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Vrinceanu D, Dumitru M, Bratiloveanu M, Marinescu A, Serboiu C, Manole F, Palade DO, Costache A, Costache M, Patrascu O. Parotid Gland Tumors: Molecular Diagnostic Approaches. Int J Mol Sci 2024; 25:7350. [PMID: 39000457 PMCID: PMC11242036 DOI: 10.3390/ijms25137350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 06/26/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024] Open
Abstract
Parotid gland pathology represents a web of differential diagnoses. There are many complex cases that require extensive diagnostic tests for a complete and correct final pathology diagnosis. Currently the official classification of parotid gland tumors extends over more than 40 subtypes. We performed a query of the PubMed database regarding the use of molecular biology tests in performing a better characterization of the tumors in specific cases. By using fluorescence in situ hybridization (FISH), reverse transcription polymerase chain reaction (RT-PCR) or next-generation sequencing, the team managing complex cases can offer a personalized therapeutic solution. We review the molecular differential diagnosis according to published articles in the last 5 years for many types of parotid gland tumors ranging from benign to borderline malign tumors to malign aggressive tumors. Mucoepidermoid carcinoma is a distinct subtype of parotid malignancy that was the subject of a consistent number of articles. However, the molecular biology diagnosis techniques helped more in excluding the diagnosis of mucoepidermoid carcinoma, and probably retrospectively limiting the number of cases with this final diagnosis. In Romania, the molecular biology diagnosis is available only in limited research facilities and should receive more consistent funding that will make it available on a larger scale. The novelty of this scoping review is that we propose an algorithm for molecular differential diagnosis of the tumors that could be encountered in the parotid gland.
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Affiliation(s)
- Daniela Vrinceanu
- ENT Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Mihai Dumitru
- ENT Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Miruna Bratiloveanu
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.B.); (A.C.); (M.C.); (O.P.)
| | - Andreea Marinescu
- Radiology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Crenguta Serboiu
- Molecular Biology and Histology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania;
| | - Felicia Manole
- ENT Department, Faculty of Medicine, University of Oradea, 410073 Oradea, Romania;
| | | | - Adrian Costache
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.B.); (A.C.); (M.C.); (O.P.)
| | - Mariana Costache
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.B.); (A.C.); (M.C.); (O.P.)
| | - Oana Patrascu
- Pathology Department, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (M.B.); (A.C.); (M.C.); (O.P.)
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Li Z, Zhou Q, Wang Y, Li G. Salivary-duct carcinoma (SDC): A rare case report. Asian J Surg 2024; 47:2441-2442. [PMID: 38302356 DOI: 10.1016/j.asjsur.2024.01.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 01/19/2024] [Indexed: 02/03/2024] Open
Affiliation(s)
- Zhen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
| | - Qiao Zhou
- Obstetrics and Gynecology Ultrasound Department, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
| | - Yifan Wang
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
| | - Guangsen Li
- Department of Ultrasound, The Second Affiliated Hospital of Dalian Medical University, Shahekou Street, Dalian, 116023, Liaoning Province, China.
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Carillo AM, De Luca C, Pisapia P, Vigliar E, Ikenberg K, Freiberger SN, Troncone G, Rupp NJ, Bellevicine C. Molecular testing in salivary gland cytopathology: A practical overview in conjunction with the Milan system. Cytopathology 2024; 35:330-343. [PMID: 38308401 DOI: 10.1111/cyt.13363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/04/2024]
Abstract
Recently, significant advances in the molecular characterization of salivary gland neoplasms have facilitated the classification and diagnosis of specific diagnostic entities. In the highly challenging diagnostic scenario of salivary malignancies, molecular testing is increasingly being adopted in routine practice to refine the cytological diagnosis of salivary lesions. Here, we reviewed the most recent evidence in the field of salivary glands molecular cytopathology.
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Affiliation(s)
- Anna Maria Carillo
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Caterina De Luca
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Pasquale Pisapia
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Kristian Ikenberg
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Sandra N Freiberger
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Niels J Rupp
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Muthu G, Thankappan P, Angelin D, Franklin R. Salivary duct carcinoma in the submandibular gland: A rare case report with differential diagnosis. J Oral Maxillofac Pathol 2024; 28:311-314. [PMID: 39157820 PMCID: PMC11329099 DOI: 10.4103/jomfp.jomfp_476_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 08/20/2024] Open
Abstract
Salivary duct carcinoma (SDC) is a rare and highly aggressive malignant salivary gland neoplasm, accounting for only 0.2% of salivary gland tumours. It predominantly affects the parotid gland and represents a significant concern with limited prevalence (1-1.2 individuals per million). We present a case of a 65-year-old female patient with a clinical history of swelling and pain in the right lower jaw region for six months. Diagnostic investigations revealed a well-defined submandibular gland lesion. Subsequent histopathological and immunohistochemical findings confirmed the lesion to be SDC. This case report emphasises the challenges in diagnosing this aggressive malignancy, which stems from its rarity and resemblance to other neoplasms. It is worth noting that the involvement of the submandibular gland is observed in a mere 12% of SDC cases, while females account for only 25% of the reported instances.
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Affiliation(s)
- Geerthanaa Muthu
- Department of Oral and Maxillofacial Pathology, Sree Mookambika Institute of Dental Sciences, Kanyakumari District, Tamil Nadu, India
| | - Prasanth Thankappan
- Department of Oral and Maxillofacial Pathology, Sree Mookambika Institute of Dental Sciences, Kanyakumari District, Tamil Nadu, India
| | - D Angelin
- Department of Oral and Maxillofacial Pathology, Sree Mookambika Institute of Dental Sciences, Kanyakumari District, Tamil Nadu, India
| | - R Franklin
- Department of Oral and Maxillofacial Pathology, Sree Mookambika Institute of Dental Sciences, Kanyakumari District, Tamil Nadu, India
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Saoud C, Bailey GE, Graham A, Bonilla LM, Sanchez SI, Maleki Z. Pitfalls in Salivary Gland Cytology. Acta Cytol 2024; 68:194-205. [PMID: 38417405 DOI: 10.1159/000538069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 02/26/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Salivary gland lesions possess diagnostic challenges on fine-needle aspiration (FNA) material. They are relatively uncommon, yet present with a wide spectrum of cytomorphology. Herein, we review common salivary gland neoplasms, their cytomorphologic features, their diagnostic pitfalls, and ancillary studies helpful in achieving an accurate diagnosis. SUMMARY There are many cytomorphologic overlaps between benign and malignant salivary gland entities. Moreover, metaplasia, cystic changes, and degenerative changes are common findings adding to diagnostic dilemmas. These complicating factors contribute to a minute risk of malignancy in salivary gland lesions that are interpreted as benign on FNA. In rare cases, even malignant salivary gland neoplasms are misinterpreted as benign on aspirated material due to the many cytomorphologic overlaps. For example, benign and malignant neoplasms containing stroma such as myoepithelioma and adenoid cystic carcinoma may be misinterpreted as pleomorphic adenoma. Moreover, diagnosis of salivary gland neoplasms with basal cell features can be confusing on FNA materials; for example, basal cell adenoma can be misinterpreted as adenoid cystic carcinoma. Mucoepidermoid carcinomas have many different appearances on aspirated material due to variable amounts of mucin, degree of nuclear atypia, cellular content, and squamous metaplasia. Acinic cell carcinoma exhibits large cells with abundant cytoplasm on FNA, which can be mistaken for oncocytic cells in oncocytoma or Warthin tumor. Salivary duct carcinoma shows distinct features of malignancy and thus can be mistaken for secondary tumors involving the salivary glands or other malignant salivary gland tumors. The presence of tumor-associated lymphocytes is another underlying cause of misdiagnosis, especially when considering the differential diagnosis of an intraparotid lymph node. Ancillary studies such as immunohistochemistry and molecular studies are gaining more attention to be utilized on FNA cases. PLAG1 immunostaining, CD117, DOG1, mammaglobin, and androgen receptor (AR) are examples of commonly used immunostains in diagnosis of salivary gland lesions. MYB gene fusion, rearrangements of the MAML2 gene, and ERBB2/HER2 are examples of molecular alterations useful in diagnosis of salivary gland neoplasms. In conclusion, the aim of salivary gland cytology is to differentiate benign entities from the malignant ones and to prevent unnecessary aggressive treatments. KEY MESSAGES The diagnostic pitfalls are enormous in salivary gland cytology. Familiarity with cytomorphology of different entities and their cytomorphologic overlaps, and application of ancillary studies improves the diagnostic yield, patient management and prevents unnecessary aggressive procedures.
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Affiliation(s)
- Carla Saoud
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Medical Institution, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Gabrielle E Bailey
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Medical Institution, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Ashleigh Graham
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Medical Institution, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Lorena Marcano Bonilla
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Medical Institution, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Sandra Ixchel Sanchez
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Medical Institution, Johns Hopkins Hospital, Baltimore, Maryland, USA
| | - Zahra Maleki
- Division of Cytopathology, Department of Pathology, The Johns Hopkins Medical Institution, Johns Hopkins Hospital, Baltimore, Maryland, USA
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Hayashi S, Bandoh N, Hayashi M, Goto T, Kato Y, Baba S, Aimono E, Nishihara H. Salivary Duct Carcinoma Arising in the Submandibular Gland in a Patient with Neurofibromatosis Type 1. EAR, NOSE & THROAT JOURNAL 2024:1455613241231146. [PMID: 38369960 DOI: 10.1177/01455613241231146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
A 71-year-old man with neurofibromatosis type 1 (NF1) presented to our department with a 1-week history of a painful mass in the left submandibular area. Computed tomography (CT) and magnetic resonance imaging revealed an irregular-shaped tumor with a diameter of 2.0 cm in the left submandibular gland and a metastatic lymph node with a diameter of 1.0 cm adjacent to the tumor. Fluorodeoxyglucose-positron emission tomography/CT revealed increased uptake in the tumor. Fine-needle aspiration cytology revealed atypical cells, suggesting salivary duct carcinoma (SDC). Left neck dissection with resection of the tumor and submandibular gland was performed under general anesthesia. Histologic examination revealed ductal formation with a solid, cystic, cribriform, and papillary structure with intraductal comedonecrosis, diagnosing as SDC originating in the submandibular gland (pT3N1M0 pStage III). Mutational analysis of 160 cancer-related genes by next-generation sequencing (NGS) revealed a germline and frameshift mutation in the NF1 gene (p.R2408Kfs*14) and a somatic and frameshift mutation in the TP53 gene (p.C176Wfs*22). The patient received postoperative radiotherapy to the left neck area at 66 Gy. No evidence of recurrence or metastasis has been observed as of 10 months postoperatively. This is the first reported case of SDC in the submandibular gland in a patient with NF1. The mutational data by NGS may contribute to a better understanding of the oncogenesis of SDC in patients with NF1.
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Affiliation(s)
- Shuto Hayashi
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Nobuyuki Bandoh
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Misaki Hayashi
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
- Department of Otolaryngology-Head and Neck Surgery, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Takashi Goto
- Department of Otolaryngology-Head and Neck Surgery, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Yasutaka Kato
- Department of Biology and Genetics, Laboratory of Cancer Medical Science, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Shogo Baba
- Department of Biology and Genetics, Laboratory of Cancer Medical Science, Hokuto Hospital, Obihiro, Hokkaido, Japan
| | - Eriko Aimono
- Keio Cancer Center, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
| | - Hiroshi Nishihara
- Keio Cancer Center, Keio University School of Medicine, Shinjukuku, Tokyo, Japan
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Dou CB, Ma SR, Zhang SL, Su H, Yu ZL, Jia J. Algorithm for the reconstruction of the parotid region: a single institution experience. BMC Oral Health 2024; 24:106. [PMID: 38238723 PMCID: PMC10795291 DOI: 10.1186/s12903-024-03872-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 01/07/2024] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE This study aims to discuss the characteristics and treatment methods of malignant tumors in the parotid region, as well as the therapeutic effects of immediate free flap reconstruction of soft tissue for postoperative defects. MATERIALS AND METHODS A retrospective review was conducted on 11 cases of soft tissue flap reconstruction for postoperative defects following the resection of malignant tumors in the parotid region. Statistical analysis was performed based on clinical data. RESULTS Among the 11 cases of malignant tumors in the parotid region, there were 2 cases of secretory carcinoma (SC) of the salivary gland, 2 cases of squamous cell carcinoma (SCC), 2 cases of carcinosarcoma, 1 case of mucoepidermoid carcinoma (MEC), 1 case of epithelial-myoepithelial carcinoma (EMC), 1 case of salivary duct carcinoma (SDC), 1 case of basal cell carcinoma (BCC), and 1 case of osteosarcoma. Among these cases, 4 were initial diagnoses and 7 were recurrent tumors. The defect repairs involved: 8 cases with anterolateral thigh free flap (ALTF), 2 cases with pectoralis major muscle flaps, and 1 case with forearm flap. The size of the flaps ranged from approximately 1 cm × 3 cm to 7 cm × 15 cm. The recipient vessels included: 4 cases with the facial artery, 4 cases with the superior thyroid artery, and 1 case with the external carotid artery. The ratio of recipient vein anastomosis was: 57% for branches of the internal jugular vein, 29% for the facial vein, and 14% for the external jugular vein. Among the 8 cases that underwent neck lymph node dissection, one case showed lymph node metastasis on pathological examination. In the initial diagnosis cases, 2 cases received postoperative radiotherapy, and 1 case received 125I seed implantation therapeutic treatment after experiencing two recurrences. Postoperative follow-up revealed that 2 cases underwent reoperation due to local tumor recurrence, and there were 2 cases lost to follow-up. The survival outcomes after treatment included: one case of distant metastasis and one case of death from non-cancerous diseases. CONCLUSION Immediate soft tissue flap reconstruction is an important and valuable option to address postoperative defects in patients afflicted with malignant tumors in the parotid region.
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Affiliation(s)
- Chun-Bo Dou
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
- Dongfeng Stomatological Hospital, Hubei University of Medicine, Shiyan, China
| | - Si-Rui Ma
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Shi-Long Zhang
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
- Dongfeng Stomatological Hospital, Hubei University of Medicine, Shiyan, China
| | - Heng Su
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China
| | - Zi-Li Yu
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Jun Jia
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, 430079, China.
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.
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