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Zanella VG, Costa SFDS, Schuch LF, Pilar EFS, Paes Leme AF, Dos Santos JN, Khurram SA, Elalawy F, Bingle L, Nunes FD, Fonseca FP, Vargas PA, Martins MD, Wagner VP. Pleomorphic adenoma and carcinoma ex-pleomorphic adenoma tumorigenesis: A proteomic analysis. Oral Dis 2024. [PMID: 39155517 DOI: 10.1111/odi.15109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 06/27/2024] [Accepted: 08/06/2024] [Indexed: 08/20/2024]
Abstract
OBJECTIVES To conduct a comprehensive proteomic analysis of normal salivary gland tissue, pleomorphic adenoma (PA), and carcinoma ex-pleomorphic adenoma (CXPA), and validate the proteomic findings using immunohistochemistry. METHODS Six normal salivary gland tissues, seven PA and seven CXPA samples underwent laser microdissection followed by liquid chromatography coupled to mass spectrometry. Protein identification and quantification were performed using MaxQuant software. Statistical analysis and functional enrichment were conducted using the Perseus platform and STRING tool, respectively. Immunohistochemistry was used for validation. RESULTS Comparative proteomic analysis revealed 2680 proteins across the three tissue types, with 799 significantly altered between groups. Translocation protein SEC63 homolog, Annexin A6 and Biglycan were up-regulated in CXPA compared to PA. Decorin was markedly up-regulated in both PA and CXPA compared to normal salivary gland (log2 fold changes of 7.58 and 7.38, respectively). Validation confirmed elevated levels of Biglycan and Decorin in the extracellular matrix of CXPA compared to PA. CONCLUSIONS Proteomic analysis identified differential protein expression patterns associated with malignant transformation of PA into CXPA. Findings indicate a crucial role for extracellular matrix proteins, specifically Biglycan and Decorin, in the tumorigenic progression of PA and CXPA.
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Affiliation(s)
- Virgílio Gonzales Zanella
- Department of Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Head and Neck Surgery Department, Santa Rita Hospital, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil
| | - Sara Ferreira Dos Santos Costa
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Lauren Frenzel Schuch
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | | | - Adriana Franco Paes Leme
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Jean Nunes Dos Santos
- Postgraduation Program in Dentistry and Health, Federal University of Bahia, Salvador, Brazil
| | - Syed Ali Khurram
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Fatima Elalawy
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Lynne Bingle
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Fabio Daumas Nunes
- Department of Oral and Maxillofacial Pathology, Dental School, University of São Paulo (USP), São Paulo, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Brazil
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Manoela Domingues Martins
- Department of Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
| | - Vivian Petersen Wagner
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, Brazil
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
- Department of Oral and Maxillofacial Pathology, Dental School, University of São Paulo (USP), São Paulo, Brazil
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Guimarães ACS, Raposo Vedovi JV, de Almeida Ribeiro CR, Martinelli KG, Pelajo Machado M, de Abreu Manso PP, Euzebio Pereira Dias de Oliveira BC, Bergamini ML, de Rosa CS, Tozetto-Mendoza TR, Fernandes de Souza ACM, Martins MT, Braz-Silva PH, de Paula VS. Cytomegalovirus in Adenoma and Carcinoma Lesions: Detecting Mono-Infection and Co-Infection in Salivary Glands. Int J Mol Sci 2024; 25:7502. [PMID: 39062747 PMCID: PMC11276870 DOI: 10.3390/ijms25147502] [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: 10/03/2023] [Revised: 11/17/2023] [Accepted: 11/22/2023] [Indexed: 07/28/2024] Open
Abstract
Salivary glands' neoplasms are hard to diagnose and present a complex etiology. However, several viruses have been detected in these neoplasms, such as HCMV, which can play a role in certain cancers through oncomodulation. The co-infections between HCMV with betaherpesviruses (HHV-6 and HHV-7) and polyomaviruses (JCV and BKV) has been investigated. The aim of the current study is to describe the frequency of HCMV and co-infections in patients presenting neoplastic and non-neoplastic lesions, including in the salivary gland. Multiplex quantitative polymerase chain reaction was used for betaherpesvirus and polyomavirus quantification purposes after DNA extraction. In total, 50.7% of the 67 analyzed samples were mucocele, 40.3% were adenoma pleomorphic, and 8.9% were mucoepidermoid carcinoma. Overall, 20.9% of samples presented triple-infections with HCMV/HHV-6/HHV-7, whereas 9.0% were co-infections with HCMV/HHV-6 and HCMV/HHV-7. The largest number of co-infections was detected in pleomorphic adenoma cases. All samples tested negative for polyomaviruses, such as BKV and JCV. It was possible to conclude that HCMV can be abundant in salivary gland lesions. A high viral load can be useful to help better understand the etiological role played by viruses in these lesions. A lack of JCV and BKV in the samples analyzed herein does not rule out the involvement of these viruses in one or more salivary gland lesion subtypes.
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Affiliation(s)
- Ana Carolina Silva Guimarães
- Molecular Virology and Parasitology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, 4365 Brasil Ave., Manguinhos, Rio de Janeiro CEP 21040-360, Brazil; (A.C.S.G.); (J.V.R.V.); (C.R.d.A.R.)
| | - Jéssica Vasques Raposo Vedovi
- Molecular Virology and Parasitology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, 4365 Brasil Ave., Manguinhos, Rio de Janeiro CEP 21040-360, Brazil; (A.C.S.G.); (J.V.R.V.); (C.R.d.A.R.)
| | - Camilla Rodrigues de Almeida Ribeiro
- Molecular Virology and Parasitology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, 4365 Brasil Ave., Manguinhos, Rio de Janeiro CEP 21040-360, Brazil; (A.C.S.G.); (J.V.R.V.); (C.R.d.A.R.)
| | | | - Marcelo Pelajo Machado
- Pathology Laboratory, Oswaldo Cruz Foundation, 4365 Brasil Ave., Manguinhos, Rio de Janeiro CEP 21040-360, Brazil; (M.P.M.); (P.P.d.A.M.); (B.C.E.P.D.d.O.)
| | - Pedro Paulo de Abreu Manso
- Pathology Laboratory, Oswaldo Cruz Foundation, 4365 Brasil Ave., Manguinhos, Rio de Janeiro CEP 21040-360, Brazil; (M.P.M.); (P.P.d.A.M.); (B.C.E.P.D.d.O.)
| | | | - Mariana Lobo Bergamini
- Stomatology Department, Dentistry School, University of São Paulo, São Paulo CEP 05508-000, Brazil; (M.L.B.); (C.S.d.R.); (M.T.M.); (P.H.B.-S.)
| | - Catharina Simioni de Rosa
- Stomatology Department, Dentistry School, University of São Paulo, São Paulo CEP 05508-000, Brazil; (M.L.B.); (C.S.d.R.); (M.T.M.); (P.H.B.-S.)
| | - Tania Regina Tozetto-Mendoza
- Virology Laboratory, Tropical Medicine Institute of São Paulo, Medical School, University of São Paulo, São Paulo CEP 05508-000, Brazil; (T.R.T.-M.); (A.C.M.F.d.S.)
| | - Ana Carolina Mamana Fernandes de Souza
- Virology Laboratory, Tropical Medicine Institute of São Paulo, Medical School, University of São Paulo, São Paulo CEP 05508-000, Brazil; (T.R.T.-M.); (A.C.M.F.d.S.)
| | - Marília Trierveiler Martins
- Stomatology Department, Dentistry School, University of São Paulo, São Paulo CEP 05508-000, Brazil; (M.L.B.); (C.S.d.R.); (M.T.M.); (P.H.B.-S.)
| | - Paulo Henrique Braz-Silva
- Stomatology Department, Dentistry School, University of São Paulo, São Paulo CEP 05508-000, Brazil; (M.L.B.); (C.S.d.R.); (M.T.M.); (P.H.B.-S.)
- Virology Laboratory, Tropical Medicine Institute of São Paulo, Medical School, University of São Paulo, São Paulo CEP 05508-000, Brazil; (T.R.T.-M.); (A.C.M.F.d.S.)
| | - Vanessa Salete de Paula
- Molecular Virology and Parasitology Laboratory, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, 4365 Brasil Ave., Manguinhos, Rio de Janeiro CEP 21040-360, Brazil; (A.C.S.G.); (J.V.R.V.); (C.R.d.A.R.)
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Sakamoto S, Kikuchi K. Expanding the cytological and architectural spectrum of mucoepidermoid carcinoma: The key to solving diagnostic problems in morphological variants. Semin Diagn Pathol 2024; 41:182-189. [PMID: 38609754 DOI: 10.1053/j.semdp.2024.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 03/17/2024] [Accepted: 04/02/2024] [Indexed: 04/14/2024]
Abstract
Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumor. Varying sized cysts and sheets composed of three cell types (epidermoid, intermediate, and mucous cells) with varying degrees of atypia form the characteristic histological appearance of MEC. MEC frequently contains a wide variety of modified tumor cells and can be entirely cystic or completely solid. Under these circumstances, MEC requires critical differentiation from many mimickers, ranging from simple cysts and benign tumors to high-grade carcinomas. Tumor-associated lymphoid proliferation and sclerotic changes in the stroma also contribute to diagnostic difficulties. Several well-known diagnostically challenging variants (oncocytic, clear cell, spindle cell, and sclerosing) exist in MEC. With the advent of studies on specific CRTC1/3::MAML2 fusion genes in MEC, newly proposed subtypes have emerged, including Warthin-like and non-sebaceous lymphadenoma-like MECs. In addition to the recently defined mucoacinar variant with a serous cell phenotype, MEC devoid of squamous differentiation has also been reported, implying the need to reconsider this basic concept. In this article, we outline the general clinical features and MAML2 status of conventional MEC and review the cytoarchitectural subtypes, with an emphasis on a pitfall in the interpretation of this histologically diverse single entity.
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Affiliation(s)
- Shinnichi Sakamoto
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan.
| | - Kentaro Kikuchi
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
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Dos Santos CMB, Cunha JLS, Barnabé LÉG, Nonaka CFW, Alves PM, Gordón-Núñez MA. Basal cell adenocarcinoma of the soft palate: A closer look for an exceedingly rare salivary gland tumor. Oral Oncol 2023; 147:106617. [PMID: 37925896 DOI: 10.1016/j.oraloncology.2023.106617] [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: 10/24/2023] [Accepted: 10/30/2023] [Indexed: 11/07/2023]
Abstract
Basal cell adenocarcinoma (BCAd) is an extremely rare primary biphasic carcinoma of the salivary glands with few well-documented cases reported in the literature. Herein, we report a rare case of a 44-year-old male patient who presented an oral medicine service with an erythematous nodular lesion on the soft palate, measuring 1.5 cm in its largest diameter, with a 5-year duration. The clinical diagnosis was pleomorphic adenoma, and an excisional biopsy was performed. Histopathological analysis revealed a biphasic infiltrative tumor composed of a mixture of central ductal cells and abluminal basal cells with slight atypia arranged in solid, trabecular, tubular and cribriform growth patterns in a loose stroma. The peripheral cells show a palisading arrangement with round hyperchromatic nuclei and scanty cytoplasm. Occasional mitotic figures were seen. Few spindle-shaped cells suggestive of myoepithelial cells were present in the stroma surrounding the basaloid tumor nests. The diagnosis was BCAd. The patient was referred to a head and neck service and has been followed up for 8 months with no signs of recurrence. In conclusion, although the diagnosis of BCAd can be challenging due to its rarity and morphological overlap with other salivary gland lesions, a meticulous morphological assessment is key for accurate diagnosis, especially in cases originating from minor salivary glands. Surgical excision with a wide safety margin is the treatment of choice and long-term follow-up is recommended to monitor possible recurrences.
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Affiliation(s)
| | | | | | | | - Pollianna Muniz Alves
- Department of Dentistry, State University of Paraíba (UEPB), Campina Grande, Brazil.
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Ghaderi H, Kruger E, Ahmadvand S, Mohammadi Y, Khademi B, Ghaderi A. Epidemiological Profile of Salivary Gland Tumors in Southern Iranian Population: A Retrospective Study of 405 Cases. J Cancer Epidemiol 2023; 2023:8844535. [PMID: 38026266 PMCID: PMC10681769 DOI: 10.1155/2023/8844535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/07/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Aims Salivary gland tumors (SGTs) are a rare and diverse group of tumors that account for 3 to 10% of all head and neck malignancies. We aimed to conduct a comprehensive epidemiological analysis of SGTs in the south of Iran and compare the findings with previous reports from Iran and other parts of the world. Methods Using a retrospective study, 405 patients diagnosed with SGTs were observed over an eight-year period between April 2013 and October 2021 in Shiraz, Iran. Patients' demographic and clinicopathological features were obtained from patients' records. Quantitative and descriptive data analysis was performed using SPSS software. Results There were 302 benign (74.5%) and 103 (25.4%) malignant SGTs. Pleomorphic adenoma and Warthin's tumors were the most common benign SGTs (70.5% and 21.5%, respectively). The most common malignant SGTs were mucoepidermoid carcinoma and adenoid cystic carcinoma (26.2% and 22.3%, respectively). There was a statistically significant association between tumor origin and its malignancy status (p < 0.001). In addition, the results indicated that benign tumors were most commonly detected in the parotid gland (p < 0.05). The benign tumors were more frequently observed among the younger population (p = 0.006). Conclusion In summary, the findings of the current study were mainly consistent with the previous reports from Iran and the rest of the world. Benign tumors were the most prevalent type of SGTs, and the parotid gland was the most common site. While the majority of cases that developed from the major salivary glands were benign, all the minor SGTs were malignant. Older patients were more likely to develop malignant tumors compared to younger ones. This study provides insights into the prevalence, age-related incidence, gender distribution, and geographic variation of salivary gland tumors. This can be instrumental to develop a guideline for screening, diagnosis, and determining an optimal treatment.
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Affiliation(s)
- Hamid Ghaderi
- Faculty of Science, School of Human Science, University of Western Australia, Australia
- West Wimmera Health Service, Nhill, Victoria 3418, Australia
| | - Estie Kruger
- Faculty of Science, School of Human Science, University of Western Australia, Australia
| | - Simin Ahmadvand
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yousef Mohammadi
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bijan Khademi
- Department of Otolaryngology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Abbas Ghaderi
- Shiraz Institute for Cancer Research, Shiraz University of Medical Sciences, Shiraz, Iran
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Manou M, Loupis T, Vrachnos DM, Katsoulas N, Theocharis S, Kanakoglou DS, Basdra EK, Piperi C, Papavassiliou AG. Enhanced Transcriptional Signature and Expression of Histone-Modifying Enzymes in Salivary Gland Tumors. Cells 2023; 12:2437. [PMID: 37887281 PMCID: PMC10604940 DOI: 10.3390/cells12202437] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 10/06/2023] [Accepted: 10/10/2023] [Indexed: 10/28/2023] Open
Abstract
Salivary gland tumors (SGTs) are rare and complex neoplasms characterized by heterogenous histology and clinical behavior as well as resistance to systemic therapy. Tumor etiology is currently under elucidation and an interplay of genetic and epigenetic changes has been proposed to contribute to tumor development. In this work, we investigated epigenetic regulators and histone-modifying factors that may alter gene expression and participate in the pathogenesis of SGT neoplasms. We performed a detailed bioinformatic analysis on a publicly available RNA-seq dataset of 94 ACC tissues supplemented with clinical data and respective controls and generated a protein-protein interaction (PPI) network of chromatin and histone modification factors. A significant upregulation of TP53 and histone-modifying enzymes SUV39H1, EZH2, PRMT1, HDAC8, and KDM5B, along with the upregulation of DNA methyltransferase DNMT3A and ubiquitin ligase UHRF1 mRNA levels, as well as a downregulation of lysine acetyltransferase KAT2B levels, were detected in ACC tissues. The protein expression of p53, SUV39H1, EZH2, and HDAC8 was further validated in SGT tissues along with their functional deposition of the repressive histone marks H3K9me3 and H3K27me3, respectively. Overall, this study is the first to detect a network of interacting proteins affecting chromatin structure and histone modifications in salivary gland tumor cells, further providing mechanistic insights in the molecular profile of SGTs that confer to altered gene expression programs.
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Affiliation(s)
- Maria Manou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.M.); (D.S.K.); (E.K.B.)
| | - Theodoros Loupis
- Haematology Research Laboratory, Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece; (T.L.); (D.M.V.)
| | - Dimitrios M. Vrachnos
- Haematology Research Laboratory, Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece; (T.L.); (D.M.V.)
| | - Nikolaos Katsoulas
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.K.); (S.T.)
| | - Stamatios Theocharis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (N.K.); (S.T.)
| | - Dimitrios S. Kanakoglou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.M.); (D.S.K.); (E.K.B.)
| | - Efthimia K. Basdra
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.M.); (D.S.K.); (E.K.B.)
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.M.); (D.S.K.); (E.K.B.)
| | - Athanasios G. Papavassiliou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece; (M.M.); (D.S.K.); (E.K.B.)
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Pires EG, Ferreira CR, Cavalcante RB, de Aguiar MCF, Mesquita RA, Alves PM, Nonaka CFW. Immunoexpression of Autophagy-Related Proteins in Salivary Gland Tumors: An Exploratory Study. Head Neck Pathol 2023; 17:589-598. [PMID: 37118353 PMCID: PMC10513970 DOI: 10.1007/s12105-023-01556-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 04/13/2023] [Indexed: 04/30/2023]
Abstract
BACKGROUND Autophagy is a cellular survival mechanism involved in several human diseases, but its participation in the development of salivary gland tumors is not fully understood. This study investigated the immunoexpression of autophagy-related proteins (autophagy-related 7 [Atg7], microtubule-associated protein 1 light chain 3A [LC3A], microtubule-associated protein 1 light chain 3B [LC3B], protein p62 [p62], and phosphorylated mammalian target of rapamycin [p-mTOR]) in pleomorphic adenoma (PA), polymorphous adenocarcinoma (PAC), mucoepidermoid carcinoma (MEC), and adenoid cystic carcinoma (ACC) of salivary glands. METHODS Twenty PAs, 20 PACs, 20 MECs, and 14 ACCs were selected. The percentages of cytoplasmic and nuclear positivity for autophagy-related proteins in neoplastic cells were assessed and correlated with histopathological parameters. RESULTS Cytoplasmic immunoexpression of Atg7 was observed in all groups, with high median percentages of positivity. Regarding LC3A and LC3B, cytoplasmic immunoexpression was found in most PACs (95%) and in all cases of PA, MEC and ACC, with the highest percentages of positivity in PACs and PAs (p < 0.005). ACCs exhibited lower cytoplasmic immunoexpression of p-mTOR (p < 0.005) and lower nuclear expression of p62 (p < 0.05) when compared to PAs, PACs and MECs. Low nuclear immunoexpression of Atg7, LC3A and p-mTOR and absence of nuclear staining for LC3B were observed in all groups. Regarding histopathological parameters of PAs, MECs and ACCs, there were no significant differences in the expression of autophagy-related proteins. In all groups, positive correlations were observed between the immunoexpression of some autophagy-related proteins (p < 0.05). CONCLUSIONS The results suggest the participation of autophagy in the pathogenesis of PA, PAC, MEC, and ACC of salivary glands. Upregulation of autophagy and reduced nuclear translocation of p62 may contribute to the aggressive biological behavior of salivary gland ACC.
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Affiliation(s)
- Emanuene Galdino Pires
- Department of Dentistry, School of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | | | | | - Maria Cássia Ferreira de Aguiar
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Ricardo Alves Mesquita
- Department of Oral Pathology and Surgery, School of Dentistry, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil
| | - Pollianna Muniz Alves
- Department of Dentistry, School of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil
| | - Cassiano Francisco Weege Nonaka
- Department of Dentistry, School of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil.
- Programa de Pós-Graduação em Odontologia, Departamento de Odontologia, Universidade Estadual da Paraíba, Rua Baraúnas, 351 - Bairro Universitário, Campina Grande, PB, CEP 58429-500, Brasil.
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8
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Kokubun K, Chujo T, Yamamoto K, Akashi Y, Nakajima K, Takano M, Katakura A, Matsuzaka K. Intraoral Minor Salivary Gland Tumors: A Retrospective, Clinicopathologic, Single-Center Study of 432 Cases in Japan and a Comparison with Epidemiological Data. Head Neck Pathol 2023; 17:739-750. [PMID: 37076754 PMCID: PMC10513980 DOI: 10.1007/s12105-023-01551-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 03/30/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Intraoral minor salivary gland tumors are relatively rare lesions with histological subtypes not commonly found in major salivary glands. This study aimed to retrospectively evaluate the clinicopathologic features of intraoral minor salivary gland tumors from the Tokyo Dental College Hospital, Japan, and compare them with findings from other epidemiological studies. METHODS We conducted a retrospective clinicopathologic evaluation of 432 cases of intraoral minor salivary gland tumors [161 male (37.3%) and 271 female (62.7%) patients; mean age: 52.5 and 48.6 years for males and females, respectively; age at diagnosis: 7-87 (mean: 50.1) years] from the Tokyo Dental College Hospital between 1975 and 2022, including 283 benign tumors (65.5%) and 149 malignant tumors (34.5%). RESULTS The most common benign tumor was pleomorphic adenoma (n = 239), whereas mucoepidermoid carcinoma was the most common malignant tumor (n = 74). The mean age of patients with benign and malignant tumors was 48.4 and 53.2 years, respectively, with patients with malignant tumors being significantly older (P = 0.0042). The mean age of patients with malignant tumors was significantly higher in males (56.7 years) than in females (50.9 years) (P = 0.0376), although the mean age of patients with benign tumors did not differ by sex. Tumors were commonly located in the palate [250 cases (57.9%)]. Benign tumors were more frequent in the palate, upper lip, and buccal mucosa, whereas malignant tumors were more frequent in the palate, floor of the mouth, buccal mucosa, and retromolar area. CONCLUSIONS Understanding the features of intraoral minor salivary gland tumors is useful for diagnosis. Our study provides important epidemiological data (patient differences in age at occurrence, sex, and site of origin) that will inform clinicians and researchers.
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Affiliation(s)
- Katsutoshi Kokubun
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan.
| | - Takatoshi Chujo
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Kei Yamamoto
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Yoshihiko Akashi
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Kei Nakajima
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
| | - Masayuki Takano
- Department of Oral and Maxillofacial Surgery, Tokyo Dental College, Tokyo, Japan
| | - Akira Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - Kenichi Matsuzaka
- Department of Pathology, Tokyo Dental College, 2-9-18 Kandamisaki-Cho, Chiyoda-Ku, Tokyo, 101-0061, Japan
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Singh M, Mokhtar EA, Akbar S, Shivhare P, Salahudheen A. Pleomorphic Adenoma of the Palate With an Atypical Malignant Presentation: A Case Report. Cureus 2023; 15:e42365. [PMID: 37621800 PMCID: PMC10445511 DOI: 10.7759/cureus.42365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
A pleomorphic adenoma is a mixed salivary gland tumor. The parotid gland is the most common site. The intraoral palate is the most common site due to the abundance of accessory salivary glands in the palatal area. It has a very slow growth rate and is usually painless. Consequently, patients often have a lengthy history of presentation. Herein, we report a case of pleomorphic adenoma of the palate in a 53-year-old male patient. The mass was 5 cm by 4 cm in size. The growth rate was rapid, and it attained a large size in just nine months. On clinical examination, the overlying mucosa was ulcerated. On general examination, lymphadenopathy of the right side level 1 b lymph node was found. These clinical findings were consistent with malignancy. However, the histopathological report negated the clinical findings of malignant salivary gland tumors. The tumor was managed with a wide local excision of the tumor with a 1 cm clear margin. The postoperative course was uneventful. No recurrence was seen after two years of follow-up. A thorough cytological or histological examination is a prerequisite to defining the malignant nature of the lesion.
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Affiliation(s)
- Mandeep Singh
- Oral and Maxillofacial Surgery, Dr. B.R. Ambedkar Institute of Dental Sciences and Hospital, Patna, IND
| | - Ejaz A Mokhtar
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Patna, IND
| | | | | | - Ameera Salahudheen
- Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, Patna, IND
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10
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Coleman M, Liang J, Rastatter JC, Arch RS, Gartrell J, Chelius DC, Sheyn A, Li C, Richard C. Exploring the Epidemiology and Survival Trends in Pediatric Major Salivary Gland Malignancies: Insights from the National Cancer Database. Curr Oncol 2023; 30:6134-6147. [PMID: 37504316 PMCID: PMC10378439 DOI: 10.3390/curroncol30070456] [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: 05/02/2023] [Revised: 06/07/2023] [Accepted: 06/17/2023] [Indexed: 07/29/2023] Open
Abstract
OBJECTIVE To investigate the clinicopathological, therapeutic, and survival data on pediatric major salivary gland cancers. MATERIALS AND METHODS National Cancer Database (NCDB) query from 2004 to 2018. RESULTS In total, 967 cases of individuals under the age of 21 were identified. Most cancers affected the parotid gland (86%). Mucoepidermoid carcinoma (41.3%) and acinic cell adenocarcinoma (33.6%) were the most common. Tumors occurred more often from age 11 to 21, and females were more affected. Histology varied by age, gender, and race. In the 0-5 age group, mucoepidermoid carcinoma and myoepithelial carcinoma/sarcoma/rhabdomyosarcoma were the most common pathologies. In patients over 5 years old, mucoepidermoid carcinoma was the most frequent tumor in boys, while acinic cell adenocarcinoma was more common in girls. African American patients had a higher incidence of mucoepidermoid carcinoma, while White patients in the 0-5 age group had a higher incidence of myoepithelial carcinoma/sarcoma/rhabdomyosarcoma tumors. Low-grade tumors were commonly diagnosed at stage I, but the 0-5 age group had a high frequency of stage IV tumors. The overall 5-year survival rate was 94.9%, with 90% for the 0-5 years age group and 96% for the 11-15 years age group. Negative margins were associated with higher 5-year survival rates in high-stage tumors (93%) compared to positive margins (80%). Submandibular malignancies had worse 5-year survival rates across all age groups. CONCLUSIONS Major salivary gland malignancies in pediatric patients exhibit variations in histopathologic characteristics by age, gender, and race. Negative margins impact 5-year survival rates, especially in high-stage tumors.
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Affiliation(s)
- Madison Coleman
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, TN 38103, USA
- Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN 38103, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Jia Liang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Jeffrey C Rastatter
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Rebecca S Arch
- Division of Pediatric Otolaryngology-Head and Neck Surgery, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL 60611, USA
- Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jessica Gartrell
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN 38105, USA
| | - Daniel C Chelius
- Department of Otolaryngology-Head and Neck Surgery, Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, Houston, TX 77030, USA
| | - Anthony Sheyn
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, TN 38103, USA
- Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN 38103, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Cai Li
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
| | - Celine Richard
- Department of Otolaryngology, University of Tennessee Health Science Center College of Medicine, Memphis, TN 38103, USA
- Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN 38103, USA
- Division of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN 38103, USA
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11
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Manou M, Kanakoglou DS, Loupis T, Vrachnos DM, Theocharis S, Papavassiliou AG, Piperi C. Role of Histone Deacetylases in the Pathogenesis of Salivary Gland Tumors and Therapeutic Targeting Options. Int J Mol Sci 2023; 24:10038. [PMID: 37373187 DOI: 10.3390/ijms241210038] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 06/09/2023] [Accepted: 06/10/2023] [Indexed: 06/29/2023] Open
Abstract
Salivary gland tumors (SGTs) comprise a rare and heterogenous category of benign/malignant neoplasms with progressively increasing knowledge of the molecular mechanisms underpinning their pathogenesis, poor prognosis, and therapeutic treatment efficacy. Emerging data are pointing toward an interplay of genetic and epigenetic factors contributing to their heterogeneity and diverse clinical phenotypes. Post-translational histone modifications such as histone acetylation/deacetylation have been shown to actively participate in the pathobiology of SGTs, further suggesting that histone deacetylating factors (HDACs), selective or pan-HDAC inhibitors (HDACis), might present effective treatment options for these neoplasms. Herein, we describe the molecular and epigenetic mechanisms underlying the pathology of the different types of SGTs, focusing on histone acetylation/deacetylation effects on gene expression as well as the progress of HDACis in SGT therapy and the current status of relevant clinical trials.
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Affiliation(s)
- Maria Manou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Dimitrios S Kanakoglou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Theodoros Loupis
- Haematology Research Laboratory, Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece
| | - Dimitrios M Vrachnos
- Haematology Research Laboratory, Clinical, Experimental Surgery and Translational Research Center, Biomedical Research Foundation, Academy of Athens, 11527 Athens, Greece
| | - Stamatios Theocharis
- First Department of Pathology, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Athanasios G Papavassiliou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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12
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Bruzinga FFB, Fernandes FCF, Dias FR, Lima MG, de Souza PEA, de Aguiar MCF, Grossmann SDMC. Clinical and demographic features of minor salivary gland tumors: A collaborative study of 480 cases. Oral Dis 2023; 29:1028-1038. [PMID: 34965007 DOI: 10.1111/odi.14119] [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: 10/18/2021] [Revised: 11/15/2021] [Accepted: 12/10/2021] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe the frequency, clinical, and demographic features of minor salivary gland tumors and possible associated factors. MATERIALS AND METHODS A cross-sectional study was conducted. Clinical and demographic data were collected from biopsy records of two oral pathology services. Chi-square test, Fisher's exact test, and descriptive statistical analysis were performed. RESULTS A total of 480 (0.89%) minor salivary gland tumors were retrieved, 272 (56.7%) benign and 147 (30.7%) malignant. Sixty-one (12.6%) had no subtype specification. Most patients were women (307/64.0%), in sixth decade of life (80/16.7%), with a mean age of 45.32 years. Palate was the most common site (336/70.1%). Pleomorphic adenoma (PA; 245/51.1%), mucoepidermoid carcinoma (MEC; 70/14.6%), and adenoid cystic carcinoma (ACC; 43/8.9%) were the most frequent tumors. Symptomatic case, recurrence, and tobacco use were associated with malignancy (p < 0.05). PA and MEC were more frequent in palate (p < 0.05). No association between the three most frequent histological types and gender or age group was observed (p > 0.05). CONCLUSIONS This represents one of the largest exclusive series of minor salivary gland tumors in Brazil and worldwide. PA, MEC, and ACC were the most frequent tumors. Clinical and demographic data are similar from Brazilian studies or from other countries.
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Affiliation(s)
- Fábio Fernandes Borém Bruzinga
- Department of Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Brazil
| | | | - Fernanda Ribeiro Dias
- Department of Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Brazil
| | - Marla Gabriela Lima
- Department of Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Brazil
| | - Paulo Eduardo Alencar de Souza
- Department of Dentistry, School of Dentistry, Pontifícia Universidade Católica de Minas Gerais (PUC Minas), Belo Horizonte, Brazil
| | - Maria Cássia Ferreira de Aguiar
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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13
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AlSalem A, AlKraidees M, AlKarni A, Yahya B, AlRamyan R, AlSumairi S, AlEssa M, Elkrim M. Major salivary gland carcinoma in KSA: A 10-year nationwide retrospective study of 571 cases. J Taibah Univ Med Sci 2023; 18:1148-1156. [DOI: 10.1016/j.jtumed.2023.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/27/2023] [Accepted: 03/22/2023] [Indexed: 04/04/2023] Open
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14
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Mat Lazim N, Yousaf A, Abusalah MAH, Sulong S, Mohd Ismail ZI, Mohamud R, Abu-Harirah HA, AlRamadneh TN, Hassan R, Abdullah B. The Epigenesis of Salivary Glands Carcinoma: From Field Cancerization to Carcinogenesis. Cancers (Basel) 2023; 15:cancers15072111. [PMID: 37046772 PMCID: PMC10093474 DOI: 10.3390/cancers15072111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 03/17/2023] [Accepted: 03/24/2023] [Indexed: 04/05/2023] Open
Abstract
Salivary gland carcinomas (SGCs) are a diverse collection of malignant tumors with marked differences in biological activity, clinical presentation and microscopic appearance. Although the etiology is varied, secondary radiation, oncogenic viruses as well as chromosomal rearrangements have all been linked to the formation of SGCs. Epigenetic modifications may also contribute to the genesis and progression of SGCs. Epigenetic modifications are any heritable changes in gene expression that are not caused by changes in DNA sequence. It is now widely accepted that epigenetics plays an important role in SGCs development. A basic epigenetic process that has been linked to a variety of pathological as well as physiological conditions including cancer formation, is DNA methylation. Transcriptional repression is caused by CpG islands hypermethylation at gene promoters, whereas hypomethylation causes overexpression of a gene. Epigenetic changes in SGCs have been identified, and they have been linked to the genesis, progression as well as prognosis of these neoplasms. Thus, we conduct a thorough evaluation of the currently known evidence on the involvement of epigenetic processes in SGCs.
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Affiliation(s)
- Norhafiza Mat Lazim
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Anam Yousaf
- Department of Molecular Pathology Laboratory, Pakistan Kidney and Liver Institute and Research Centre, Lahore 54000, Pakistan
| | - Mai Abdel Haleem Abusalah
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Zarqa University, Al-Zarqa 13132, Jordan
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Kelantan, Malaysia
| | - Sarina Sulong
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Human Genome Centre, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Zul Izhar Mohd Ismail
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Rohimah Mohamud
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Immunology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Hashem A. Abu-Harirah
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Zarqa University, Al-Zarqa 13132, Jordan
| | - Tareq Nayef AlRamadneh
- Department of Medical Laboratory Sciences, Faculty of Allied Medical Sciences, Zarqa University, Al-Zarqa 13132, Jordan
| | - Rosline Hassan
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
- Department of Haematology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Baharudin Abdullah
- Department of Otorhinolaryngology-Head and Neck Surgery, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Hospital USM, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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15
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Quixabeira Oliveira GA, Pérez-DE-Oliveira ME, Robinson L, Khurram SA, Hunter K, Speight PM, Kowalski LP, Lopes Pinto CA, Sales De Sá R, Mendonça EF, Sousa-Neto SS, de Carlucci Junior D, Mariano FV, Altemani AMDAM, Martins MD, Zanella VG, Perez DEDC, Dos Santos JN, Romañach MJ, Abrahão AC, Andrade BABD, Pontes HAR, Jorge Junior J, Santos-Silva AR, Lopes MA, Van Heerden WFP, Vargas PA. Epithelial salivary gland tumors in pediatric patients: An international collaborative study. Int J Pediatr Otorhinolaryngol 2023; 168:111519. [PMID: 36965251 DOI: 10.1016/j.ijporl.2023.111519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 03/10/2023] [Accepted: 03/19/2023] [Indexed: 03/27/2023]
Abstract
OBJECTIVE Salivary gland tumors (SGT) are a diverse group of uncommon neoplasms that are rare in pediatric patients. This study aimed to characterize the clinicopathological profile of pediatric patients affected by SGT from a large case series derived from an international group of academic centers. STUDY DESIGN A retrospective analysis of pediatric patients with SGT (0-19 years old) diagnosed between 2000 and 2021 from Brazil, South Africa, and the United Kingdom was performed. SPSS Statistics for Windows was used for a quantitative analysis of the data, with a descriptive analysis of the clinicopathological characteristics and the association between clinical variables and diagnoses. RESULTS A total of 203 cases of epithelial SGT were included. Females were slightly more commonly (56.5%), with a mean age of 14.1 years. The palate was the most common site (43.5%), followed by the parotid gland (29%), lip (10%), and submandibular gland (7.5%). The predominant clinical presentation was a flesh-colored, smooth, and painless nodule. Pleomorphic adenoma (PA) was the most frequently diagnosed SGT (58.6%), followed by mucoepidermoid carcinoma (MEC) (26.6%). Surgery (90.8%) was the favored treatment option. CONCLUSIONS Benign SGT in pediatric patients are more commonly benign than malignant tumors. Clinicians should keep PA and MEC in mind when assessing nodular lesions of possible salivary gland origin in pediatric patients.
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Affiliation(s)
| | | | - Liam Robinson
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Syed Ali Khurram
- Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Keith Hunter
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa; Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Paul M Speight
- Unit of Oral and Maxillofacial Medicine and Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, United Kingdom
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil; Department of Head and Neck Surgery, University of São Paulo (USP) Medical School, São Paulo, Brazil
| | - Clóvis Antonio Lopes Pinto
- Department of Head and Neck Surgery and Otorhinolaryngology, A.C. Camargo Cancer Center, São Paulo, Brazil
| | - Raísa Sales De Sá
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Elismauro Francisco Mendonça
- Department of Stomatology (Oral Pathology), School of Dentistry, Federal University of Goiás (UFG), Goiânia, Brazil
| | | | | | - Fernanda Viviane Mariano
- Department of Pathology, Faculty of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil
| | - Virgílio Gonzales Zanella
- Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Brazil; Head and Neck Surgery Department, Santa Rita Hospital, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Danyel Elias da Cruz Perez
- Department of Oral Pathology, School of Dentistry, Universidade Federal de Pernambuco (UFPE), Recife, Brazil
| | - Jean Nunes Dos Santos
- Laboratory of Oral Surgical Pathology, School of Dentistry, Federal University of Bahia (UFBA), Salvador, Brazil
| | - Mário José Romañach
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Aline Corrêa Abrahão
- Department of Oral Diagnosis and Pathology, School of Dentistry, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Hélder Antônio Rebelo Pontes
- Service of Oral Pathology, João de Barros Barreto University Hospital, Federal University of Pará (UFPA), Belém, Brazil
| | - Jacks Jorge Junior
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil
| | - Willie F P Van Heerden
- Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, State University of Campinas (UNICAMP), São Paulo, Brazil; Department of Oral Pathology and Oral Biology, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
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16
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Sandhu S, Handa S. Pathology Mimicking Orofacial Pain. Dent Clin North Am 2023; 67:117-127. [PMID: 36404072 DOI: 10.1016/j.cden.2022.07.009] [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: 11/19/2022]
Abstract
A case of a 64-year-old woman is reported, who developed new-onset pain over a preexisting area of right mandibular fullness. Clinical examination, MRI, and fine-needle aspiration cytology confirmed the diagnosis of a benign parotid gland tumor-pleomorphic adenoma, which was treated by total parotidectomy with complete removal of the tumor. When evaluating a patient with orofacial pain, oral health care providers should be cognizant of all potential differential diagnoses, especially in the setting of red flags such as persistent or enlarging facial swelling/fullness.
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Affiliation(s)
- Shaiba Sandhu
- Division of Orofacial Pain, Oral and Maxillofacial Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Harvard School of Dental Medicine, Boston, MA, USA.
| | - Shruti Handa
- Division of Orofacial Pain, Oral and Maxillofacial Surgery, Department of Surgery, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114, USA; Harvard School of Dental Medicine, Boston, MA, USA
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17
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Rose GE, Vahdani K, Lewis J, Rose AM. Risk and Lag-time for Development of Lacrimal Gland Carcinoma Expleomorphic Adenoma: Observations and Conjectural Study. Ophthalmic Plast Reconstr Surg 2022; 38:563-566. [PMID: 35550483 DOI: 10.1097/iop.0000000000002203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIMS To estimate the proportion of de novo lacrimal gland pleomorphic adenomas (PAs) and carcinomas expleomorphic adenomas (CEPAs), together with age at presentation and first symptom. Conjectural models of tumor growth are considered. METHODS Retrospective review of patients with orbital lobe PA or CEPA. The presenting age was examined for conformation to a Gaussian distribution and the cumulative distribution function derived for both tumor types. The risk of CEPA with age was estimated by logistic regression. RESULTS About one-sixth (27/172; 16%) of these primary orbital lobe tumors were CEPAs, with 145 PAs (76/145 male; 52%) and 27 CEPAs (12/27 male; 44%). The mean presenting age for PAs was 48.3 years (median 47.7; range 11-84 years) and 57.7 years for CEPAs (median 61.2, range 27-91 years) ( p = 0.0062), and the standard deviations for each group are almost identical (16.3 for PAs, 15.9 for CEPAs; p = 0.92). Five (3.4%) PAs and 1 (3.7%) CEPA were asymptomatic: otherwise, the median symptom duration was 24 months for both PAs and CEPAs ( U test: p = 0.65). The odds of CEPA rises significantly with age, increasing 1.04-fold annually ( p = 0.0079). CONCLUSION The almost identical measures of dispersion for the presenting ages of PA and CEPA suggests that, once malignant transformation occurs, there might be a relatively constant period before it is evident. CEPAs present about a decade after PAs, this unexpectedly later presentation for the malignancy possibly being explained by a gradual replacement of the PA by the newly arising carcinoma within the preceding benign tumor.
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Affiliation(s)
- Geoffrey E Rose
- Adnexal Service, Moorfields Eye Hospital, London, United Kingdom
| | - Kaveh Vahdani
- Adnexal Service, Moorfields Eye Hospital, London, United Kingdom
| | - Joanna Lewis
- Freelance Medical Statistician, London, United Kingdom
| | - Anna M Rose
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, United Kingdom
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Miyahara GI, de Castro TF, Araújo WAF, Tomo S, Biasoli ER, Santos-Silva AR, Xavier-Júnior JCC, Crivelini MM, Bernabé DG. A submucous yellow nodule of the fornix. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:124-127. [PMID: 35210203 DOI: 10.1016/j.oooo.2021.12.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 11/23/2021] [Accepted: 12/02/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Glauco Issamu Miyahara
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil.
| | - Tamara Fernandes de Castro
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Winícius Arildo Ferreira Araújo
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Saygo Tomo
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Eder Ricardo Biasoli
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, University of Campinas - UNICAMP, Piracicaba, São Paulo, Brazil
| | - José Cândido Caldeira Xavier-Júnior
- Pathology Institute of Araçatuba, Araçatuba, São Paulo, Brazil; School of Medicine, Centro Universitário Católico Unisalesiano Auxilium, Araçatuba, São Paulo, Brazil
| | - Marcelo Macedo Crivelini
- Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
| | - Daniel Galera Bernabé
- Oral Oncology Center, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil; Department of Diagnosis and Surgery, São Paulo State University (UNESP), School of Dentistry, Aracatuba, São Paulo, Brazil
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Laohavisudhi F, Chunchai T, Ketchaikosol N, Thosaporn W, Chattipakorn N, Chattipakorn SC. Evaluation of CD44s, CD44v6, CXCR2, CXCL1, and IL-1β in Benign and Malignant Tumors of Salivary Glands. Diagnostics (Basel) 2022; 12:1275. [PMID: 35626430 PMCID: PMC9141664 DOI: 10.3390/diagnostics12051275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 05/14/2022] [Accepted: 05/19/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Several studies have reported an association between high expression of CD44 in different types of cancer. However, no study has reported a link among CD44 expression, other biomarkers, and the aggressiveness of salivary gland tumors. METHODS A total of 38 specimens were obtained from non-tumorous salivary glands, benign and malignant tumors in salivary glands. Immunohistochemical analyses of CD44s, CD44v6, IL-1β, CXCL1, and CXCR2 were performed, and the area of positive cells was assessed. RESULTS We found that both CD44s and CXCR2 expression were increased in the benign and malignant groups. CD44v6 was also increased in both groups, but it had the highest level in the malignant group. IL-1β was the only biomarker that increased significantly in the malignant group in comparison to the other two groups. CONCLUSIONS CD44s, CD44v6, CXCR2, and IL-1β expressions were found to be higher in salivary gland tumors. However, IL-1β alone may play a crucial role in the aggressiveness of salivary gland tumors as this cytokine was expressed only in the malignant group with high expression associated with high-grade malignancy.
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Affiliation(s)
- Fonthip Laohavisudhi
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (F.L.); (N.K.); (W.T.)
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (T.C.); (N.C.)
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Titikorn Chunchai
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (T.C.); (N.C.)
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Natnicha Ketchaikosol
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (F.L.); (N.K.); (W.T.)
| | - Wacharaporn Thosaporn
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (F.L.); (N.K.); (W.T.)
| | - Nipon Chattipakorn
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (T.C.); (N.C.)
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Siriporn C. Chattipakorn
- Department of Oral Biology and Oral Diagnostic Sciences, Faculty of Dentistry, Chiang Mai University, Chiang Mai 50200, Thailand; (F.L.); (N.K.); (W.T.)
- Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand; (T.C.); (N.C.)
- Center of Excellence in Cardiac Electrophysiology Research, Chiang Mai University, Chiang Mai 50200, Thailand
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20
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Silva LC, Faustino ISP, Cantadori GR, Santos-Silva AR, Vargas PA, Lopes MA. Adenocarcinoma not otherwise specified (NOS) arising in the sublingual gland: Rare case report and follow-up. Oral Oncol 2022; 126:105754. [PMID: 35123257 DOI: 10.1016/j.oraloncology.2022.105754] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 01/25/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adenocarcinoma not otherwise specified (AdCaNOS) is a rare malignant salivary gland tumor that occurs with higher frequency in the parotid gland of male patients. In this study, we described a second case of AdCaNOS arising in the sublingual gland, in a female patient with 39 years of age, highlighting the clinical, radiographic, microscopic, treatment features and follow-up. CASE REPORT A 39-year-old female patient presented a fibroelastic nodule with a yellowish coloration, in the left region of the floor of mouth, measuring about 4.0 cm in its largest diameter. An incisional biopsy was performed and the main microscopic features revealed an infiltrative lesion with glandular differentiation organized in cystic spaces, where neoplastic cells secreting eosinophilic material were observed. The tumor showed immunopositivity for pancytokeratin (AE1/AE3), keratins 7 (CK7) and 14 (CK14), and negativity for p63. The proliferation level measured by Ki-67 marker was considered higher. The patient underwent radical surgical resection, but unfortunately, she developed local recurrence, lymph node mestastasis and died 1.5 year after diagnosis. CONCLUSION Although rare in the sublingual gland, particularly at this age, AdCaNOS can occur and early diagnosis and early treatment are essential for a better prognosis and survival rates of the patients.
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Affiliation(s)
- Luan César Silva
- Oral Semiology and Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Isabel Schausltz Pereira Faustino
- Oral Semiology and Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Gabriela Rossi Cantadori
- Oral Semiology and Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Oral Semiology and Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Pablo Agustin Vargas
- Oral Semiology and Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Oral Semiology and Oral Pathology, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil.
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21
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Li X, Hu M, Gu W, Liu D, Mei J, Chen S. Nomogram Predicting Cancer-Specific Death in Parotid Carcinoma: a Competing Risk Analysis. Front Oncol 2021; 11:698870. [PMID: 34722245 PMCID: PMC8548358 DOI: 10.3389/fonc.2021.698870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 09/17/2021] [Indexed: 12/01/2022] Open
Abstract
Purpose Multiple factors have been shown to be tied to the prognosis of individuals with parotid cancer (PC); however, there are limited numbers of reliable as well as straightforward tools available for clinical estimation of individualized mortality. Here, a competing risk nomogram was established to assess the risk of cancer-specific deaths (CSD) in individuals with PC. Methods Data of PC patients analyzed in this work were retrieved from the Surveillance, Epidemiology, and End Results (SEER) data repository and the First Affiliated Hospital of Nanchang University (China). Univariate Lasso regression coupled with multivariate Cox assessments were adopted to explore the predictive factors influencing CSD. The cumulative incidence function (CIF) coupled with the Fine-Gray proportional hazards model was employed to determine the risk indicators tied to CSD as per the univariate, as well as multivariate analyses conducted in the R software. Finally, we created and validated a nomogram to forecast the 3- and 5-year CSD likelihood. Results Overall, 1,467 PC patients were identified from the SEER data repository, with the 3- and 5-year CSD CIF after diagnosis being 21.4% and 24.1%, respectively. The univariate along with the Lasso regression data revealed that nine independent risk factors were tied to CSD in the test dataset (n = 1,035) retrieved from the SEER data repository. Additionally, multivariate data of Fine-Gray proportional subdistribution hazards model illustrated that N stage, Age, T stage, Histologic, M stage, grade, surgery, and radiation were independent risk factors influencing CSD in an individual with PC in the test dataset (p < 0.05). Based on optimization performed using the Bayesian information criterion (BIC), six variables were incorporated in the prognostic nomogram. In the internal SEER data repository verification dataset (n = 432) and the external medical center verification dataset (n = 473), our nomogram was well calibrated and exhibited considerable estimation efficiency. Conclusion The competing risk nomogram presented here can be used for assessing cancer-specific mortality in PC patients.
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Affiliation(s)
- Xiancai Li
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Burn, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mingbin Hu
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Weiguo Gu
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Dewu Liu
- Department of Burn, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Jinhong Mei
- Department of Pathology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Shaoqing Chen
- Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
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22
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Silva LC, Borgato GB, Wagner VP, Martins MD, Rocha GZ, Lopes MA, Santos-Silva AR, de Castro Júnior G, Kowalski LP, Nor JE, Squarize CH, Castilho RM, Vargas PA. Cephaeline is an inductor of histone H3 acetylation and inhibitor of mucoepidermoid carcinoma cancer stem cells. J Oral Pathol Med 2021; 51:553-562. [PMID: 34661317 DOI: 10.1111/jop.13252] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/21/2021] [Accepted: 09/08/2021] [Indexed: 01/02/2023]
Abstract
AIM To evaluate the potential use of Cephaeline as a therapeutic strategy to manage mucoepidermoid carcinomas (MEC) of the salivary glands. MATERIAL AND METHODS UM-HMC-1, UM-HMC-2, and UM-HMC-3A MEC cell lines were used to establish the effects of Cephaeline over tumor viability determined by MTT assay. In vitro wound healing scratch assays were performed to address cellular migration while immunofluorescence staining for histone H3 lysine 9 (H3k9ac) was used to identify the acetylation status of tumor cells upon Cephaeline administration. The presence of cancer stem cells was evaluated by the identification of ALDH enzymatic activity by flow cytometry and through functional assays using in vitro tumorsphere formation. RESULTS A single administration of Cephaeline resulted in reduced viability of MEC cells along with the halt on tumor growth and cellular migration potential. Administration of Cephaeline resulted in chromatin histone acetylation as judged by the increased levels of H3K9ac and disruption of tumorspheres formation. Interestingly, ALDH levels were increased in UM-HMC-1 and UM-HMC-3A cell lines, while UM-HMC-2 showed a reduced enzymatic activity. CONCLUSION Cephaeline has shown anti-cancer properties in all MEC cell lines tested by regulating tumor cells' viability, migration, proliferation, and disrupting the ability of cancer cells to generate tumorspheres.
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Affiliation(s)
- Luan César Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | - Vivian Petersen Wagner
- Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Manoela Domingues Martins
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil.,Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | - Guilherme Zweig Rocha
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | - Gilberto de Castro Júnior
- Clinical Oncology Service, São Paulo State Cancer Institute (ICESP), School of Medicine of the University of São Paulo, São Paulo, Brazil
| | - Luiz Paulo Kowalski
- Department of Head and Neck Surgery, Faculty of Medicine, Head and Neck Surgery and Otorhinolaryngology Department, A C Camargo Cancer Center, Universidade de São Paulo, São Paulo, Brazil
| | - Jacques E Nor
- Department of Cariology, Restorative Sciences, Endodontics, School of Dentistry, University of Michigan, Ann Arbor, Michigan, USA
| | - Cristiane H Squarize
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Rogerio Moraes Castilho
- Laboratory of Epithelial Biology, Department of Periodontics and Oral Medicine, University of Michigan School of Dentistry, Ann Arbor, Michigan, USA
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
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23
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Alves LDB, de Melo AC, Farinha TA, de Lima Araujo LH, Thiago LDS, Dias FL, Antunes HS, Amaral Eisenberg AL, Santos Thuler LC, Cohen Goldemberg D. A systematic review of secretory carcinoma of the salivary gland: where are we? Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:e143-e152. [PMID: 32493686 DOI: 10.1016/j.oooo.2020.04.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/22/2020] [Accepted: 04/11/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this systematic review was to describe the epidemiology, diagnostic criteria, differential diagnosis, treatment, prognostic factors, and treatment outcomes of secretory carcinoma. STUDY DESIGN A comprehensive search of Lilacs, PubMed, Science Direct, and Web of Science databases was conducted to identify all case reports, letter to the editor, and histopathologic reclassifications regarding salivary gland secretory carcinoma published in English, Spanish, French, and Portuguese. RESULTS The final analysis included 119 studies, which totaled 642 secretory carcinoma diagnoses, with 239 case reports and 403 diagnostic reclassifications, mostly in the United States. The age range was 5 to 87 years, and cases were predominantly in males (58.7%) and mostly affecting the parotid glands (73.7%). The disease usually presents as a slow-growing, painless mass. The main differential diagnosis is acinic cell carcinoma, and the tumor is usually treated with surgery. The prognosis is considered favorable, although there have been reports of local recurrences, distant metastases, and deaths. CONCLUSIONS It is important that clinicians become aware of this salivary gland neoplasm and report clinical data, clinical course, management and long-term follow-up. There is an urgent need to conduct more clinical trials, especially on tropomyosin receptor kinase (TRK) inhibitors and other potential target therapy modalities.
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Affiliation(s)
| | | | - Thayana Alves Farinha
- Scientific Initiation Student, Clinical Research Division, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA)
| | | | - Leandro de Souza Thiago
- Clinical Research Division, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA)
| | - Fernando Luiz Dias
- Head and Neck Surgery Service, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA)
| | | | | | | | - Daniel Cohen Goldemberg
- Clinical Research Division, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA).
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24
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Basset CA, Rappa F, Lentini VL, Barone R, Pitruzzella A, Unti E, Cappello F, Conway de Macario E, Macario AJL, Leone A. Hsp27 and Hsp60 in human submandibular salivary gland: Quantitative patterns in healthy and cancerous tissues with potential implications for differential diagnosis and carcinogenesis. Acta Histochem 2021; 123:151771. [PMID: 34419757 DOI: 10.1016/j.acthis.2021.151771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 08/10/2021] [Indexed: 11/17/2022]
Abstract
Tumors of the submandibular salivary gland (SMG) are uncommon but sufficiently frequent for the physician to consider them in routine examinations and for the pathologist to be prepared to differentiate them from other tissue abnormalities. However, scarcity of specimens makes training difficult, a situation compounded by the lack of accepted universal diagnostic guidelines. Furthermore, there is little information on the chaperone system (CS) of the gland, despite the increasing evidence of its participation in carcinogenesis as a biomarker for diagnosis and patient follow up, and in the mechanisms by which the tumor cells thrive. We are investigating this aspect of various tumors, and here we describe standardized methods for assessing the tissue levels of two chaperones, Hsp27 and Hsp60, in normal SMG and its tumors. We present illustrative results obtained with immunohistochemistry (IHC) and immunofluorescence-confocal microscopy (IF-CM), which we propose as a platform onto which a data base could be built by adding new information and which would provide material for developing guidelines for tumor identification and monitoring. The initial findings are encouraging in as much as the tumors surveyed showed quantitative patterns of Hsp27 and Hsp60 that distinguished tumoral from normal tissue and certain tumors from the others, and the results from IHC were confirmed by IF-CM.
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Affiliation(s)
- Charbel A Basset
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, Palermo, Italy.
| | - Francesca Rappa
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, Palermo, Italy.
| | | | - Rosario Barone
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, Palermo, Italy.
| | - Alessandro Pitruzzella
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy; Consorzio Universitario Di Caltanissetta, University of Palermo, Caltanissetta, Italy.
| | | | - Francesco Cappello
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, Palermo, Italy; Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy; Department of Biology, College of Science and Technology, Temple University, Philadelphia, PA, USA.
| | - Everly Conway de Macario
- Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy; Department of Microbiology and Immunology, School of Medicine, University of Maryland at Baltimore-Institute of Marine and Environmental Technology (IMET), Baltimore, MD, USA.
| | - Alberto J L Macario
- Euro-Mediterranean Institute of Science and Technology (IEMEST), Palermo, Italy; Department of Microbiology and Immunology, School of Medicine, University of Maryland at Baltimore-Institute of Marine and Environmental Technology (IMET), Baltimore, MD, USA.
| | - Angelo Leone
- Department of Biomedicine, Neuroscience and Advanced Diagnostics, Institute of Human Anatomy and Histology, University of Palermo, Palermo, Italy.
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Gontarz M, Urbańska-Gąsiorowska M, Bargiel J, Gąsiorowski K, Marecik T, Szczurowski P, Zapała J, Wyszyńska-Pawelec G. Sublingual gland neoplasms: clinicopathological study of 8 cases. Med Oral Patol Oral Cir Bucal 2021; 26:e626-e631. [PMID: 34415003 PMCID: PMC8412453 DOI: 10.4317/medoral.24634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 06/21/2021] [Indexed: 12/02/2022] Open
Abstract
Background Sublingual gland neoplasms are very rare and the majority of them are malignant. The aim of this study was to evaluate the clinical course, treatment, and outcomes of these uncommon neoplasms based on the authors’ experience and the recent literature. Material and Methods The medical charts of 8 patients with primary epithelial sublingual gland tumors treated between 1994 and 2020 were reviewed. Results Malignant tumors comprised 75% (6/8) of cases. Adenoid cystic carcinoma was the most common (50%, 3/6) and characterized by high risk of local recurrence and lung metastasis. Pleomorphic adenoma was the only representative of benign tumors with no evidence of local recurrence in follow up. Conclusions Treatment of choice of sublingual gland tumors is surgery. However, due to the fact that adenoid cystic carcinoma is the most common malignancy with poor prognosis, surgical treatment should be combined with postoperative radiotherapy. Benign sublingual tumors are less common and treatment of choice in these cases is tumor resection together with sublingual gland. Key words:Salivary gland neoplasms, sublingual gland, pleomorphic adenoma, adenoid cystic carcinoma, mucoepidermoid carcinoma.
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Affiliation(s)
- M Gontarz
- Department of Cranio-Maxillofacial Surgery Jagiellonian University Medical College, University Hospital 2 Jakubowskiego Street, 30-688 Cracow, Poland
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26
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Cunha JLS, Peñalonzo MA, Soares CD, Andrade BABD, Romañach MJ, Almeida OPD, Carlos R. Oncocytic Lipoadenoma: Report of 3 Rare Cases Involving the Parotid Gland, Including a Synchronous Presentation With Paraganglioma of the Right Carotid Bifurcation and Literature Review. Int J Surg Pathol 2021; 30:91-98. [PMID: 34057368 DOI: 10.1177/10668969211021966] [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: 11/16/2022]
Abstract
Oncocytic lipoadenoma (OL) is a rare salivary gland tumor characterized by the presence of oncocytic cells and mature adipose tissue. To date, only 30 cases of OL have been reported in the English-language literature. We present 3 additional OL cases involving the parotid, including a synchronous presentation with paraganglioma of the right carotid bifurcation. Microscopically, both the OLs were composed of a mixed population of oncocytes and adipocytes in varying proportions surrounded by a thin, connective tissue fibrous capsule. Oncocytes were positive for pan-cytokeratins (CKs) AE1/AE3, epithelial membrane antigen, CK5, CK7, CK14, CK18, and CK19. Calponin, p63, alpha-smooth muscle actin, and carcinoembryonic antigen were negative. Vimentin and S-100 protein were positive only in adipose cells. Despite distinctive morphologic features, OL is often misdiagnosed, given its rarity. We hope to contribute to surgeons' and pathologists' awareness and knowledge regarding the existence of this tumor and provide adequate management through conservative surgical excision.
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Affiliation(s)
- John L S Cunha
- Piracicaba Dental School, 28132University of Campinas (UNICAMP), Piracicaba, Brazil
| | | | - Ciro D Soares
- Piracicaba Dental School, 28132University of Campinas (UNICAMP), Piracicaba, Brazil
| | - Bruno A B de Andrade
- School of Dentistry, 28125Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | - Mário J Romañach
- School of Dentistry, 28125Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil
| | | | - Roman Carlos
- Integra Cancer Institute, Guatemala City, Guatemala
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27
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Gontarz M, Bargiel J, Gąsiorowski K, Marecik T, Szczurowski P, Zapała J, Wyszyńska-Pawelec G. Epidemiology of Primary Epithelial Salivary Gland Tumors in Southern Poland-A 26-Year, Clinicopathologic, Retrospective Analysis. J Clin Med 2021; 10:1663. [PMID: 33924553 PMCID: PMC8070067 DOI: 10.3390/jcm10081663] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/01/2021] [Accepted: 04/10/2021] [Indexed: 01/09/2023] Open
Abstract
(1) Background: Epidemiological studies of epithelial salivary gland neoplasms are difficult to conduct effectively due to tumor rarity, histological heterogeneity, tumor location diversity, and a lack of national registries collecting data. This study presents 26 years of epidemiological data from a single institution in southern Poland that estimates incidence rates of primary epithelial salivary gland tumors. (2) Methods: The charts of 805 patients with epithelial salivary gland tumors were retrospectively reviewed. (3) Results: Pleomorphic adenomas occurred less frequently in elderly patients; however, Warthin tumors were more common (p < 0.001). Pediatric patients mainly suffered from mucoepidermoid carcinoma. The estimated crude and European age-standardized incidence rates of all primary epithelial salivary gland tumors were 6.7 and 6.02 per 100,000 population, respectively. The incidence rates of salivary gland tumors increased in recent years; however, this is attributed to an increase in benign tumors (p < 0.001). (4) Conclusions: The incidence of primary epithelial salivary gland tumors in southern Poland has increased over the past 26 years. This increase is attributed to a rise in the number of patients with benign tumors, particularly Warthin tumors in elderly patients. Moreover, the incidence of malignant salivary gland tumors appears to be higher in pediatric patients.
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Affiliation(s)
- Michał Gontarz
- Department of Cranio-Maxillofacial Surgery, Jagiellonian University Medical College, 31-008 Cracow, Poland; (J.B.); (K.G.); (T.M.); (P.S.); (J.Z.); (G.W.-P.)
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28
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Thimsen V, Goncalves M, Koch M, Mantsopoulos K, Hornung J, Iro H, Schapher M. The current value of quantitative shear wave sonoelastography in parotid gland tumors. Gland Surg 2021; 10:1374-1386. [PMID: 33968689 DOI: 10.21037/gs-20-837] [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: 11/06/2022]
Abstract
Background The preoperative differentiation between salivary gland tumor entities using computed tomography, magnetic resonance imaging (MRI) and ultrasound (US) is still limited. Biopsies are often regarded as indispensable for properly characterizing these various lesions. The aim of this study was to analyze the value of acoustic radiation force impulse (ARFI) sonoelastography as an US differentiation tool when examining parotid gland (PG) lesions. Methods We included 104 patients with PG masses in this study, employing two different US devices using quantitative ARFI-sonoelastography (Siemens Acuson-S3000, n=59; Siemens Acuson-Sequoia, n=45). The ability of sonoelastographic measurements to differentiate between different neoplasms was compared and analyzed for both US machines. Results Quantitative shear wave sonoelastography is limited in its ability to reliably differentiate between tumor entities of the PG as a stand-alone parameter. Measurement results were unsystematically distributed and not transferable between the two US devices. A significant differentiation of benign and malignant lesions was not possible with either US machine (S3000: P=0.770, Sequoia: P=0.382). A differentiation between pleomorphic adenomas (PA) and Warthin tumors was only possible with the Acuson S3000 system (P=0.001, Spearman-Rho =0.492, sensitivity 73.9%, specificity 65.0%). Conclusions A reliable identification and differentiation of PG tumors as well as clinical treatment decisions cannot be made with the sole use of ARFI-sonoelastography. The results emphasize the device-dependence and high error-proneness of this US technique when examining lesions of the PG.
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Affiliation(s)
- Vivian Thimsen
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Erlangen, University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Miguel Goncalves
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Aachen, RWTH, Aachen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Erlangen, University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Erlangen, University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Joachim Hornung
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Erlangen, University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Erlangen, University of Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Mirco Schapher
- Department of Otorhinolaryngology, Head and Neck Surgery, Universitätsklinikum Erlangen, University of Erlangen-Nürnberg (FAU), Erlangen, Germany
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Louredo BVR, Santos-Silva AR, Vargas PA, Ajudarte Lopes M, Martins MD, Guerra ENDS, Prado Ribeiro AC, Brandão TB, de Mendonça RMH, Kowalski LP, Speight PM, Khurram SA, Pérez-de-Oliveira ME. Clinicopathological analysis and survival outcomes of primary salivary gland tumors in pediatric patients: A systematic review. J Oral Pathol Med 2021; 50:435-443. [PMID: 33314344 DOI: 10.1111/jop.13151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Salivary gland tumors are a diverse group of uncommon neoplasms that are rare in pediatric patients. The aim of this study was to evaluate the clinicopathological profile and survival outcomes of pediatric patients affected by salivary gland tumors. MATERIALS AND METHODS An extensive search was carried out using the MEDLINE/PubMed, EMBASE, Scopus databases, and grey literature. The risk of bias was available in all papers included. RESULTS A total of 2,830 articles were initially retrieved with 54 remaining for data extraction, resulting in 2,937 cases. This comprised forty-five case series' and nine cohort studies. These tumors were slightly more prevalent in females (57.4%). The patients' age ranged from 0.3 to 19 years old, with a mean age of 13.3 years. Parotid was the most affected site (81.9%), and 99.2% of cases clinically exhibited a swelling. Presence of pain/tenderness was reported in 13.5% of the cases, with an average duration of 12.6 months for the appearance of symptoms. Most of the reported cases were malignant tumors (75.4%), with mucoepidermoid carcinoma the most common tumor of all tumors (44.8%), followed by pleomorphic adenoma (24.1%). Surgery alone was the leading treatment choice in 74.9% cases, and the 5-year overall survival rate of patients was 93.1%. Patients with symptoms (P = .001), local recurrence (P < .001), metastasis (P < .001), and those not undergoing surgery or surgery combined with radiotherapy (P < .001) showed lower survival rates. CONCLUSION The pediatric patients present a high frequency of malignant salivary neoplasms and a high overall survival rate.
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Affiliation(s)
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Pablo Agustin Vargas
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil
| | - Manoela Domingues Martins
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.,Department of Oral Pathology, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil
| | | | - Ana Carolina Prado Ribeiro
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.,Dental Oncology Service, São Paulo State Cancer Institute, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Thaís Bianca Brandão
- Dental Oncology Service, São Paulo State Cancer Institute, School of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Luiz Paulo Kowalski
- Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas, Piracicaba, Brazil.,Department of Head and Neck Surgery and Otorhinolaryngology, AC Camargo Cancer Center, São Paulo, Brazil.,Department of Head and Neck Surgery, School of Medicine, University of São Paulo, São Paulo, Brazil
| | - Paul M Speight
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
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Santana BW, Silva LP, Serpa MS, Borges MD, Moura SR, Silveira MM, Sobral AP. Incidence and profile of benign epithelial tumors of salivary glands from a single center in Northeast of Brazil. Med Oral Patol Oral Cir Bucal 2021; 26:e108-e113. [PMID: 33247571 PMCID: PMC7806355 DOI: 10.4317/medoral.24056] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 11/16/2020] [Indexed: 11/21/2022] Open
Abstract
Background Benign tumors of the salivary glands are a group of lesions with varied histopathological and clinical spectrum. The aim was to determine the incidence and clinicopathological characteristics of benign salivary gland neoplasms diagnosed between 2007 and 2016 in a single center located in northeastern Brazil.
Material and Methods Records regarding sex, age, anatomical location, histopathological subtype and treatment were retrieved, and data were analyzed using the Stata/IC software (version 12.0).
Results There were above 7,100 cases of neoplasms in the head and neck region, of which 403 corresponded to salivary gland neoplasms. Of these, 238 (59%) were benign, being pleomorphic adenoma (PA) the most frequent neoplasm (n=178; 74.8%), followed by Warthin's tumor (WT) (n=23; 9.7%). Overall, most cases occurred in females (n=136; 57.1%) and age ranged from 11 to 83 years. The parotid gland (n=188; 79%) was the most common anatomical site, and all patients were treated by surgical excision. Of the cases diagnosed as PA, malignant transformation to carcinoma ex-pleomorphic adenoma (CAEXPA) occurred in 7 (3.9%) cases.
Conclusions The present study confirmed the clinical and demographic profile of benign salivary gland neoplasms, which contributes to the continuous knowledge of current data about these lesions. Key words:Salivary gland, benign neoplasms, epidemiology.
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Affiliation(s)
- B-W Santana
- Postgraduate Program in Dentistry, School of Dentistry, University of Pernambuco Av. General. Newton Cavalcanti, 1650 - Tabatinga Camaragibe, Zip code: 54756-220, Recife/PE, Brazil
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Incidental Cone Beam CT Finding of Juvenile Pleomorphic Adenoma. Case Rep Dent 2020; 2020:8862657. [PMID: 33312742 PMCID: PMC7719488 DOI: 10.1155/2020/8862657] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 11/08/2020] [Accepted: 11/16/2020] [Indexed: 11/17/2022] Open
Abstract
Pleomorphic adenoma is a benign mixed tumor composed of epithelial and myoepithelial cells, less commonly occurring in minor salivary glands or in children. A case of juvenile pleomorphic adenoma missed clinically and incidentally found in cone beam CT images is described. Clinical, radiographic, and histologic images are presented.
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Hiyama T, Kuno H, Sekiya K, Oda S, Kobayashi T. Imaging of Malignant Minor Salivary Gland Tumors of the Head and Neck. Radiographics 2020; 41:175-191. [PMID: 33245669 DOI: 10.1148/rg.2021200062] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Minor salivary gland carcinomas (MSGCs) are nonminor tumors in the head and neck region and account for about half of all salivary gland carcinomas. Imaging evaluation based on the anatomy of minor salivary and mucous glands in the head and neck region as well as invasion patterns in each site helps in identifying optimal treatment modalities and planning suitable treatment strategies. MSGCs can be divided radiologically into localized and invasive subtypes on the basis of the clinical utility of such categorization. Characteristic invasion patterns of the invasive type include deep submucosal extension, bone marrow infiltration, and perineural spread, which are difficult to assess clinically. MSGCs easily invade adjacent structures because of their submucosal location and may spread along the muscles, nerves, periosteum, and dura mater. Moreover, the tumor may spread into the bone marrow without obvious bone destruction. In addition to imaging classification, examining the anatomy and distribution of the minor salivary glands, including the palatal, lingual, buccal, labial, and retromolar glands, as well as other mucous glands, including the glands of the sinonasal cavity and nasopharynx, lacrimal glands, ceruminous glands, laryngeal glands, and tracheal glands, facilitates MSGC diagnosis and tumor extension assessment. The authors review the precise anatomy of the minor salivary and mucous glands in the head and neck region, discuss the MSGC imaging classifications, and describe how to evaluate the extent of MSGCs in each site on the basis of the imaging classification and invasion patterns. ©RSNA, 2020.
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Affiliation(s)
- Takashi Hiyama
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Hirofumi Kuno
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Kotaro Sekiya
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Shioto Oda
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Tatsushi Kobayashi
- From the Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan
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Cunha JLS, Hernandez-Guerrero JC, de Almeida OP, Soares CD, Mosqueda-Taylor A. Salivary Gland Tumors: A Retrospective Study of 164 Cases from a Single Private Practice Service in Mexico and Literature Review. Head Neck Pathol 2020; 15:523-531. [PMID: 33044721 PMCID: PMC8134594 DOI: 10.1007/s12105-020-01231-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/01/2020] [Indexed: 12/31/2022]
Abstract
Salivary gland tumors (SGT) represent an uncommon heterogeneous group of tumors with complex clinical and pathological characteristics. The prevalence of these lesions varies between studies but has been estimated between 3 and 6% of all tumors in the head and neck region. The present study aimed to evaluate the distribution and demographic findings of salivary gland tumors diagnosed in an oral pathology service in Mexico. A retrospective descriptive cross-sectional study was performed. A total of 164 cases of SGT from a private oral pathology service were diagnosed between 2000 and 2019 in Mexico City. All cases were reviewed histologically, and demographic data and histopathological diagnoses were collected. A total of 110 (67.1%) tumors were benign, and 54 (32.9%) were malignant. The majority of patients were female (n = 100, 61.0%) with an overall female:male ratio of 1.6:1. The minor salivary glands were affected more than the major salivary glands (68.9% vs. 25.6%). The palate (n = 67, 40.9%) was the most commonly affected site, followed by the parotid gland (n = 37, 22.6%), lips (n = 16, 9.8%), and buccal mucosa (n = 14, 8.5%). Pleomorphic adenoma (n = 88; 80.0%) and mucoepidermoid carcinoma (n = 16, 29.6%) were the most frequent benign and malignant tumors, respectively. The general features of SGT from the studied Mexican population shared some similarities and differences compared to previously reported series from various parts of the world.
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Affiliation(s)
- John Lennon Silva Cunha
- grid.411087.b0000 0001 0723 2494Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, P.O. Box. 52, Piracicaba, São Paulo 1314-903 Brazil
| | - Juan Carlos Hernandez-Guerrero
- grid.9486.30000 0001 2159 0001Facultad de Odontología, Laboratory of Immunology, Universidad Nacional Autónoma de México (UNAM), México City, México
| | - Oslei Paes de Almeida
- grid.411087.b0000 0001 0723 2494Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, P.O. Box. 52, Piracicaba, São Paulo 1314-903 Brazil
| | - Ciro Dantas Soares
- grid.411087.b0000 0001 0723 2494Oral Pathology Section, Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira 901, P.O. Box. 52, Piracicaba, São Paulo 1314-903 Brazil
| | - Adalberto Mosqueda-Taylor
- grid.7220.70000 0001 2157 0393Facultad de Odontología, Universidad Autónoma Metropolitana Xochimilco (UAM), México City, México
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de Morais EF, da Silva LP, Moreira DGL, Mafra RP, Rolim LSA, de Moura Santos E, de Souza LB, de Almeida Freitas R. Prognostic Factors and Survival in Adenoid Cystic Carcinoma of the Head and Neck: A Retrospective Clinical and Histopathological Analysis of Patients Seen at a Cancer Center. Head Neck Pathol 2020; 15:416-424. [PMID: 32779101 PMCID: PMC8134621 DOI: 10.1007/s12105-020-01210-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Accepted: 08/03/2020] [Indexed: 12/25/2022]
Abstract
Adenoid cystic carcinoma (AdCC) is a rare malignancy that accounts for approximately 1% of all head and neck cancers. This neoplasm is characterized by slow but often relentless growth and dissemination. Our aim was to retrospectively evaluate the clinical-pathological features of patients diagnosed with head and neck AdCC and to identify possible prognostic factors. This retrospective observational study analyzed 87 cases of AdCC of the head and neck. Clinical parameters (tumor size, lymph node and distant metastasis, clinical stage, and survival) were obtained from the records. Survival curves were constructed using the Kaplan-Meier method. A p value ≤ 0.05 was considered significant. There was a slight predominance of cases diagnosed in female patients (54%). The mean age at diagnosis was 51.5 years. Analysis using Cox's proportional hazards model considering 10-year disease-specific survival identified histologic pattern and presence of perineural invasion as independent prognostic variables. Primary tumor size and distant metastasis were prognostic predictors of 5- and 10-year disease-free survival. Detailed analysis of the association between clinical-pathological parameters and prognosis can assist professionals with cancer treatment planning and adequate patient management. Considering the long-term aggressive behavior of AdCC, rigorous patient follow-up is important to identify possible locoregional or distant recurrences.
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Affiliation(s)
- Everton Freitas de Morais
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Leorik Pereira da Silva
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil ,grid.411181.c0000 0001 2221 0517Health and Biotechnology Institute, Federal University of Amazonas-UFAM, Coari, AM Brazil
| | - Deborah Gondim Lambert Moreira
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Rodrigo Porpino Mafra
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Larissa Santos Amaral Rolim
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Edilmar de Moura Santos
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Lélia Batista de Souza
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
| | - Roseana de Almeida Freitas
- grid.411233.60000 0000 9687 399XDepartment of Oral Pathology, Federal University of Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, CEP 59056-000, Natal, RN Brazil
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Filho OVDO, Rêgo TJRD, Mendes FHDO, Dantas TS, Cunha MDPSS, Malta CEN, Silva PGDB, Sousa FB. Prognostic factors and overall survival in a 15-year followup of patients with malignant salivary gland tumors: a retrospective analysis of 193 patients. Braz J Otorhinolaryngol 2020; 88:365-374. [PMID: 32855094 PMCID: PMC9422552 DOI: 10.1016/j.bjorl.2020.06.016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 01/17/2023] Open
Abstract
INTRODUCTION Malignant tumors of the salivary glands are uncommon pathological entities, representing less than 5% of head and neck neoplasms. The prognosis of patients with malignant tumors of the salivary glands is highly variable and certain clinical factors can significantly influence overall survival. OBJECTIVE To analyze the clinicopathologic and sociodemographic characteristics that influence survival in patients with malignant tumors of the salivary glands METHODS: This retrospective study analyzed sex, age, race, education level, tumor location, tumor size, lymph node involvement, distant metastasis, margin status, treatment type, marital status, method of health care access and 15-year overall survival in 193 patients with malignant tumors of the salivary glands. The X², log-rank Mantel-Cox, multinomial regression and Cox logistic regression tests were used (SPSS 20.0,p < 0.05). RESULTS The most common histological types were adenocarcinoma (32.1%), adenoid cystic carcinoma (31.1%) and mucoepidermoid carcinoma (18.7%). The 15-year overall survival rate was 67.4%, with a mean of 116±6 months. The univariate analysis revealed that male sex (p = 0.026), age > 50 years (p=0.001), referral origin from the public health system (p=0.011), T stage (p= 0.007), M stage (p< 0.001), clinical stage (p< 0.001), compromised surgical margins (p= 0.013), and chemotherapy (p< 0.001) were associated with a poor prognosis. Multivariate analyses also showed that age > 50 years was independently associated with a poor prognosis (p= 0.016). The level of education was the only factor more prevalent in older patients (p= 0.011). CONCLUSIONS Patients with malignant tumors of the salivary glands older than 50 years have a worse prognosis and an independent association with a low education level.
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Affiliation(s)
- Osias Vieira de Oliveira Filho
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem, Divisão de Patologia Oral, Fortaleza, CE, Brazil
| | | | | | - Thinali Sousa Dantas
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem, Divisão de Patologia Oral, Fortaleza, CE, Brazil; Centro Universitário Christus (Unichristus), Departamento de Odontologia, Fortaleza, CE, Brazil
| | | | - Cássia Emanuella Nóbrega Malta
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem, Divisão de Patologia Oral, Fortaleza, CE, Brazil
| | - Paulo Goberlânio de Barros Silva
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem, Divisão de Patologia Oral, Fortaleza, CE, Brazil; Centro Universitário Christus (Unichristus), Departamento de Odontologia, Fortaleza, CE, Brazil.
| | - Fabrício Bitu Sousa
- Universidade Federal do Ceará, Faculdade de Farmácia, Odontologia e Enfermagem, Divisão de Patologia Oral, Fortaleza, CE, Brazil; Centro Universitário Christus (Unichristus), Departamento de Odontologia, Fortaleza, CE, Brazil
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Aro K, Korpi J, Tarkkanen J, Mäkitie A, Atula T. Preoperative evaluation and treatment consideration of parotid gland tumors. Laryngoscope Investig Otolaryngol 2020; 5:694-702. [PMID: 32864441 PMCID: PMC7444776 DOI: 10.1002/lio2.433] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Revised: 05/28/2020] [Accepted: 07/02/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND The nature of parotid tumors often remains unknown preoperatively and final histopathology may reveal unexpected malignancy. Still, the use of fine-needle aspiration cytology (FNAC) and imaging varies in the management of these tumors. METHODS We evaluated the preoperative examinations and management of all 195 parotid gland tumors diagnosed within our catchment area of 1.6 million people during 2015. RESULTS Altogether 171 (88%) tumors were classified as true salivary gland neoplasms. FNAC showed no false malignant findings, but it was false benign in 5 (2.6%) cases. Preoperative MRI was utilized in 48 patients (25%). Twenty (10%) malignancies included 16 salivary gland carcinomas. Pleomorphic adenomas accounted for 52% of all adenomas. For 24 (40%) Warthin tumors, surgery was omitted. CONCLUSION The proportion of malignancies was lower than generally presented. Our proposed guidelines include ultrasound-guided FNAC with certain limitations. MRI is warranted in selected cases, but seems unnecessary routinely.
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Affiliation(s)
- Katri Aro
- Department of Otorhinolaryngology—Head and Neck SurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Jarkko Korpi
- Department of Otorhinolaryngology—Head and Neck SurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Jussi Tarkkanen
- Department of PathologyHUSLAB, University of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Antti Mäkitie
- Department of Otorhinolaryngology—Head and Neck SurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
- Research Program in Systems Oncology, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and TechnologyKarolinska Institutet and Karolinska HospitalStockholmSweden
| | - Timo Atula
- Department of Otorhinolaryngology—Head and Neck SurgeryUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
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Poletto AG, Mello FW, Melo G, Rivero ERC. Prevalence of mucoepidermoid carcinoma among intraoral minor salivary gland tumors: A systematic review and meta-analysis. J Oral Pathol Med 2020; 49:720-726. [PMID: 32531838 DOI: 10.1111/jop.13073] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/30/2022]
Abstract
This study aimed to synthetize and critically appraise available evidence regarding mucoepidermoid carcinoma (MEC) prevalence among intraoral minor salivary gland tumors (MiSGT). Five main electronic databases and three grey literature databases were searched. The risk of bias (RoB) was assessed using the Joanna Briggs Institute Critical Appraisal Checklist for Studies Reporting Prevalence Data. Proportion meta-analyses were performed. From 1321 studies identified, 82 were included in qualitative synthesis and 80 in meta-analyses. Sixteen were classified as high, 33 as moderate, and 33 as low RoB. A total of 12 774 MiSGT were found, of which overall MEC prevalence was 16.5% (95% Confidence Interval [95% CI] = 14.8%-18.4%). Most MiSGT were found in the palate (n = 7115), although MEC pooled prevalence in this anatomic location was only 13.6% (95% CI = 11.7%-15.6%). The retromolar area presented the highest pooled prevalence (58.9%; 95% CI = 47.0%-70.3%), followed by gingiva (28.8%; 95% CI = 22.7%-35.4%) and tongue (27.2%; 95% CI = 21.2%-33.6%). Regarding geographic location, Middle East presented the highest pooled prevalence (20.8%; 95% CI = 14.8%-27.6%), followed by America (20.0%, 95% CI = 17.2%-23%) and Europe (15.6%; 95% CI = 9.2%-23.5%). Among MiSGT, the MEC overall prevalence was approximately 16.5%. Although most MiSGT were found in the palate, the retromolar area was proportionally more affected by MEC.
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Affiliation(s)
- André Goulart Poletto
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Fernanda Weber Mello
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
| | - Gilberto Melo
- Postgraduate Program in Dentistry, Federal University of Santa Catarina, Florianópolis, Brazil
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Cunha JL, Coimbra AC, Silva JV, Nascimento IS, Andrade ME, Oliveira CR, Almeida OP, Soares CD, Sousa SF, Albuquerque-Júnior RL. Epidemiologic analysis of salivary gland tumors over a 10-years period diagnosed in a northeast Brazilian population. Med Oral Patol Oral Cir Bucal 2020; 25:e516-e522. [PMID: 32388524 PMCID: PMC7338061 DOI: 10.4317/medoral.23532] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/24/2020] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Salivary gland tumors (SGT) correspond to a heterogeneous group of lesions with variable biological behavior. The present study aimed to determine the distribution and demographic findings of salivary gland neoplasms in a northeast Brazilian population. MATERIAL AND METHODS A retrospective descriptive cross-sectional study was performed. A total of 588 cases of SGT were diagnosed between 2006 and 2016 of 4 pathology services in the state of Sergipe, Brazil. All cases were reviewed, and data such as sex, age, anatomical location, and histopathological diagnosis were collected. RESULTS A total of 470 (79.9%) tumors were benign and 118 (20.1%) were malignant. The majority of the patients were females (n=328, 55.8%) with an overall female:male ratio of 1.2:1. The major salivary glands were affected more than the minor glands (69.5% vs. 30.5%). Pleomorphic adenoma (n=419, 71.3%) and mucoepidermoid carcinoma (n=29, 4.9%) were the most frequent benign and malignant tumors, respectively. In addition, both benign and malignant tumors occurred more frequently in the parotid gland (n=300, 51%, p<0.05). CONCLUSIONS The epidemiologic profile and clinical characteristics of SGT were similar to those described in other countries and other regions of Brazil. Epidemiological studies of SGT help to understand their clinical and pathological features and are essential to establish the proper management and prognosis.
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Affiliation(s)
- J-L Cunha
- Laboratory of Morphology and Experimental Pathology Institute of Technology and Research, Tiradentes University Av. Murilo Dantas, 300, Farolândia, Aracaju, SE 49032-490, Brazil
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Piwowarczyk K, Bartkowiak E, Klimza H, Greczka G, Wierzbicka M. Review and characteristics of 585 salivary gland neoplasms from a tertiary hospital registered in the Polish National Major Salivary Gland Benign Tumors Registry over a period of 5 years: a prospective study. Otolaryngol Pol 2020; 74:1-6. [PMID: 34550095 DOI: 10.5604/01.3001.0014.1261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Introduction:</b> A Polish National Major Salivary Gland Benign Tumors Registry (SGR) is a report of benign salivary gland neoplasms (SGNs) from 26 different centres in Poland, introduced in 2014. The aim of this study is to analyze demographic characteristics and clinico-pathological factors of benign SGNs treated in large tertiary institutions and to determine possible correlations between selected variables. <br><b>Material and method:</b> Analysis of 585 patients recorded in SGR and operated on for SGNs in the Department of Otolaryngology and Laryngological Surgery, University of Medical Sciences, Poznań, Poland, over a 5-year period. Patient age, sex, occupation, place of residence, tumor location, size, histology, recurrence, facial nerve function after surgery, wound healing, surgery procedure, availability of pre-operative imaging examinations, fine-needle aspiration cytology (FNAC) results were analyzed. <br><b>Results:</b> 338 females and 247 males with a mean age of 53 years were operated on. In total, 96.2% of tumors originated from the parotid and 3.8% from the submandibular gland. The most frequent primary tumor diameter was 2-4 cm (59.5%) followed by <2 cm (29.2%) and >4 cm (8.4%). Tumors of over 4 cm were frequently removed by partial superficial parotidectomy, while those under 2 cm - by extracapsullar dissection (ECD). Pleomorphic adenomas (PA) were predominant (58.8%), followed by Warthin's tumor (WT) - 37.1%. Patients with WT were on average 13.3 years older than patients with PA. <br><b>Discussion:</b> This research can be helpful to better understand the clinico-pathological features of SGNs. Long-termin hospital-based analysis is important for subsequent metaanalyses and comparisons with other centers. The reasons why not all patients' data are reported to the national SGR should be further precisely analyzed.
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Affiliation(s)
- Krzysztof Piwowarczyk
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Ewelina Bartkowiak
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Hanna Klimza
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Grażyna Greczka
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
| | - Małgorzata Wierzbicka
- Department of Otolaryngology and Laryngological Oncology, Poznan University of Medical Sciences, Poznan, Poland
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Intra-Cystic (In Situ) Mucoepidermoid Carcinoma: A Clinico-Pathological Study of 14 Cases. J Clin Med 2020; 9:jcm9041157. [PMID: 32325647 PMCID: PMC7231055 DOI: 10.3390/jcm9041157] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 04/13/2020] [Accepted: 04/14/2020] [Indexed: 12/20/2022] Open
Abstract
AIMS To report on the clinico-pathological features of a series of 14 intra-oral mucoepidermoid carcinomas showing exclusive intra-cystic growth. Materials and methods All mucoepidermoid carcinomas diagnosed in the period 1990–2012 were retrieved; the original histological preparations were reviewed to confirm the diagnosis and from selected cases, showing exclusive intra-cystic neoplastic components, additional sections were cut at three subsequent 200 m intervals and stained with Hematoxylin–Eosin, PAS, Mucicarmine and Alcian Blue, to possibly identify tumor invasion of the adjacent tissues, which could have been overlooked in the original histological preparations. Additionally, pertinent findings collected from the clinical charts and follow-up data were analyzed. Results We identified 14 intraoral mucoepidermoid carcinomas
treated by conservative surgery and with a minimum follow up of five years. The neoplasms were located in the hard palate (nine cases), the soft palate (two), the cheek (two) and the retromolar
trigone (one). In all instances, histological examination revealed the presence of a single cystic space, containing clusters of columnar, intermediate, epidermoid, clear and mucous-producing cells, the latter exhibiting distinct intra-cytoplasmic mucin production, as confirmed by PAS, Mucicarmine and Alcian Blue stains. The cysts were entirely circumscribed by fibrous connective tissue, and no solid areas or infiltrating tumor cell clusters were detected. Conservative surgical resection was performed in all cases, and no recurrences or nodal metastases were observed during follow up. Conclusions Mucoepidermoid carcinomas showing prominent (>20%) intra-cystic proliferation currently are considered low-grade tumors. In addition, we also unveil the possibility that mucoepidermoid
carcinomas, at least in their early growth phase, may display an exclusive intra-cystic component and might be considered as in situ carcinomas, unable to infiltrate adjacent tissues and metastasize.
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