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Alsugair Z, Fieux M, Descotes F, Lopez J, Cordonnier C, Russel J, Champagnac A, Pissaloux D, Céruse P, Philouze P, Benzerdjeb N. Peculiar nuclear atypia associated with MDM2 gene amplification in carcinoma ex-pleomorphic adenoma harbouring an alteration of HMGA2. Histopathology 2024. [PMID: 38708906 DOI: 10.1111/his.15209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/15/2024] [Accepted: 04/21/2024] [Indexed: 05/07/2024]
Abstract
AIMS Salivary gland neoplasms (SGN) exhibiting the HMGA2::WIF1 fusion are recognized by their resemblance to histology found in canalicular adenoma. Recently, ~20% of cases among 28 HMGA2::WIF1-rearranged-SGN showed malignancy and adverse outcomes (recurrence, distant metastasis, and disease-specific mortality). Among them, MDM2/CDK4 amplifications were identified in one case. This outcome suggests that the MDM2/CDK4 amplifications could be useful to predict an aggressive course of carcinoma ex-pleomorphic adenoma (CEPA). METHODS AND RESULTS We investigated the correlation between HMGA2 fusion and MDM2 amplification in four salivary gland neoplasms, providing detailed clinicopathological features and outcomes. Cases were selected from different institutions. Histological examination, immunohistochemistry, fluorescence in situ hybridization (FISH), RNA sequencing, and whole-exome capture were performed. The cohort included four CEPA cases, all female, aged between 32 and 89 years. Tumours arose from the parotid gland with an average size of 24.5 mm. None exhibited recurrence or distant metastases during the 4-5 months of follow-up. Pathologically, all cases displayed a peculiar atypical nuclei with 'gear-like appearance'. Immunohistochemically, tumours exhibited a biphasic pattern with myoepithelial and ductal differentiation markers. All cases showed HMGA2 overexpression and MDM2 amplification by FISH and RNA sequencing. In a control cohort of MDM2 nonamplified CEPA cases, not exhibiting the peculiar nuclear atypia. CONCLUSIONS Our findings suggest a strong correlation between HMGA2 alteration/MDM2 amplification and a peculiar nuclear atypia, advocating for their evaluation in biphasic tumours to facilitate accurate diagnosis and tailored posttumour removal monitoring. Further studies are warranted to validate these observations and elucidate their prognostic implications.
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Affiliation(s)
- Ziyad Alsugair
- Department of Pathology, Institut of Pathologie Multisite, Hospices Civils de Lyon, University South Lyon Hospital, Pierre-Bénite, France
| | - Maxime Fieux
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Hospices Civils de Lyon, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
- University Claude Bernard Lyon 1, Lyon, France
| | - Françoise Descotes
- Biochemistry and Molecular Biology Department, Hospices Civils de Lyon, University South Lyon Hospital, Pierre-Bénite, France
| | - Jonathan Lopez
- University Claude Bernard Lyon 1, Lyon, France
- Biochemistry and Molecular Biology Department, Hospices Civils de Lyon, University South Lyon Hospital, Pierre-Bénite, France
| | | | | | | | - Daniel Pissaloux
- Biopathology Department, Centre Leon Berard, Lyon, France
- The Unit of Molecular Pathology, INSERM 1052, CNRS 5286 of Cancer Research Center of Lyon, and Team Genetics, Epigenetics and Biology of Sarcomas, Université Claude Bernard Lyon 1, Lyon, France
| | - Philippe Céruse
- University Claude Bernard Lyon 1, Lyon, France
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Hospices Civils de Lyon, La Croix Rousse Hospital, Lyon, France
| | - Pierre Philouze
- University Claude Bernard Lyon 1, Lyon, France
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery, Hospices Civils de Lyon, La Croix Rousse Hospital, Lyon, France
| | - Nazim Benzerdjeb
- Department of Pathology, Institut of Pathologie Multisite, Hospices Civils de Lyon, University South Lyon Hospital, Pierre-Bénite, France
- University Claude Bernard Lyon 1, Lyon, France
- EMR3738, CICLY, Pierre-Bénite, France
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Tondi-Resta I, Hobday SB, Gubbiotti MA, Jalaly JB, Rassekh CH, Montone KT, Baloch ZW. Carcinoma Ex Pleomorphic Adenomas: An Institutional Experience and Literature Review. Am J Clin Pathol 2023; 159:502-515. [PMID: 36921078 DOI: 10.1093/ajcp/aqac181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/13/2022] [Indexed: 03/17/2023] Open
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.
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Affiliation(s)
| | - Sara B Hobday
- Otorhinolaryngology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Christopher H Rassekh
- Otorhinolaryngology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
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Choi SY, Choi J, Hwang I, Cho J, Ko YH, Jeong HS. Comparative Longitudinal Analysis of Malignant Transformation in Pleomorphic Adenoma and Recurrent Pleomorphic Adenoma. J Clin Med 2022; 11:jcm11071808. [PMID: 35407417 PMCID: PMC8999507 DOI: 10.3390/jcm11071808] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 03/10/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Recurrence in pleomorphic adenoma (PA) has been debated as a risk factor for malignant transformation (MT). In this study, we investigated whether recurrence is a risk factor for MT, by longitudinally analyzing cases with recurrent PA (RPA), and carcinomas from PA (CXPA) or RPA (CXRPA). Methods: The study population included 24 CXPA, 24 RPA, 6 CXRPA, and 386 PA cases (study period 2010−2018). Time and event data were collected from the medical documents to identify the time−event sequences. Results: The time interval to MT in CXRPA was significant longer than that of benign recurrence (median 342.0 vs. 109.5 months). In CXRPA, the recurrence intervals were not shorter than those in RPA according to recurrence frequency. Crudely, the MT rate was 5.9% among primary cases and 20.0% among recurrent cases. However, the time-adjusted MT rates increased up to 11.4% (incubation time > 60 months) and 20.0% (>120 months) in primary cases, which were not different from recurrent cases. Conclusion: In these longitudinal analyses, we did not find any clinical evidence that recurrence facilitates MT in the background of PA. Instead, a long incubation time seems to be a key factor for MT of underlying RPA.
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Affiliation(s)
- Sung Yong Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (S.Y.C.); (J.C.)
- Department of Otorhinolaryngology-Head and Neck Surgery, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Daejeon 34824, Korea
| | - Jaehyuck Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (S.Y.C.); (J.C.)
| | - Inwoo Hwang
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (I.H.); (J.C.); (Y.-H.K.)
| | - Junhun Cho
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (I.H.); (J.C.); (Y.-H.K.)
| | - Young-Hyeh Ko
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (I.H.); (J.C.); (Y.-H.K.)
| | - Han-Sin Jeong
- Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea; (S.Y.C.); (J.C.)
- Correspondence: ; Tel.: +82-2-3410-3579
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Saripalli RRK, Alluri LSC, Jakkula A, Yadavilli SS. Extracapsular Dissection for Small Benign Tumors of Parotid Gland: A Case Report on Contemporary Technique. Cureus 2021; 13:e17007. [PMID: 34540408 PMCID: PMC8423323 DOI: 10.7759/cureus.17007] [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] [Accepted: 08/08/2021] [Indexed: 11/30/2022] Open
Abstract
Salivary gland tumor looms as painless enlarging mass which may embrace in both major or minor glands. Pleomorphic adenoma (PA) accord about 40-70% of all salivary gland tumors, where Warthin tumor, basal cell adenoma (BCA), adenoid cystic carcinoma (ACC), and sebaceous tumors have a strong predilection for major salivary gland. However, polymorphous low-grade adenocarcinoma (PLGA) has a marked predilection for the minor salivary gland. We present a case of PA in a 26-year-old male patient that has been successfully managed by extracapsular dissection (ECD) without any post-operative complications.
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Affiliation(s)
| | | | - Ananthnag Jakkula
- Department of Oral and Maxillofacial Surgery, GSL Dental College & Hospital, Rajahmundry, IND
| | - Sai Sarat Yadavilli
- Department of Oral and Maxillofacial Surgery, St. Joseph Dental College, Eluru, IND
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Mariano FV, Fidalgo F, Casarim ALM, Martins AS, Scarini JF, de Lima Souza RA, Egal ES, Kowalski LP, Krepischi ACV, Altemani A. Somatic copy number alterations in pleomorphic adenoma and recurrent pleomorphic adenoma. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 129:59-64. [PMID: 31607675 DOI: 10.1016/j.oooo.2019.08.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 08/07/2019] [Accepted: 08/25/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE As the genetic changes in recurrent pleomorphic adenoma (RPA) have not yet been investigated, the aim of this study was to assess the genomic profile of somatic copy number alteration in RPA and pleomorphic adenoma (PA) by using array comparative genomic hybridization (aCGH). STUDY DESIGN Four cases of RPA and 13 cases of PA were evaluated by using aCGH, using a 180 K platform. Data were analyzed by using Nexus Copy Number Discovery. RESULTS The RPA group rarely showed any copy number alteration, except for 1 case that exhibited losses in 5 p15.33 p15.1, 5 q13.1 q35.3 and 12 q12 q13.11. The PA group also showed few copy number alterations, and the most frequent findings involved chromosomes 8: 8p21.3-p12 (gain), 8q12.1 (loss), 8p23.3-q24.3 (gain), and 8q12.1-q21.11 (gain). Genomic amplifications were revealed in the PA group, and the relevant affected genes were MAML2 and LIFR. CONCLUSIONS PA and RPA exhibit few somatic copy number alterations and show a similar genomic profile on aCGH.
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Affiliation(s)
| | - Felipe Fidalgo
- International Research Center, AC Camargo Cancer Center, São Paulo-SP, Brazil
| | | | - Antônio Santos Martins
- Head and Neck Surgery Department, Faculty of Medical Sciences/UNICAMP, Campinas-SP, Brazil
| | | | | | - Erika Said Egal
- Pathology Department, Faculty of Medical Sciences/UNICAMP, Campinas-SP, Brazil
| | - Luiz Paulo Kowalski
- Head and Neck Surgery Department, AC Camargo Cancer Center, São Paulo-SP, Brazil
| | | | - Albina Altemani
- Pathology Department, Faculty of Medical Sciences/UNICAMP, Campinas-SP, Brazil
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