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Kusafuka K, Yamashita M, Yamanaka S, Hirata K, Kubota A, Muramatsu A, Arai K, Suzuki M. Hybrid Carcinoma of the Parotid Gland: An Extremely Rare Three Cases with an Immunohistochemical Analysis and a Review of the Literature. Int J Surg Pathol 2021; 30:23-32. [PMID: 34487466 DOI: 10.1177/10668969211036942] [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: 11/15/2022]
Abstract
Salivary hybrid carcinoma (HC) is defined as when two or more kinds of carcinoma exist at the same location in a single mass. We reestimated and examined three cases of salivary gland HC. Case 1 involved a 76-year-old male. Case 2 involved a 74-year-old female. Case 3 involved a 66-year-old male. Histologically, case 1 involved a combination of salivary duct carcinoma (SDC) and squamous cell carcinoma (SqCC). Immunohistochemically, the former was positive for gross cystic disease fluid protein (GCDFP)-15 and androgen receptor (AR). Case 2 involved a combination of SqCC and neuroendocrine carcinoma. Immunohistochemically the latter was positive for synaptophysin and neural cell adhesion molecule (NCAM). Case 3 involved a combination of SDC and epithelial-myoepithelial carcinoma (EMC). Immunohistochemically, the former was positive for GCDFP-15 and AR, whereas the inner cells of the latter were positive for cytokeratin 7, and the outer cells of the latter were positive for actin. Because of the transitional zone between SDC and EMC, it was speculated that high-grade SDC arose from low-grade EMC.
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Affiliation(s)
| | - Masaru Yamashita
- 26389Shizuoka General Hospital, Shizuoka City, Japan.,208512Kagoshima University, Kagoshima City, Japan
| | - Shoji Yamanaka
- 218758Yokohama City University Hospital, Yokohama City, Japan
| | - Kazuki Hirata
- 26389Shizuoka General Hospital, Shizuoka City, Japan
| | - Aki Kubota
- 26389Shizuoka General Hospital, Shizuoka City, Japan
| | - Aya Muramatsu
- 26389Shizuoka General Hospital, Shizuoka City, Japan
| | - Kazumori Arai
- 26389Shizuoka General Hospital, Shizuoka City, Japan
| | - Makoto Suzuki
- 26389Shizuoka General Hospital, Shizuoka City, Japan
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Hamamoto Y, Harada H, Suzuki M, Fujii T, Nakatsuka SI. Salivary Duct Carcinoma of the Parotid Gland Originating from an Epithelial-Myoepithelial Carcinoma: Report of a Rare Case. Head Neck Pathol 2019; 14:283-289. [PMID: 30937832 PMCID: PMC7021872 DOI: 10.1007/s12105-019-01034-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 03/20/2019] [Indexed: 11/29/2022]
Abstract
Salivary duct carcinoma (SDC) is a high-grade carcinoma with poor prognosis, especially among various salivary carcinomas. In this study, we report a rare case of SDC of the parotid gland originating from an epithelial-myoepithelial carcinoma (EMC). A 71-year-old Japanese man presented with swelling of the right parotid region and a right facial nerve paralysis for 10 months. He underwent extended total parotidectomy and chemoradiotherapy after the surgery. Histologically, a major part of the tumor was an androgen receptor (AR)-positive, human epidermal growth factor receptor 2 (HER2)-positive, gross cystic disease fluid protein-15 (GCDFP-15)-positive SDC, with a focus of a typical EMC component at the periphery of the lesion. In the transitional area of the two components, inner ductal cells of double-layered ducts showed similar morphology and immunophenotype to SDC. These findings suggest that SDC originated from the inner ductal cells of EMC. Because the tumor included an EMC as a low-grade carcinoma and an SDC as a high-grade carcinoma, we can consider our case as a dedifferentiated carcinoma as well as a hybrid tumor.
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Affiliation(s)
- Yuichiro Hamamoto
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, Osaka 541-8567 Japan
| | - Hiroshi Harada
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, Osaka 541-8567 Japan ,Department of Diagnostic Pathology, Seichokai Fuchu Hospital, 1-10-17, Hiko-Town, Izumi-City, Osaka 594-0076 Japan
| | - Motoyuki Suzuki
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, 2-2, Yamadaoka, Suita, Osaka 565-0871 Japan
| | - Takashi Fujii
- Department of Head and Neck Surgery, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, Osaka 541-8567 Japan
| | - Shin-ichi Nakatsuka
- Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, Osaka 541-8567 Japan
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An Unusual Hybrid Salivary Gland Tumor: Molecular Analysis Informs the Potential Pathogenesis of This Rare Neoplasm. Case Rep Pathol 2019; 2019:2713234. [PMID: 31032133 PMCID: PMC6458882 DOI: 10.1155/2019/2713234] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 02/20/2019] [Accepted: 03/07/2019] [Indexed: 11/18/2022] Open
Abstract
Background The presence of two or more tumor entities growing in adjacent locations within the salivary gland is very rare, and pathologic studies on such lesions are limited, particularly those with molecular information. Since the clinical history and imaging studies are usually nonspecific, accurate diagnosis and clinical management largely depend on a thorough histological examination. Methods and Results We describe a 71-year-old man with an unusual case of hybrid salivary gland tumor composed of mucoepidermoid carcinoma and basal cell adenoma. Molecular analysis revealed differing driver genetic alterations in each component. Conclusions Hybrid salivary gland tumors are rare, and their pathogenesis is controversial. The combination of mucoepidermoid carcinoma and basal cell adenoma has not been previously described. While malignant transformation of adenoma to carcinoma seems plausible, gene sequencing was more suggestive of their independent derivation. Key to appropriate surgical management is identifying the more aggressive component, ideally at the time of intraoperative consultation.
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Hellquist H, Skalova A, Azadeh B. Salivary gland hybrid tumour revisited: could they represent high-grade transformation in a low-grade neoplasm? Virchows Arch 2016; 469:643-650. [PMID: 27605055 DOI: 10.1007/s00428-016-2018-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/27/2016] [Accepted: 09/01/2016] [Indexed: 11/25/2022]
Abstract
Salivary gland hybrid tumour, first described in 1996, is a very rare neoplasm for which exact morphological criteria have not been universally agreed upon. In contrast, the concept of high-grade transformation (HGT) in salivary neoplasms has been widely accepted during the last decade, and the number of reported cases is rapidly increasing. A review of the literature revealed 38 cases of hybrid tumour reported in 22 publications. During approximately the same time period, well over 100 cases of HGT in salivary neoplasms have been reported. There are important histological similarities between hybrid tumours and salivary tumours with HGT. In the latter, containing one tumour component of low-grade malignancy and the other of high grade, the two tumour components are not entirely separated and appear to originate in the same area. Virtually, all cases reported as hybrid tumour had no clear lines of demarcation between the two tumour types. We are inclined to suggest that most of the 38 cases of hybrid tumours described in the literature would today better be called tumour with HGT rather than hybrid tumour. The relative proportion of the two components may vary, and the high-grade component is sometimes very small, which emphasises the importance of very generous sampling of the surgical specimen. The molecular genetic mechanisms responsible for HGT, including what used to be called hybrid tumour, remain largely unknown. Abnormalities of a few genes (including p53, C-MYC, cyclin D1, HER-2/neu) have been documented. As insufficient data exist on gene abnormalities in these lesions, conclusions as to whether or not they have a common origin and which mechanisms are involved in transformation cannot be drawn. Due to the small number of cases reported, many of which lack follow-up details; indicators of prognosis of hybrid tumours are not available, but their behaviour seems to be similar to that of tumours with HGT, i.e. an accelerated aggressive course. HGT of salivary gland neoplasms greatly influences macroscopic and microscopic evaluation of the specimen but also, given the high incidence of metastases and morbidity, carries significant treatment implications.
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Affiliation(s)
- Henrik Hellquist
- Department of Biomedical Sciences and Medicine, University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal.
| | - Alena Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic
| | - Bahram Azadeh
- Department of Pathology, Glan Clwyd Hospital, Rhyl, UK
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Dedifferentiated salivary hybrid carcinoma of the maxillary sinus with pagetoid spread to the overlying lining mucosa. Head Neck Pathol 2014; 9:293-9. [PMID: 25179376 PMCID: PMC4424200 DOI: 10.1007/s12105-014-0564-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 08/13/2014] [Indexed: 10/24/2022]
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Wilson TC, Robinson RA. Basal cell adenocarcinoma and Basal cell adenoma of the salivary glands: a clinicopathological review of seventy tumors with comparison of morphologic features and growth control indices. Head Neck Pathol 2014; 9:205-13. [PMID: 25141971 PMCID: PMC4424211 DOI: 10.1007/s12105-014-0562-4] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 08/04/2014] [Indexed: 01/13/2023]
Abstract
Basal cell adenoma and basal cell adenocarcinoma represent uncommon basaloid salivary gland neoplasms that show marked morphologic similarity. We wished to compare clinical outcome and morphologic features as well as growth and proliferation associated markers for both neoplasms. We reviewed the pathologic features of 70 neoplasms diagnosed as basal cell adenoma or basal cell adenocarcinoma. Observations included maximum mitotic activity and presence or absence of invasion into surrounding normal tissues as well as immunohistochemical studies for Ki-67, caspase 3, p53, and bcl-2. Establishing malignancy on the basis of invasion into surrounding benign tissues, 41 basal cell adenomas and 29 basal cell adenocarcinomas were identified. For tumors with follow-up, recurrence rates were 6.7 % for basal cell adenoma and 16.7 % for basal cell adenocarcinoma. One patient with basal cell adenocarcinoma had distant metastases and died of disease. Overall basal cell adenocarcinomas showed significantly higher values for growth and proliferation markers compared to basal cell adenomas. Salivary gland basal cell adenoma and basal cell adenocarcinoma show morphologic similarity. Basal cell adenocarcinoma can exhibit a locally aggressive behavior and has potential metastatic behavior. The overall mitotic rate and Ki-67 expression were higher in basal cell adenocarcinoma compared to basal cell adenoma, but overlap between the results of these observations in each tumor did not allow for accurate diagnosis or prediction of outcome in individual cases. We conclude that morphologic observation of local tissue invasion is the best marker for separating basal cell adenoma from basal cell adenocarcinoma.
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Affiliation(s)
- Thomas C. Wilson
- Department of Pathology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
| | - Robert A. Robinson
- Department of Pathology, University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242 USA
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Tian Z, Hu Y, Wang L, Li L, Zhang C, Li J. An unusual cribriform variant of salivary basal cell tumours: a clinicopathological study of 22 cases. Histopathology 2012; 61:921-9. [PMID: 22978388 DOI: 10.1111/j.1365-2559.2012.04302.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS To clarify the clinicopathological characteristics of salivary basal cell tumours exhibiting cribriform architecture, and to discuss the differential diagnosis of these tumours with regard to adenoid cystic carcinoma (AdCC). METHODS AND RESULTS Eighteen basal cell adenomas (BCAs) and four basal cell adenocarcinomas (BcACs) with at least a 10% area of cribriform morphology were collected, and the histological and immunohistochemical features were evaluated. The majority of tumours showed the typical histological patterns of basal cell tumours, in addition to cribriform architecture. In some areas, the periphery of cribriform nests had a palisade arrangement. Focal capsular infiltration, but not invasion of surrounding normal tissue, was detected in 14 of 18 BCAs. The capsules were absent or incomplete and mainly accompanied by focal invasion in BcACs. Cystic degeneration was observed in 12 of 22 tumours. The Ki67 labelling index of basal cell tumours was significantly lower than that of cribriform AdCCs (P = 0.001). All patients had a good outcome after a follow-up of 15-96 months. CONCLUSIONS The cribriform variant shares most of the clinicopathological features of conventional basal cell tumours. Admixtures of cribriform and trabecular or tubulo-trabecular subtypes, peripheral palisading, cystic changes, non-invasive or low-grade invasive growth patterns and a low Ki67 labelling index may be useful for distinguishing basal cell tumours with a cribriform architecture from AdCCs.
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Affiliation(s)
- Zhen Tian
- Department of Oral Pathology, School of Stomatology, Ninth People's Hospital, Jiao Tong University School of Medicine, Shanghai, China
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Kainuma K, Oshima A, Suzuki H, Fukushima M, Shimojo H, Usami SI. Hybrid carcinoma of the parotid gland: report of a case (epithelial-myoepithelial carcinoma and salivary duct carcinoma) and review of the literature. Acta Otolaryngol 2010; 130:185-9. [PMID: 19449226 DOI: 10.3109/00016480902930458] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Hybrid tumors of salivary glands are rare neoplasms. We describe a case of a 74-year-old male with a hybrid carcinoma composed of epithelial-myoepithelial and salivary duct carcinomas of the right parotid gland. The presence of two components was verified by differential immunohistochemical staining. The tumor was surgically resected. There has been no evidence of recurrence to date. To our knowledge, this is the first report of a hybrid carcinoma composed of epithelial-myoepithelial and salivary duct carcinomas of the parotid gland in Japan.
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Affiliation(s)
- Kazuyuki Kainuma
- Department of Otolaryngology, Shinshu University School of Medicine, Matsumoto, Japan.
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