Cribriform Adenocarcinoma of the Tongue and Minor Salivary Glands: A Review

Abstract

Cribriform adenocarcinoma of the tongue and minor salivary glands (CATMSG) is a tumor occurring mostly, but not exclusively, in the base of the tongue. Other locations are minor salivary glands of the oral cavity. Histopathologically, CATMSG resembles papillary carcinoma of the thyroid gland. It usually reveals a solid growth devoid of colloid, and eosinophilic material present in follicular areas is rather pale in contrast to metastatic foci seen in papillary thyroid carcinoma that shows typical deeply eosinophilic colloid with ''moth-eaten peripheries'' and cystic configuration. In addition, giant multinucleated cells are not observed in CATMSG and psammoma bodies are found only exceptionally. Unlike papillary thyroid carcinoma, CATMSG is composed of hybrid secretorymyoepithelial cells. Most importantly, CATMSG is consistently negative with both thyroglobulin and TTF-1. CATMSG is a distinct tumor entity that also differs from polymorphous low-grade adenocarcinoma by location, cytology, histological architecture, and behavior, with frequent metastases at the time of presentation. Paradoxically, early metastatic disease seen in most cases of CATMSG is associated with an indolent behavior. It makes CATMSG a unique neoplasm among all low-grade salivary gland tumors.

Approach to Metastatic Carcinoma of Unknown Primary in the Head and Neck: Squamous Cell Carcinoma and Beyond

“…Immunohistochemistry, such as for thyroid transcription factor-1 (TTF-1) or thyroglobulin, can be performed in difficult cases, but PAX-8 should be avoided as it is usually positive in both thyroid and thymic lesions. For metastatic PTC with well-developed nuclear features and more solid architecture, the differential diagnosis may include metastatic cribriform adenocarcinoma of the tongue and minor salivary glands (CATMSG) [34]. CATMSG is a rare salivary gland tumor that occurs, as its name implies, in the minor salivary glands of the oral cavity (especially the tongue).…”

“…CATMSG is a rare salivary gland tumor that occurs, as its name implies, in the minor salivary glands of the oral cavity (especially the tongue). More than 50 % of patients have lymph node metastases at presentation [34]. It has similar nuclear features to PTC including nuclear clearing and contour irregularity, and may have papillary architecture as well as psammoma bodies in rare cases.…”

“…They do not, however, contain colloid and are not immunoreactive for TTF-1 or thyroglobulin. Fortunately, CATMSG is quite rare, although a case of metastatic CATMSG mistaken for metastatic PTC with an occult primary has already been reported [34].…”

Giant cribriform adenocarcinoma of the tongue showing PRKD3 rearrangement

“…Differential diagnosis of CAMSG includes papillary thyroid carcinoma (PTC, either metastatic or developing within the lingual thyroid), polymorphous low grade adenocarcinoma (PLGA) and adenoid cystic carcinoma [1,3,4,6,9].…”

“…Although originally designated as CAT and considered to be restricted to the tongue, it was later shown to arise from the minor salivary glands of the soft palate, buccal mucosa, area of the palatine tonsils, upper lip and even epiglottis [4]. Therefore, the tumor was renamed as "cribriform adenocarcinoma of the tongue and minor salivary glands" (CAMSG) [4,9,10].…”