definitively to further elucidate oncologic outcomes. <h3>Materials/Methods</h3> Patients with non-metastatic ASC-HN treated definitively between 2003 and 2021 were identified retrospectively from an IRB approved database with histology verified by head and neck pathologists. All tumors of the oropharynx were tested for p16 and/or HPV to document HPV associated disease. For non-oropharyngeal lesions, a designation of HPV positivity required the presence of HPV DNA/RNA per CISH. Actuarial analyses were performed for PFS and OS. <h3>Results</h3> 29 patients with ASC-HN (72.4% male, 93.1% Caucasian) with median age of 66 (range 34-91) and a median follow up of 33 months (range 6.6-126.7) were identified. The most common primary tumor sites were: oropharynx (27.6%), oral cavity (20.7%), nasal cavity (17.2%), and larynx (17.2%). 3 patients had primaries in the hypopharynx, nasopharynx and parotid gland respectively. 11 patients (37.9%) were HPV positive of whom 8 had oropharyngeal primaries. The majority (n=23, 79.3%) were treated with primary surgery of whom 19 (82.6%) received adjuvant radiation (RT) to a median dose of 60 Gy (range 36-70 Gy) with 7 receiving concurrent chemotherapy. 6 patients were treated with definitive RT to a median dose of 70 Gy with two receiving concurrent chemotherapy. There were 10 recurrences (34.5%) which occurred at a median of 14.3 months (range 5.4-28) after diagnosis including 8 loco-regional and 2 distant recurrences. Recurrences were documented in patients with primary salivary gland, oral cavity, laryngeal, hypo-pharyngeal, and oropharyngeal tumors. 3 of the 10 recurrences were in patients with HPV positive disease. Among the 6 patients treated with definitive radiation or chemo-radiation no failures were observed. 9 patients (31%) were deceased at the time of analysis. Overall, 3-year PFS and OS were 54.2% and 72.9%, respectively. 3-year PFS and OS were 45.6% and 69.6% for primary surgery and 83.3% and 83.3% in the definitive RT group. 3-year PFS was 50% and 75% for HPV negative and positive patients respectively. <h3>Conclusion</h3> In our single institutional experience of 29 patients with adenosquamous carcinoma of the head and neck there was a 34.5% recurrence rate. Loco-regional recurrence was the primary mode of failure.

A RIDDLE WRAPPED IN A MYSTERY: MUCOEPIDERMOID CARCINOMA (MEC) FOUND DURING EVALUATION OF PERSISTENT LUNG COLLAPSE

A RIDDLE WRAPPED IN A MYSTERY: MUCOEPIDERMOID CARCINOMA (MEC) FOUND DURING EVALUATION OF PERSISTENT LUNG COLLAPSE

MARKERS PROFILE OF PRIMARY SALIVARY GLAND TUMORS: A SYSTEMATIC REVIEW

<h3>Objectives</h3> The objective of this study was to perform a systematic review to integrate the proteomic markers profile of primary salivary gland tumors (SGT) detected by mass spectrometry-based proteome profile (MSBPP). <h3>Study Design</h3> An electronic search was carried out using the MEDLINE/PubMed, Embase, Web of Science, Scopus databases, and hand search to retrieve all the available articles published in the English-language literature regarding MSBPP in SGT. <h3>Results</h3> A total of 6 published articles were included in the qualitative synthesis. In total, 2.136 proteins were identified and quantified in 11 SGT type, representing 1980 differential proteins. Ninety-one proteins were proposed as markers in SGT, being 76 differential proteins. Fibrinogen beta chain was the most common protein marker identified in 10 SGT types. Nine protein markers (alpha-crystallin B chain, annexin A1, annexin A5, guanine nucleotide-binding protein subunit beta-2-like 1, Ig gamma-1 chain C region, macrophage-capping protein, peptidyl-prolyl cis-trans isomerase A, protein S100-A9, and superoxide dismutase [Cu-Zn]) were identified as markers in 10 differential neoplasms. <h3>Conclusions</h3> Although significant limitations were found in the published studies, the results of this systematic review demonstrated a potential biomarkers profile of the SGT.

Multiplexed single-cell analysis of FNA allows accurate diagnosis of salivary gland tumors.

Diagnosing salivary gland tumors (SGTs) through fine‐needle aspiration (FNA) biopsies is challenging due to the overlapping cytomorphologic features between benign and malignant tumors. The authors developed an innovative, multiplexed cycling technology for the rapid analyses of single cells obtained from FNA that can facilitate the molecular analyses and diagnosis of SGTs. Antibodies against 29 protein markers associated with 7 SGT subtypes were validated and chemically modified via custom linker–bio‐orthogonal probes (FAST). Single‐cell homogenates and FNA samples were profiled by FAST cyclic imaging and computational analysis. A prediction model was generated using a training set of 151,926 cells from primary SGTs (N = 26) and validated on a separate cohort (N = 30). Companion biomarker testing, such as neurotrophic tyrosine receptor kinase (NTRK), was also assessed with the FAST technology. The FAST molecular diagnostic assay was able to distinguish between benign and malignant SGTs with an accuracy of 0.86 for single‐cell homogenate samples and 0.88 for FNA samples. Profiling of multiple markers as compared to a single marker increased the diagnostic accuracy (0.82 as compared to 0.65‐0.74, respectively), independent of the cell number sampled. NTRK expression was also assessed by the FAST assay, highlighting the potential therapeutic application of this technology. Application of the novel multiplexed single‐cell technology facilitates rapid biomarker testing from FNA samples at low cost. The customizable and modular FAST‐FNA approach has relevance to multiple pathologies and organ systems where cytologic samples are often scarce and/or indeterminate resulting in improved diagnostic workflows and timely therapeutic clinical decision‐making.

FAST-FNA molecular diagnostic assay facilitates rapid diagnosis and ntrk biomarker testing of salivary gland tumors.

e18089 Background: Primary epithelial salivary gland tumors (SGTs)are classified into 31 tumor types. Diagnosing SGTs through fine needle aspiration (FNA) biopsies is challenging due to the overlapping cytomorphologic features between benign and malignant tumors. In this study, we developed an innovative, multiplexed cycling technology which allows for the rapid cellular analyses of single cells obtained from FNA which can facilitate the rapid molecular analyses and diagnosis of SGTs. Methods: Antibodies against 29 cell surface markers associated with 7 SGT subtypes were validated and chemically modified via custom linker–bio-orthogonal quencher probes (FAST). Single cell homogenates and a FNA sample set representing 7 SGT subtypes were profiled by FAST cyclic staining, imaging, and automated computational analysis. A prediction model was generated utilizing a training set of 151,926 single cells obtained from primary SGTs (N = 26) and validated on a separate cohort of SGTs (N = 30). Companion biomarker testing, such as NTRK, was also assessed with the FAST technology. Results: The customized FAST-FNA SGT molecular diagnostic and biomarker panel was validated on human cell lines and specificity confirmed by both flow cytometry and clinical immunohistochemical staining on primary SGTs. The FAST molecular diagnostic assay was able to distinguish between benign and malignant SGTs with an accuracy of 0.86 for single-cell suspension samples and 0.88 for FNA samples. Profiling of multiple markers as compared to a single tumor marker increased the diagnostic accuracy of the SGTs, 0.82 as compared to 0.65-0.74, respectively. The results of the assay were highly reproducible and independent of the cell number sampled. NTRK expression in SGTs was also assessed by the FAST assay within hours, highlighting the potential therapeutic application of this technology. Conclusions: High dimensional single-cell profiling and molecular diagnostic testing on FNA samples are feasible at relatively low cost and as a rapid test. Application of the novel multiplexed single cell technology improves the diagnostic accuracy of SGT biopsy and facilitates multiplex biomarker testing from FNA samples. The customizable and modular FAST-FNA approach has relevance to multiple pathologies and organ systems where cytologic samples are often scarce and/or indeterminate resulting in improved diagnostic workflows and timely therapeutic clinical decision making.

Metastases to the Parotid Gland: Study from a Tertiary Care Centre.

Metastases account for 6-25% of parotid tumors, often presenting dilemmas in their diagnosis. Parotid metastases diagnosed on histology/cytology were retrieved. MUC2, MUC5AC, androgen receptor immunohistochemistry was performed in select cases. Fifty-one samples were identified from 42 patients, including 14 aspirates, 7 biopsies and 30 parotidectomies. Previous history was available in 17 cases, 13 parotidectomies accompanied excision of the primary, and relevant clinical data was unavailable for 12 patients. Majority (81%) had head and neckprimaries; eye and ocular adnexa were the commonest subsite (52.4%), and sebaceous carcinoma the commonest histology (33%). When history was unavailable, most metastases were initially diagnosed as poorly differentiated carcinoma/malignant tumor, or mucoepidermoid carcinoma on cytology. Intraparotid metastases encompass a wide spectrum, often mimicking primary salivary gland neoplasms, particularly on limited samples. Metastases should be considered when histological/cytological features are unusual; detailed clinical information and ancillary techniques aid in arriving at an accurate diagnosis.

Outcomes of Patients With Adenosquamous Carcinoma of the Head and Neck after Definitive Treatment

<h3>Purpose/Objective(s)</h3> Adenosquamous carcinoma of the head and neck (ASC-HN) is a rare and aggressive variant of squamous cell carcinoma (SCC). Limited data suggests inferior outcomes compared to conventional SCC. We report one of the largest single institutional experiences of this disease in patients treated definitively to further elucidate oncologic outcomes. <h3>Materials/Methods</h3> Patients with non-metastatic ASC-HN treated definitively between 2003 and 2021 were identified retrospectively from an IRB approved database with histology verified by head and neck pathologists. All tumors of the oropharynx were tested for p16 and/or HPV to document HPV associated disease. For non-oropharyngeal lesions, a designation of HPV positivity required the presence of HPV DNA/RNA per FISH. Actuarial analyses were performed for PFS and OS. <h3>Results</h3> 29 patients with ASC-HN (72.4% male, 93.1% Caucasian) with median age of 66 (range 34-91) and a median follow up of 33 months (range 6.6-126.7) were identified. The most common primary tumor sites were: oropharynx (27.6%), oral cavity (20.7%), nasal cavity (17.2%), and larynx (17.2%). 3 patients had primaries in the hypopharynx, nasopharynx and parotid gland respectively. 11 patients (37.9%) were HPV positive of whom 8 had oropharyngeal primaries. The majority (n=23, 79.3%) were treated with primary surgery of whom 19 (82.6%) received adjuvant radiation (RT) to a median dose of 60 Gy (range 36-70 Gy) with 7 receiving concurrent chemotherapy. 6 patients were treated with definitive RT to a median dose of 70 Gy with two receiving concurrent chemotherapy. There were 10 recurrences (34.5%) which occurred at a median of 14.3 months (range 5.4-28) after diagnosis including 8 loco-regional and 2 distant recurrences. Recurrences were documented in patients with primary salivary gland, oral cavity, laryngeal, hypo-pharyngeal, and oropharyngeal tumors. 3 of the 10 recurrences were in patients with HPV positive disease. Among the 6 patients treated with definitive radiation or chemo-radiation no failures were observed. 9 patients (31%) were deceased at the time of analysis. Overall 3 year PFS and OS were 54.2% and 72.9% respectively. 3 year PFS and OS were 45.6% and 69.6% for primary surgery and 83.3% and 83.3% in the definitive RT group. 3 year PFS was 50% and 75% for HPV negative and positive patients respectively. <h3>Conclusion</h3> In our single institutional experience of 29 patients with adenosquamous carcinoma of the head and neck there was a 34.5% recurrence rate. Loco-regional recurrence was the primary mode of failure.

Salivary duct carcinoma: A report of 70 FNA cases and review of the literature.

Although usually recognized as malignant, fine-needle aspiration (FNA) biopsy of salivary duct carcinoma (SDC) has been confused with other primary salivary gland (SG) neoplasms. This article undertook an analysis of a large collection of SDC FNA cases to assess diagnostic accuracy, specificity, and cytopathology. Cytopathology files were searched for SDC with histopathologic validation. FNA biopsy smears were performed using standard techniques. Seventy cases from 56 patients (M:F, 1.9:1; age range, 26-92 years; mean age, 65 years) met inclusion criteria. All had tissue confirmation of SDC. FNA sites included: parotid gland (42, 60% cases), neck (10), submandibular gland (7), pre-/post-auricular area (5), face/cheek (3), mediastinal lymph nodes (2), and clavicle (1). Aspirates were from primary (52, 74%), metastatic (12, 17%), and locally recurrent (6, 9%) neoplasms. FNA diagnoses included: SDC (19, 27%), favor/suspicious for SDC (7, 10%), high-grade carcinoma (11), adenocarcinoma (9), carcinoma (6), malignant (6), SG neoplasm (5), atypia (3), SDC versus another malignancy (2), and pleomorphic adenoma (2). Large polygonal cells in groups and single forms showed cribriforming, variable necrosis, pseudopapillae, and oncocytic change. Androgen receptor staining was positive in all cases. FNA biopsy is accurate and reliable in classifying SDC as a malignant neoplasm, but much less so for identification as a specific tumor type. Using the Milan system, 86% of aspirates were classified as either malignant or suspicious for malignancy. A recurring pitfall includes sampling error in cases of SDC ex pleomorphic adenoma.

Primary minor salivary gland tumors: A retrospective review of cases seen in a tertiary institution in South East Nigeria.

Tumors of the minor salivary glands (MSGs) are rare. They constitute a wide range of histologic types despite their low frequency. The aim of this study is to evaluate the clinical and pathological features of 11 different tumors of MSGs presented at the University of Nigeria Teaching Hospital Ituku-Ozalla, Enugu and to compare them with similar studies done elsewhere. This is a retrospective study of patients with tumors involving the MSGs seen at the OMFS and ORL clinics, UNTH. Information regarding demographic characteristics, duration at first presentation, types of tumors, site and side affected, and treatment given were recorded in patients' medical records. Data were analyzed using SPSS version 23; qualitative variables were compared using Chi-square test. One hundred and thirty three cases of various lesions involving the salivary gland were seen within the study period. Fifty three (39.8%) patients met the inclusion criteria and are reported further. Twenty eight (28) cases occurred in males. The mean age of the patients was 39.8 years STD 16.5, while the mean duration of the swellings at presentation was 45.5 months STD 35.4. Pleomorphic adenoma was the most common of the 29 (54.7%) benign histopathologic type seen. The soft palate was the commonest site affected 37 (69.8%). Local excision with wide margin was adequate in treating majority of the swellings 40 (75.5%), while 1 (1.9%) case of recurrence was seen within the study period. Tumors involving the MSGs are uncommon; males are mostly affected in our environment.