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Paladini I, Schirò S, Ledda RE, Leo L, Milanese G, Epifani E, Andreone A, Capurri G, Fantoni M, Gemignani A, Gritti A, Sesenna E, Menozzi R. Percutaneous injection of sclerosant agents as an effective treatment for cystic malformations of the head and neck. Oral Maxillofac Surg 2024; 28:809-818. [PMID: 38261079 DOI: 10.1007/s10006-024-01210-9] [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: 07/06/2023] [Accepted: 01/14/2024] [Indexed: 01/24/2024]
Abstract
PURPOSE To evaluate the clinical and aesthetic outcome of percutaneous injection of sclerosant agents to treat head and neck cystic malformations (HNCM) and to assess their recurrence rate based on histology and site. METHODS Fifty-four subjects (mean age 46 years) with HNCM treated by percutaneous injection of sclerosant agents between January and December 2017 were included. Imaging and clinical data before and after the procedure were collected. Quality of Life Index, Pain Visual Analogue Scale, and Aesthetic Scale scores were measured to assess clinical and aesthetic outcomes. A size reduction of ≥ 70% assessed through the visual scale was considered significant. RESULTS Of the 54 HNCM, there were 26 (48%) lymphatic malformations (LM), 13 (24%) salivary epithelial duct cysts of the parotid gland, 12 (22%) salivary mucoceles, and 3 (5%) branchial cysts. A significant size reduction and a satisfactory clinical-aesthetic outcome were observed in all types of LM. The number of reinterventions was significantly associated with the number of lesions (p < 0.001). The lowest number of interventions was observed in macrocystic lymphatic malformations (average of 1.2 interventions). All salivary epithelial duct cysts showed a significant reduction in size, a satisfactory clinical-aesthetic outcome, and an average of 1.16 interventions per patient. Mucoceles had a worse response, with only 3/14 patients showing a satisfactory and long-lasting clinical outcome (average of 1.16 interventions). Treatment of branchial cysts showed the worst outcome with a limited clinical response (3/3). CONCLUSION Percutaneous injection of sclerosant agents may be considered as a first-line treatment for LM and salivary epithelial duct cysts.
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Affiliation(s)
- Ilaria Paladini
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Silvia Schirò
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy.
| | - Roberta Eufrasia Ledda
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy
| | - Ludovica Leo
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy
| | - Gianluca Milanese
- Unit of "Scienze Radiologiche", Department of Medicine and Surgery (DiMeC), University Hospital of Parma, Parma, Italy
| | - Enrico Epifani
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Andrea Andreone
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Giulia Capurri
- Unit of Interventional Radiology, Diagnostic Department, Hospital of Parma, Via Gramsci 14, 43126, Parma, Italy
| | - Matteo Fantoni
- Neuroradiology Unit, Diagnostic Department, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy
| | - Andrea Gemignani
- Department of Medicine and Surgery (DiMec), University of Parma, Via gramsci 14 (43126), Parma, Italy
| | - Alessandro Gritti
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma,, Parma, Italy
| | - Enrico Sesenna
- Maxillo-Facial Surgery Division, Head and Neck Department, University Hospital of Parma, Parma, Italy
| | - Roberto Menozzi
- Interventional Neuroradiology Unit, Diagnostic Department, University Hospital of Parma, Via Volturno 39, 43125, Parma, Italy
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Shukla S, Rathod PV, Pandya S, Sharma M, Patel S, Warikoo V, Salunke A, Puj K, Pandya S. Secretory Carcinoma of Salivary Glands: A Case Series and Review of Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:2645-2649. [PMID: 37636750 PMCID: PMC10447787 DOI: 10.1007/s12070-023-03560-4] [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: 01/10/2023] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Mammary analogue of secretory carcinoma is a recently described entity in WHO 2017 classification of head and neck tumours. It resembles secretory carcinoma of breast. It usually affects the salivary glands and has an indolent behaviour. We reviewed five cases of Mammary analogue of secretory carcinoma in our institute and compared our results with existing literature. All the patients underwent surgical resections and appropriate adjuvant treatment. Immunohistochemistry is an alternative cost effective tool as compared to genetic testing to differentiate secretory carcinoma from its mimickers. Surgery with adequate margins followed by adjuvant therapy is the treatment of choice.
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Affiliation(s)
- Shivang Shukla
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Priyank V. Rathod
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Shashank Pandya
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Mohit Sharma
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Shailesh Patel
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Vikas Warikoo
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Abhijeet Salunke
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Ketul Puj
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Shivam Pandya
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
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Wang Y, Wang L, Huang H, Ma J, Lin L, Liu L, Song Q, Liu A. Amide proton transfer-weighted magnetic resonance imaging for the differentiation of parotid gland tumors. Front Oncol 2023; 13:1223598. [PMID: 37664057 PMCID: PMC10471989 DOI: 10.3389/fonc.2023.1223598] [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: 05/16/2023] [Accepted: 07/28/2023] [Indexed: 09/05/2023] Open
Abstract
Purpose To assess the usefulness of amide proton transfer-weighted (APTw) imaging in the differentiation of parotid gland tumors. Materials and methods Patients with parotid gland tumors who underwent APTw imaging were retrospectively enrolled and divided into groups according to pathology. Two radiologists evaluated the APTw image quality independently, and APTw images with quality score ≥3 were enrolled. The maximum and average values of APTw imaging for tumor lesions (APTmax and APTmean) were measured. The differences in APTmax and APTmean were compared between malignant tumors (MTs) and benign tumors (BTs), as well as between MTs and pleomorphic adenomas (PAs) and between MTs and Warthin tumors (WTs). Independent-samples t-test, Kruskal-Wallis H test, and receiver operating characteristic (ROC) curve analyses were used for statistical analysis. Results Seventy-three patients were included for image quality evaluation. In this study, 32/73 and 29/73 parotid tumors were scored as 4 and 3, respectively. After excluding lesions with quality score ≤2 (12/73), the APTmean and APTmax of MTs were 4.15% ± 1.33% and 7.43% ± 1.61%, higher than those of BTs 2.74% ± 1.04% and 5.25% ± 1.54%, respectively (p < 0.05). The areas under the ROC curve (AUCs) of the APTmean and APTmax for differentiation between MTs and BTs were 0.819 and 0.821, respectively. MTs indicated significantly higher APTmean and APTmax values than those of PAs (p < 0.05) and WTs (p < 0.05). The AUCs of the APTmean and APTmax for differentiation between MTs and PAs were 0.830 and 0.815 and between MTs and WTs were 0.847 and 0.920, respectively. Conclusion Most APTw images for parotid tumors had acceptable image quality for APTw value evaluation. Both APTmax and APTmean can be used to differentiate MTs from BTs and to differentiate MTs from subtype parotid gland tumors.
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Affiliation(s)
- Yihua Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Lijun Wang
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haitao Huang
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Juntao Ma
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Liangjie Lin
- Clinical and Technical Support, Philips Healthcare, Beijing, China
| | - Lin Liu
- Department of Stomatology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Qingwei Song
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Ailian Liu
- Department of Radiology, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Meirovitz A, Shouchane-Blum K, Maly A, Bersudski E, Hirshoren N, Abrams R, Popovtzer A, Orevi M, Weinberger J. The potential of somatostatin receptor 2 as a novel therapeutic target in salivary gland malignant tumors. J Cancer Res Clin Oncol 2021; 147:1335-1340. [PMID: 33598797 DOI: 10.1007/s00432-021-03538-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 01/15/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Treatment regimens for patients with metastatic or recurrent post-radiation, locoregional, unresectable salivary cancer are limited. An inverse correlation between somatostatin receptor 2 (SSTR2) and the proliferating marker Ki-67 in neuroendocrine tumors has enabled a treatment plan for metastatic disease, utilizing peptide receptor radionuclide therapy. Interestingly, healthy salivary glands express high levels of SSTR2. In this study, the presence of SSTR2, its correlation with Ki-67 in glandular salivary carcinomas and the clinical applicability thereof was determined. METHODS In the retrospective part of this study, 76 adequate tumor tissue specimens obtained from patients diagnosed with primary or metastatic salivary carcinomas between 1988 and 2016, were collected for tissue array and histologically classified. Immunohistochemistry was performed to determine the presence, relative expression and potential correlation of SSTR2 and Ki-67. The clinical significance of SSTR2 expression was determined by prospectively assessing 68Ga-DOTATATE uptake using PET-CT imaging, in patients diagnosed with metastatic salivary gland malignant tumors between 2015 and 2016. RESULTS Sixty-three primary cancer tumors and 14 metastatic tumors were tested. All tumor subtypes were found to express SSTR2 to some extent. The highest expression was seen in Mucoepidermoid carcinoma (MEC) tissues where the majority of specimens (86.4%) expressed SSTR2. A relatively strong immunohistochemical staining score for SSTR2 was observed in MEC, adenoid cystic carcinoma and polymorphous adenocarcinoma. Interestingly, an inverse correlation between SSTR2 and Ki-67 expressions was observed (44%) in MEC tissue. Uptake of 68Ga-DOTATATE was visualized using PET-CT imaging in 40% of patients, across metastatic MEC and ACC. All observations were found to be statistically significant. CONCLUSION This study confirms the expression of SSTR2 in glandular salivary carcinomas and an inverse correlation in expression levels between SSTR2 and Ki-67. This lays a foundation for novel treatment options in salivary metastatic cancers where SSTR2 may be a potential novel therapeutic target.
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Affiliation(s)
- Amichay Meirovitz
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel.
| | - Karny Shouchane-Blum
- Hebrew University Medical School, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Alexander Maly
- Department of Pathology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Evgeniya Bersudski
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Nir Hirshoren
- Department of Otolaryngology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Ross Abrams
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Aron Popovtzer
- Sharett Institute of Oncology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Marina Orevi
- Department of Nuclear Medicine, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
| | - Jeffrey Weinberger
- Department of Otolaryngology, Hadassah University Hospital, P.O. Box 12000, 91120, Jerusalem, Israel
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Saitou M, Gaylord EA, Xu E, May AJ, Neznanova L, Nathan S, Grawe A, Chang J, Ryan W, Ruhl S, Knox SM, Gokcumen O. Functional Specialization of Human Salivary Glands and Origins of Proteins Intrinsic to Human Saliva. Cell Rep 2020; 33:108402. [PMID: 33207190 PMCID: PMC7703872 DOI: 10.1016/j.celrep.2020.108402] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/31/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022] Open
Abstract
Salivary proteins are essential for maintaining health in the oral cavity and proximal digestive tract, and they serve as potential diagnostic markers for monitoring human health and disease. However, their precise organ origins remain unclear. Through transcriptomic analysis of major adult and fetal salivary glands and integration with the saliva proteome, the blood plasma proteome, and transcriptomes of 28+ organs, we link human saliva proteins to their source, identify salivary-gland-specific genes, and uncover fetal- and adult-specific gene repertoires. Our results also provide insights into the degree of gene retention during gland maturation and suggest that functional diversity among adult gland types is driven by specific dosage combinations of hundreds of transcriptional regulators rather than by a few gland-specific factors. Finally, we demonstrate the heterogeneity of the human acinar cell lineage. Our results pave the way for future investigations into glandular biology and pathology, as well as saliva's use as a diagnostic fluid.
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Affiliation(s)
- Marie Saitou
- Department of Biological Sciences, University at Buffalo, The State University of New York, Buffalo, NY, U.S.A; Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, IL, U.S.A; Faculty of Biosciences, Norwegian University of Life Sciences, Ås, Viken, Norway
| | - Eliza A Gaylord
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, School of Dentistry, University of California, San Francisco, CA, U.S.A
| | - Erica Xu
- Department of Biological Sciences, University at Buffalo, The State University of New York, Buffalo, NY, U.S.A
| | - Alison J May
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, School of Dentistry, University of California, San Francisco, CA, U.S.A
| | - Lubov Neznanova
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY, U.S.A
| | - Sara Nathan
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, School of Dentistry, University of California, San Francisco, CA, U.S.A
| | - Anissa Grawe
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, School of Dentistry, University of California, San Francisco, CA, U.S.A
| | - Jolie Chang
- Department of Otolaryngology, School of Medicine, University of California, San Francisco, CA, U.S.A
| | - William Ryan
- Department of Otolaryngology, School of Medicine, University of California, San Francisco, CA, U.S.A
| | - Stefan Ruhl
- Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY, U.S.A.
| | - Sarah M Knox
- Program in Craniofacial Biology, Department of Cell and Tissue Biology, School of Dentistry, University of California, San Francisco, CA, U.S.A.
| | - Omer Gokcumen
- Department of Biological Sciences, University at Buffalo, The State University of New York, Buffalo, NY, U.S.A.
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Abstract
There have been rapid and significant advances in diagnostic and predictive molecular techniques in recent years with profound impact on patient care. In situ hybridization (ISH) studies have become well entrenched in surgical pathology practice and their role in the evaluation of HER2 in breast carcinoma and their diagnostic utility in soft tissue pathology are well known. Fluorescent ISH is being increasingly used in other sites such as the head and neck and the gynecologic tract. Like most tests in surgical pathology, ISH studies require good quality tissue, correlation with clinical and histopathologic findings, and adherence to guidelines for optimal assay performance and interpretation. Although ISH studies are largely performed in tertiary centers, the tissue is often processed by a variety of laboratories and the referring pathologists are required to discuss the need, relevance, and significance of these tests and the results with their clinical colleagues. Here we review the predictive and diagnostic utility of fluorescent ISH studies in a variety of organ systems, the preanalytical factors that may affect the results, and the pitfalls in the interpretation that all practicing surgical pathologists should be aware of.
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Alamri AM, Liu X, Blancato JK, Haddad BR, Wang W, Zhong X, Choudhary S, Krawczyk E, Kallakury BV, Davidson BJ, Furth PA. Expanding primary cells from mucoepidermoid and other salivary gland neoplasms for genetic and chemosensitivity testing. Dis Model Mech 2018; 11:dmm031716. [PMID: 29419396 PMCID: PMC5818080 DOI: 10.1242/dmm.031716] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/01/2017] [Indexed: 12/15/2022] Open
Abstract
Restricted availability of cell and animal models is a rate-limiting step for investigation of salivary gland neoplasm pathophysiology and therapeutic response. Conditionally reprogrammed cell (CRC) technology enables establishment of primary epithelial cell cultures from patient material. This study tested a translational workflow for acquisition, expansion and testing of CRC-derived primary cultures of salivary gland neoplasms from patients presenting to an academic surgical practice. Results showed that cultured cells were sufficient for epithelial cell-specific transcriptome characterization to detect candidate therapeutic pathways and fusion genes, and for screening for cancer risk-associated single nucleotide polymorphisms (SNPs) and driver gene mutations through exome sequencing. Focused study of primary cultures of a low-grade mucoepidermoid carcinoma demonstrated amphiregulin-mechanistic target of rapamycin-protein kinase B (AKT; AKT1) pathway activation, identified through bioinformatics and subsequently confirmed as present in primary tissue and preserved through different secondary 2D and 3D culture media and xenografts. Candidate therapeutic testing showed that the allosteric AKT inhibitor MK2206 reproducibly inhibited cell survival across different culture formats. By contrast, the cells appeared resistant to the adenosine triphosphate competitive AKT inhibitor GSK690693. Procedures employed here illustrate an approach for reproducibly obtaining material for pathophysiological studies of salivary gland neoplasms, and other less common epithelial cancer types, that can be executed without compromising pathological examination of patient specimens. The approach permits combined genetic and cell-based physiological and therapeutic investigations in addition to more traditional pathologic studies, and can be used to build sustainable bio-banks for future inquiries.This article has an associated First Person interview with the first author of the paper.
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Affiliation(s)
- Ahmad M Alamri
- Oncology, Georgetown University, Washington, DC 20057, USA
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha, 61413, Saudi Arabia
| | - Xuefeng Liu
- Pathology, Center for Cell Reprogramming, Georgetown University, Washington, DC 20057, USA
| | - Jan K Blancato
- Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
| | - Bassem R Haddad
- Oncology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
| | - Weisheng Wang
- Oncology, Georgetown University, Washington, DC 20057, USA
| | - Xiaogang Zhong
- Biostatistics, Bioinformatics and Biomathematics, Georgetown University, Washington, DC 20057, USA
| | | | - Ewa Krawczyk
- Pathology, Center for Cell Reprogramming, Georgetown University, Washington, DC 20057, USA
| | - Bhaskar V Kallakury
- Pathology, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
| | - Bruce J Davidson
- Otolaryngology - Head and Neck Surgery, MedStar Georgetown University Hospital, Washington, DC 20007, USA
| | - Priscilla A Furth
- Oncology and Medicine, Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC 20057, USA
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Abstract
Salivary gland cancers (SGCs), categorized as head and neck cancers (HNCs), constitute about 6% of head and neck cancer diagnoses based on estimate by American Head and Neck Society. Salivary gland tumors originate from different glandular cell types and are thus morphologically diverse. These tumors arise from any of the three major and various minor salivary glands. The incidence of SGCs has slowly increased during the last four decades. The etiology of SGCs is mostly unknown; however, specific gene mutations are associated with certain types of salivary tumors. Treatment options include surgical resection, radiation therapy (RT), chemotherapy, and multimodality therapy. HNC patients treated with RT often develop xerostomia and salivary hypofunction due to damaged salivary glands. In this review, we discuss etiology of SGCs, present findings on the role of autophagy in salivary tumorigenesis, review adverse effects of radiation treatment, and examine remedies for restoration of salivary function.
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Affiliation(s)
- H. Helen Lin
- Department of Diabetes and Metabolic Diseases Research, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA 91010
| | | | - David K. Ann
- Department of Diabetes and Metabolic Diseases Research, Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, CA 91010
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Badlani J, Gupta R, Balasubramanian D, Smith J, Luk P, Clark J. Primary salivary gland malignancies: a review of clinicopathological evolution, molecular mechanisms and management. ANZ J Surg 2017; 88:152-157. [DOI: 10.1111/ans.14201] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 07/12/2017] [Accepted: 07/25/2017] [Indexed: 12/12/2022]
Affiliation(s)
- James Badlani
- Sydney Head and Neck Cancer Institute; Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Sydney New South Wales Australia
- Department of Oral and Maxillofacial Surgery; Gold Coast University Hospital; Gold Coast Queensland Australia
| | - Ruta Gupta
- Department of Pathology; Royal Prince Alfred Hospital; Sydney New South Wales Australia
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
| | | | - Joel Smith
- Sydney Head and Neck Cancer Institute; Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Sydney New South Wales Australia
| | - Peter Luk
- Department of Pathology; Royal Prince Alfred Hospital; Sydney New South Wales Australia
| | - Jonathan Clark
- Sydney Head and Neck Cancer Institute; Department of Head and Neck Surgery, Chris O'Brien Lifehouse; Sydney New South Wales Australia
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
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Wang H, Malik A, Maleki Z, Rossi ED, Ping B, Chandra A, Ali SZ, Fadda G, Wang J, Arab SE, Zhao H, Jhala N. “Atypical” salivary gland fine needle aspiration: Risk of malignancy and interinstitutional variability. Diagn Cytopathol 2017; 45:1088-1094. [DOI: 10.1002/dc.23826] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 09/09/2017] [Accepted: 09/18/2017] [Indexed: 01/19/2023]
Affiliation(s)
- He Wang
- Department of Laboratory Medicine and Pathology; Temple University Hospital; Pennsylvania
| | - Aatika Malik
- Department of Laboratory Medicine and Pathology; Temple University Hospital; Pennsylvania
| | - Zahra Maleki
- Department of Pathology; The Johns Hopkins Hospital; Maryland
| | - Esther Diana Rossi
- The Department of Anatomic Pathology and Histology; the Catholic University of Rome; Rome Italy
| | - Bo Ping
- Department of Pathology; Fudan University Cancer Hospital; Shanghai People's Republic of China
| | - Ashish Chandra
- Department of Cellular Pathology; Guy's & St Thomas's Hospital NHSfT; London United Kingdom
| | - Syed Z. Ali
- Department of Pathology; The Johns Hopkins Hospital; Maryland
| | - Guido Fadda
- The Department of Anatomic Pathology and Histology; the Catholic University of Rome; Rome Italy
| | - Jindong Wang
- Department of Laboratory Medicine and Pathology; Temple University Hospital; Pennsylvania
| | - Seyedeh Elham Arab
- Department of Laboratory Medicine and Pathology; Temple University Hospital; Pennsylvania
| | - Huaqing Zhao
- Department of Laboratory Medicine and Pathology; Temple University Hospital; Pennsylvania
| | - Nirag Jhala
- Department of Laboratory Medicine and Pathology; Temple University Hospital; Pennsylvania
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Diagnostic and therapeutic modalities for 287 malignant and benign salivary tumors: A cohort study. J Craniomaxillofac Surg 2017; 45:585-588. [PMID: 28238560 DOI: 10.1016/j.jcms.2017.01.017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2016] [Revised: 11/01/2016] [Accepted: 01/11/2017] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Salivary gland tumors (SGT's), 3-10% of head/neck tumors, exhibit a striking range of morphological diversity. This minimally symptomatic disease can be challenging to diagnose, and therapeutic policy is still controversial. METHODS We compared benign and malignant cohorts according to diagnostic modality utilized and therapeutic modality administered over 20 years in a single medical center. RESULTS Of 287 cases, 216 had benign tumors and 71 had malignant tumors. Treatment was surgery-based in 99% of cases, often accompanied by radiotherapy and/or chemotherapy. Rates of imaging and biopsy for diagnosis were significantly higher in malignant than benign tumors. Fine-needle aspiration (FNA) was used in 90.3% of benign tumors. Of 71 malignant tumors, 69 underwent surgery to fully remove the malignant tumor. Adjuvant therapy included 22 neck dissections (30%), 28 radiotherapy (39.4%), 12 chemotherapy (16.9%) and 10 combined radio-chemotherapy (14.1%). Partial parotidectomy, submandibular sialoadenectomy and local excision were used in 78.1%, 8.3% and 6.9% of benign cases. Total parotidectomy, sub-total maxillectomy and wide excision were used in 16.9%, 12.7% and 22.6% of malignant cases. DISCUSSION Diagnostic and therapeutic modalities for treatment of salivary tumor at our hospital are presented and discussed with respect to others. A paradigm of therapy administered in our institute is presented.
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12
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Nagano CP, Coutinho-Camillo CM, Pinto CA, Soares FA, Santos F, Fonseca I, Lourenço SV. Cytokeratin immunoprofile of primary and metastatic adenoid cystic carcinoma of salivary glands: a report of two cases. AUTOPSY AND CASE REPORTS 2016; 6:57-63. [PMID: 28210575 PMCID: PMC5304563 DOI: 10.4322/acr.2016.056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 10/25/2016] [Indexed: 11/23/2022] Open
Abstract
Distant metastases from salivary gland tumors are considered infrequent: the incidence of distant metastases ranges from 24% to 61% according to different histotypes and to the site of the primary mass. The most common site of distant metastases due to salivary gland malignancies is the lung. From the pathology point of view, cytokeratins (CK) are important differentiation markers in salivary gland tumors, which are often used for the diagnostic process. Their employment also may be useful to identify and confirm the diagnosis of their distant metastases. We report the expression of CK in two cases of primary and metastatic adenoid cystic carcinoma (ACC) and their CK profiles of the primary and metastatic masses. Both patients—one male and one female—were diagnosed with an ACC cribriform and tubular, respectively, with lung metastases. In case 1, the metastatic mass presented the same histotype and CK profile of the primary tumor. For case 2, the metastatic lung mass was distinct from the primary mass (a solid ACC) and presented a different CK profile. Although salivary gland metastatic disease presents a poor prognosis, both patients reported herein are alive despite the presence of the disease in long-term follow-up. Therefore, the modifications seen in the CK profiles do not appear to be predictive of tumor behavior and outcome. The use of a CK profile seems to be useful to identify the nature of a distant mass and its possible correlations with a primary salivary gland tumor.
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Affiliation(s)
| | | | - Clovis Antônio Pinto
- Department of Surgical Pathology - AC Camargo Cancer Center, São Paulo/SP - Brazil
| | - Fernando Augusto Soares
- Department of Stomatology - Dental School - Universidade de São Paulo, São Paulo/SP - Brazil.; Department of Surgical Pathology - AC Camargo Cancer Center, São Paulo/SP - Brazil
| | - Filipa Santos
- Instituto Português de Oncologia - Universidade de Lisboa, Lisboa - Portugal
| | - Isabel Fonseca
- Instituto Português de Oncologia - Universidade de Lisboa, Lisboa - Portugal
| | - Silvia Vanessa Lourenço
- Department of Stomatology - Dental School - Universidade de São Paulo, São Paulo/SP - Brazil
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13
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Altered expression of apoptosis-regulating miRNAs in salivary gland tumors suggests their involvement in salivary gland tumorigenesis. Virchows Arch 2016; 470:291-299. [PMID: 27981346 DOI: 10.1007/s00428-016-2049-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 10/06/2016] [Accepted: 11/21/2016] [Indexed: 12/19/2022]
Abstract
Salivary gland tumors comprise a heterogeneous group of lesions with different histological features and diverse clinical pathophysiology. They account for about 3% of all head and neck tumors. Apoptosis plays an important role during morphogenesis of glandular structures, including that of the salivary gland. Recent studies have demonstrated that several microRNAs (miRNAs) are involved in the control of apoptosis. The aim of the present study was to determine the expression of apoptosis-related miRNAs (miR-15a, miR-16, miR-17-5p, miR-20a, miR-21, miR-29, and miR-34) and their target mRNAs in 25 pleomorphic adenomas, 23 mucoepidermoid carcinomas, and 10 non-neoplastic salivary gland samples by real-time RT-PCR. We observed upregulation of miR-15a, miR-16, miR-17-5p, miR-21, miR-29, and miR-34a in pleomorphic adenomas. The expression of miR-21 and miR-34a was upregulated in 91 and 74% of mucoepidermoid carcinomas, respectively. Downregulation of miR-20a was observed in 75% of pleomorphic adenomas and in 57% of mucoepidermoid carcinomas. APAF1, BAX, BCL2, BID, CASP2, CASP8, DIABLO , and TP53 transcripts were upregulated in both tumor types. BAD transcripts were upregulated in pleomorphic adenomas. CASP3 and CASP6 transcripts were upregulated in mucoepidermoid carcinomas. BCL2, CASP2, CASP6, and CASP8 proteins were mostly absent in mucoepidermoid carcinomas but expressed in few cells in pleomorphic adenomas. Our study provides evidence of alterations in the expression of apoptosis-regulating miRNAs in salivary gland tumors, suggesting possible involvement of these microRNAs in salivary gland tumorigenesis.
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Hellquist H, Skalova A, Azadeh B. Salivary gland hybrid tumour revisited: could they represent high-grade transformation in a low-grade neoplasm? Virchows Arch 2016; 469:643-650. [PMID: 27605055 DOI: 10.1007/s00428-016-2018-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Revised: 07/27/2016] [Accepted: 09/01/2016] [Indexed: 11/25/2022]
Abstract
Salivary gland hybrid tumour, first described in 1996, is a very rare neoplasm for which exact morphological criteria have not been universally agreed upon. In contrast, the concept of high-grade transformation (HGT) in salivary neoplasms has been widely accepted during the last decade, and the number of reported cases is rapidly increasing. A review of the literature revealed 38 cases of hybrid tumour reported in 22 publications. During approximately the same time period, well over 100 cases of HGT in salivary neoplasms have been reported. There are important histological similarities between hybrid tumours and salivary tumours with HGT. In the latter, containing one tumour component of low-grade malignancy and the other of high grade, the two tumour components are not entirely separated and appear to originate in the same area. Virtually, all cases reported as hybrid tumour had no clear lines of demarcation between the two tumour types. We are inclined to suggest that most of the 38 cases of hybrid tumours described in the literature would today better be called tumour with HGT rather than hybrid tumour. The relative proportion of the two components may vary, and the high-grade component is sometimes very small, which emphasises the importance of very generous sampling of the surgical specimen. The molecular genetic mechanisms responsible for HGT, including what used to be called hybrid tumour, remain largely unknown. Abnormalities of a few genes (including p53, C-MYC, cyclin D1, HER-2/neu) have been documented. As insufficient data exist on gene abnormalities in these lesions, conclusions as to whether or not they have a common origin and which mechanisms are involved in transformation cannot be drawn. Due to the small number of cases reported, many of which lack follow-up details; indicators of prognosis of hybrid tumours are not available, but their behaviour seems to be similar to that of tumours with HGT, i.e. an accelerated aggressive course. HGT of salivary gland neoplasms greatly influences macroscopic and microscopic evaluation of the specimen but also, given the high incidence of metastases and morbidity, carries significant treatment implications.
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Affiliation(s)
- Henrik Hellquist
- Department of Biomedical Sciences and Medicine, University of Algarve, Campus de Gambelas, 8005-139, Faro, Portugal.
| | - Alena Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University in Prague, Plzen, Czech Republic
| | - Bahram Azadeh
- Department of Pathology, Glan Clwyd Hospital, Rhyl, UK
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15
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Pham M, Eviston TJ, Clark JR. Reconstruction of limited parotidectomy defects using the dermofat graft. ANZ J Surg 2016; 87:E256-E260. [DOI: 10.1111/ans.13608] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 02/20/2016] [Accepted: 03/15/2016] [Indexed: 11/30/2022]
Affiliation(s)
- My Pham
- Department of Head and Neck Surgery; Chris O'Brien Lifehouse at RPA; Sydney New South Wales Australia
| | - Timothy J. Eviston
- Department of Head and Neck Surgery; Chris O'Brien Lifehouse at RPA; Sydney New South Wales Australia
| | - Jonathan R. Clark
- Department of Head and Neck Surgery; Chris O'Brien Lifehouse at RPA; Sydney New South Wales Australia
- Central Clinical School; The University of Sydney; Sydney New South Wales Australia
- South Western Clinical School; University of New South Wales; Sydney New South Wales Australia
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16
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Daniele L, Nikolarakos D, Keenan J, Schaefer N, Lam AKY. Clear cell carcinoma, not otherwise specified/hyalinising clear cell carcinoma of the salivary gland: The current nomenclature, clinical/pathological characteristics and management. Crit Rev Oncol Hematol 2016; 102:55-64. [DOI: 10.1016/j.critrevonc.2016.03.018] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2016] [Revised: 03/11/2016] [Accepted: 03/22/2016] [Indexed: 02/03/2023] Open
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17
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Abstract
Pulmonary salivary gland-type tumors (SGT) comprise a very small proportion of primary lung neoplasms. The most common tumors among this group are mucoepidermoid carcinoma and adenoid cystic carcinoma. Contrary to the head and neck region, benign SGT such as pleomorphic adenomas are exceedingly rare in the pulmonary system. More recently, 2 additional SGT, namely hyalinizing clear cell carcinoma and salivary duct-like carcinoma were recognized as primary lung tumors expanding the spectrum of SGT that have been described to originate in the tracheobronchial system. Primary pulmonary SGT must be clinically excluded from metastatic salivary gland neoplasms as their morphology is indistinguishable from that of their salivary gland counterparts. Little is known about the clinical behavior and best treatment approach for these unusual tumors. In this review, we provide a comprehensive summary of primary pulmonary SGT with particular emphasis on morphologic characteristics and latest developments in terms of immunohistochemical and molecular techniques.
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