Carcinoma Ex Pleomorphic Adenomas: An Institutional Experience and Literature Review

Abstract

Objectives To provide an institutional experience with cases diagnosed as carcinoma ex pleomorphic adenoma (CXPA), including the cytologic and histologic findings and clinical follow-up, followed by a comparison to the experience documented in the literature. Methods We identified cases of CXPA diagnosed at our institution from 2011 to 2021 and reviewed the cytologic and histologic diagnoses, as well as the treatment and clinical outcomes. Additionally, a literature review of the English literature was performed on CXPAs from 2011 to 2021. Results Forty-one cases of CXPA were identified, with the majority subclassified as adenocarcinoma, not otherwise specified. Five tumors underwent cytogenetic studies and five underwent molecular studies. To date, 36 patients are alive, 8 of whom experienced locoregional recurrence or distant metastasis. Conclusions Our institutional experience was comparable to that reported in the literature. Further studies are required to inquire about the role of molecular profiles of CXPAs in clinical risk assessment.

BAP1-loss in the salivary duct carcinoma component of an intracapsular carcinoma ex pleomorphic adenoma of the parotid gland

“…Carcinomatous components most commonly include salivary duct carcinoma (SDC), myoepithelial carcinoma, and epithelial-myoepithelial carcinoma (EMC), among others [2][3].…”

“…Reported molecular alterations in CXPA are varied. In addition to those alterations common to PA, such as rearrangements of PLAG1 and HMGA2, other molecular alterations include TP53, BRCA1, BRCA2, and EGFR [1,[3][4]. However, to date there have been no reported cases of BRCA1 associated protein 1 (BAP1) in CXPA or SDC.…”