Salivary Gland Tumor “Wishes” to Add to the Next WHO Tumor Classification: Sclerosing Polycystic Adenosis, Mammary Analogue Secretory Carcinoma, Cribriform Adenocarcinoma of the Tongue and Other Sites, and Mucinous Variant of Myoepithelioma

Gnepp, Douglas R.

doi:10.1007/s12105-014-0532-x

Cited by 41 publications

(33 citation statements)

References 47 publications

(54 reference statements)

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“…With regard to its etiology, some authors consider SPA to represent a pseudotumoral and inflammatory sclerosing process 3) . On the other hand, other studies have demonstrated a monoclonal origin for this lesion, thus corroborating a possible neoplastic origin 2,12) . In addition, because it resembles a fibrocystic lesion, breast adenosis, and different degrees of dysplasia, some authors consider SPA to be a low-grade malignant neoplasm 13) .…”

Section: Discussionsupporting

confidence: 74%

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Sclerosing Polycystic Adenosis of Tongue

Braz‐Silva

Canto

Oliveira

et al. 2018

Bull. Tokyo Dent. Coll.

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Sclerosing polycystic adenosis (SPA) is a rare benign lesion of the salivary glands which appears histologically similar to sclerosing adenosis and fibrocystic disease of the mammary gland. To date, 67 cases of SPA have been reported in the literature, with the lesion arising in the minor salivary glands in only 9. The present report describes the 10th case of SPA. The patient was a 39-year-old Brazilian man who presented with an asymptomatic nodule on the ventral surface of the tongue. Based on a clinical diagnosis of benign salivary gland neoplasm, an excisional biopsy of the lesion was performed. Histopathological examination showed lobular proliferation of ductal and acinar elements surrounded by a fibrosclerotic stroma. Many of the ductal structures exhibited cystic dilatation and were surrounded by periductal fibrosis, which is consistent with SPA findings. No recurrence of the disease was observed after a 5-year follow-up. A literature review is also discussed, focusing on both the etiology of SPA and the treatment options available.

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Section: Discussionsupporting

confidence: 74%

“…Although the growth pattern of the nodules in such cases is slow and painless, some patients have reported pain as a change in sensitivity, usually manifesting as a tingling sensation 2) .…”

Section: Discussionmentioning

confidence: 99%

Sclerosing Polycystic Adenosis of Tongue

Braz‐Silva

Canto

Oliveira

et al. 2018

Bull. Tokyo Dent. Coll.

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“…In nearly two thirds of the reported cases, MASC presents as a painless, slow-growing mass involving the parotid gland, followed by the minor oral and submandibular salivary glands, with a slight male predominance. The age of presentation ranges from 13 to 78 years with the mean age being in the 5th decade [14]. The current cytology literature is limited to a few reported cases [1,3,4,5,6,7,8,9,10,11,12,13].…”

Section: Discussionmentioning

confidence: 99%

Fine-Needle Aspiration Cytology of Mammary Analog Secretory Carcinoma Masquerading as Low-Grade Mucoepidermoid Carcinoma: Case Report with a Review of the Literature

et al. 2014

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Background/Aim: The primary role of fine-needle aspiration cytology (FNAC) of salivary gland masses is to determine the underlying process and guide further management. The objective of our study is to provide a comprehensive review of cytologic features and ancillary studies of mammary analog secretory carcinoma (MASC), discuss differential diagnosis and review recent advances in the understanding of its biologic behavior. Case: A 23-year-old female underwent ultrasound-guided FNA of a slowly enlarging parotid mass. Smears displayed branching clusters of bland vacuolated polygonal cells in a secretory proteinaceous background. Eosinophilic cells with eccentric nuclei and inconspicuous nucleoli were also noted. Based on positive intracellular mucin staining and the lack of extracellular-matrix material, the cytologic diagnosis rendered was ‘suspicious for low grade mucoepidermoid carcinoma'. Superficial parotidectomy revealed an MASC confirmed by fluorescence in situ hybridization (FISH) studies for ETV6 translocation. Conclusion: MASC should be included in the differential diagnosis of mucinous salivary lesions with cystic changes on FNA. Immunohistochemistry for mammaglobin and S-100 helps in excluding morphologic mimics. FISH helps to confirm the diagnosis. Age alone should not be a deterrent in diagnosing a carcinoma.

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“…A few studies have shown that CASGs and LGPAs are associated with higher risk of regional and distant metastases, compared with the classical PLGAs (5, 8–10, 12). Therefore, several groups have proposed to classify LGPA and CASG as entities distinct from PLGA to emphasize their aggressive behaviors (8–10, 13). These tumors were included as variants of PLGA in the WHO classification of 2005 (2) but the controversies remain unresolved and uniform diagnostic criteria are yet to be formed.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Outcome in the Phenotypic Spectrum of Polymorphous Low-grade Adenocarcinoma (PLGA) and Cribriform Adenocarcinoma of Salivary Gland (CASG)

Aneja

Ghossein

et al. 2016

American Journal of Surgical Pathology

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Polymorphous low grade adenocarcinoma (PLGA) shows histologic diversity with fascicular and targetoid features while cribriform adenocarcinoma (CASG) demonstrates predominant cribriform and solid patterns with glomeruloid appearance and optical clear nuclei. The current study is designed to identify pathological features that may predict clinical outcome in 69 PLGA/CASG. Seven patients had recurrences or distant metastasis, including three local recurrences, 2 nodal metastases, and 2 distant metastases. The following histological factors predicted disease free survival on univariate analysis: tumor size, bone invasion, lymphovascular invasion (LVI), tumor necrosis, ≥10% papillary pattern, and ≥30% cribriform pattern. On multivariate analysis, 10% of papillary pattern and 30% cribriform pattern were independent prognostic factors of disease free survival (DFS). Histologic classification of the 69 tumors (based on the prior reported definition of CASG) showed 21 CASGs (30%), 23 PLGAs (33%), and 22 (32%) with indeterminate features of PLGA and CASG. Additionally, 3 (4%) tumors demonstrated a predominant papillary pattern (≥50%). Interestingly, not all CASGs were located in the minor salivary gland and two tumors were identified in the parotid. One patient died from her disease and she harbored a CASG with >30% cribriform pattern. In conclusion, tumor size, bone invasion, and LVI are significant parameters that can predict adverse clinical behaviors in PLGA/CASG on univariate analysis. Using the prior reported definition, an overlapping histology between PLGA and CASG was noted in over a third of the cases. Regardless of tumor subclassification, the percentage of cribriform and papillary patterns seems to be prognostically relevant and should be documented.

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Salivary Gland Tumor “Wishes” to Add to the Next WHO Tumor Classification: Sclerosing Polycystic Adenosis, Mammary Analogue Secretory Carcinoma, Cribriform Adenocarcinoma of the Tongue and Other Sites, and Mucinous Variant of Myoepithelioma

Cited by 41 publications

References 47 publications

Sclerosing Polycystic Adenosis of Tongue

Sclerosing Polycystic Adenosis of Tongue

Fine-Needle Aspiration Cytology of Mammary Analog Secretory Carcinoma Masquerading as Low-Grade Mucoepidermoid Carcinoma: Case Report with a Review of the Literature

Predictors of Outcome in the Phenotypic Spectrum of Polymorphous Low-grade Adenocarcinoma (PLGA) and Cribriform Adenocarcinoma of Salivary Gland (CASG)

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