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Othman BK, Steiner P, Leivo I, Skálová A. Rearrangement of KMT2A Characterizes a Subset of Pediatric Parotid Mucoepidermoid Carcinomas Arising Metachronous to Acute Lymphoblastic Leukemia. Fetal Pediatr Pathol 2023; 42:796-807. [PMID: 37517063 DOI: 10.1080/15513815.2023.2241903] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/29/2023] [Accepted: 07/12/2023] [Indexed: 08/01/2023]
Abstract
Introduction: Metachronous mucoepidermoid carcinomas (MMEC) may occur in association with childhood leukemias and lymphomas. We compared molecular abnormalities of MMEC in patients with ALL with the abnormalities found in primary mucoepidermoid carcinomas (MECs) in pediatric cases and young adults. Materials and methods: Immunohistochemical stains for p63 and SOX10, molecular alterations in MAML2 and KMT2A genes detected by FISH and/or next-generation sequencing were studied in 12 pediatric MMECs secondary to ALL and six primary MECs in pediatric patients and young adults. Follow-up information of patients in both groups was obtained. Results: KMT2A rearrangements were detected in pediatric MMECs, and they were associated with remarkable histomorphological changes, including deposits of abundant stromal collagen and intratumoral lymphoid proliferations. No KMT2A rearrangements were found in primary MECs. The prognosis of MMEC in patients with ALL, especially in KMT2A-rearranged cases, was worse than in primary MECs. Kruskal-Wallis test showed a statistically significant difference in overall survival between KMT2A-rearranged MMECs and KMT2A-intact MMECs in cases with ALL (p = 0.027). Conclusion: KMT2A-rearranged MMECs in ALL patients may have inherently more aggressive behavior, even when the histomorphology of MMEC suggests a low-grade malignancy.
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Affiliation(s)
- Bacem K Othman
- Department of Pathology, Charles University, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
| | - Petr Steiner
- Molecular Genetic Laboratory, Bioptic Laboratory, Pilsen, Czech Republic
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku, and Turku University Hospital, Turku, Finland
| | - Alena Skálová
- Department of Pathology, Charles University, Faculty of Medicine in Pilsen, Pilsen, Czech Republic
- Department of Pathology, Bioptic Laboratory, Ltd, Pilsen, Czech Republic
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Therapeutic challenges in radiation-induced salivary gland cancers. Curr Opin Otolaryngol Head Neck Surg 2021; 29:120-125. [PMID: 33394737 DOI: 10.1097/moo.0000000000000694] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE OF REVIEW To give an overview of recent advances in therapeutic approaches of radiation-induced salivary gland cancers (ri-SGCs). RECENT FINDINGS Reirradiation with protons and carbon ions demonstrated to be feasible, safe and to offer good local control rates, with the possibility of overcoming radioresistance and dosimetric issues in previously irradiated cancer patients. Chromosomal rearrangements, gene fusions and expression profiles are important to identify specific cancer subtypes and can guide tailored systemic therapy. SUMMARY Ri-SGCs are rare and heterogeneous. Patients are often heavily pretreated and at risk of toxicities, and their management remain challenging. A multidisciplinary approach in referral centers is mandatory. Knowledge about SGCs cellular and molecular mechanisms is constantly evolving. In the last years, novel advances in therapeutic approaches, such as carbon ion radiotherapy, are emerging as safe and effective options in active treatment, but further efforts are needed to offer tailored personalized treatments and to improve survival.
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Multidisciplinary Management of Radiation-Induced Salivary Gland Carcinomas in the Modern Radiotherapy Era. Cancers (Basel) 2020; 12:cancers12123769. [PMID: 33327563 PMCID: PMC7765068 DOI: 10.3390/cancers12123769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/09/2020] [Accepted: 12/10/2020] [Indexed: 12/19/2022] Open
Abstract
Simple Summary Etiopathogenesis of salivary gland cancers [SGCs] is largely unknown, even if exposition to ionizing radiation is a recognized risk factor for SGCs development. To date, exhaustive data to guide clinicians in managing patients with radiation-induced [ri] SGCs are scarce and their treatment remains challenging. The purpose of this work is to describe and to analyze clinical and histopathological features, delivered treatments, and outcome of a series of patients with ri-SGCs treated at two Italian cancer referral sites. Given the rarity of ri-SGCs, this retrospective analysis conducted on a case series of 13 patients adds further knowledge to the paucity of literature. The management of these malignancies is extremely complex requiring a multidisciplinary treatment approach. Abstract Clinical data of ri-SGCs patients treated between 2015 and 2019 at a tertiary cancer center and a national hadron therapy facility were reviewed. Latent time (LT) from first RT to ri-SGCs diagnosis, overall (OS), and disease-free survival (DFS) were assessed. Thirteen patients developed 14 ri-SGCs (one patient had 2 synchronous ri-SCGs), after a median LT of 23 years (range 16–34). Parotid was the primary site in 8 cases (57%) and salivary duct carcinoma was the most frequent histotype (29%). Nine patients (69%) underwent surgery (Sx). Among them, 4 patients (31%) underwent Sx alone, 5 received post-operative treatments: 3 (23%) photon-based (X) reRT, one (8%) protons and carbon ions, one (8%) carbon ions only. One patient (8%) received definitive XRT. The remaining 3 patients (23%) received androgen deprivation therapy. With a median follow-up of 48 months (range 24–72), median OS and PFS were 74 and 24 months, respectively. In the subgroup of AR+ ri-SGCs, median PFS and OS were 12 and 74 months, respectively. Given the rarity of ri-SGCs, this work adds further knowledge to the paucity of literature. The management of these malignancies is extremely complex requiring a multidisciplinary treatment approach.
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Ronchi A, Di Martino M, Caputo A, Zeppa P, Colella G, Franco R, Cozzolino I. Fine-Needle Aspiration Cytology Is an Effective Diagnostic Tool in Paediatric Patients with Mucoepidermoid Carcinoma as Secondary Neoplasm. Acta Cytol 2020; 64:520-531. [PMID: 32526741 DOI: 10.1159/000508395] [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: 02/05/2020] [Accepted: 04/17/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Mucoepidermoid carcinoma (MEC) is the most common malignant salivary gland tumour in paediatric population, accounting for 16% of all cases. Patients affected by a previous solid or leukaemic neoplasm during their childhood may develop a second different tumour during the follow-up. In this setting, salivary gland MEC is relatively frequent, accounting for 6% of the second neoplasms in paediatric patients. Consequently, the occurrence of salivary gland nodules in paediatric patients with a previous neoplasm should be considered an event with a high risk of malignancy that poses peculiar diagnostic challenges. SUMMARY This study was designed to define clinical and instrumental findings and morphological features of MEC on fine-needle aspiration cytology (FNAC) samples in paediatric patients with and without a previous neoplasm. Five patients under 19 years are included in this series. FNAC was performed in all patients on a parotid nodule. We have identified 2 groups of patients: (a) 2 cases with previous history of malignancy (acute lymphoblastic leukaemia and Hodgkin lymphoma) and (b) 3 cases without previous malignant neoplasms. In all cases, a final diagnosis of MEC was rendered. Key Messages: MEC may occur as a second malignancy in paediatric patients. FNAC is certainly a valid and accurate diagnostic tool for this type of neoplasm, even in the paediatric age, allowing the correct management of the patients.
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Affiliation(s)
- Andrea Ronchi
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Martina Di Martino
- Unit of Hematology-Oncology, Pediatric Department, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - Pio Zeppa
- Department of Medicine and Surgery, University of Salerno, Fisciano, Italy
| | - Giuseppe Colella
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Dental Specialty, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Renato Franco
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy,
| | - Immacolata Cozzolino
- Pathology Unit, Department of Mental and Physical Health and Preventive Medicine, University of Campania "Luigi Vanvitelli", Naples, Italy
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Hao L, Shi C, Xu Y. Comparison Between Primary and Secondary Pediatric Mucoepidermoid Carcinoma of the Head and Neck. Front Pediatr 2020; 8:473. [PMID: 32974245 PMCID: PMC7468489 DOI: 10.3389/fped.2020.00473] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives: Secondary mucoepidermoid carcinoma (MEC) of the head and neck is occasionally observed in childhood cancer survivors. The goal of this research was to compare the demographic and pathologic characteristics, as well as survival between primary and secondary MEC in children and adolescent patients. Methods: Pediatric patients (younger than 19 years old) with surgically treated MEC of the head and neck were retrospectively enrolled at the Affiliated Children's Hospital of Zhengzhou University and divided into two groups based on their cancer history. Demographic, pathologic, and survival characteristics between the two groups were compared. The main study interests were recurrence-free survival (RFS), overall survival (OS), and disease-specific survival (DSS). Results: The primary and secondary groups consisted of 63 and 15 patients, respectively. The two groups had similar distributions in terms of age, sex, tumor stage, neck lymph node stage, perineural invasion, lymphovascular invasion, p53, Bcl-2, proliferating cell nuclear antigen, carcinoembryonic antigen, and Ki-67 index. The 10-year RFS rates for the primary group and secondary group were 80 and 71%, respectively, and this difference was not significant (p = 0.464). The 10-year DSS rates for the primary group and secondary group were 83 and 82%, respectively, and this difference was also not significant (p = 0.649). The 10-year OS rates for the primary group and secondary group were 74 and 51%, respectively; this difference was significant (p = 0.023). Further Cox model analysis confirmed the independence of a previous cancer history (p = 0.043) in decreasing OS. Conclusions: Pediatric patients with secondary MEC exhibit similar demographic, pathologic, and molecular characteristics as primary patients but worse OS. These findings indicate that special disease management approaches might be needed for secondary patients.
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Affiliation(s)
- Li Hao
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Children Hospital of Zhengzhou University, Henan Children Hospital, Zhengzhou, China
| | - Caixiao Shi
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Children Hospital of Zhengzhou University, Henan Children Hospital, Zhengzhou, China
| | - Ying Xu
- Department of Otorhinolaryngology Head and Neck Surgery, The Affiliated Children Hospital of Zhengzhou University, Henan Children Hospital, Zhengzhou, China
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Mardassi A, Mathlouthi N, Hlila N, Halouani C, Mezri S, Zgolli C, Chebbi G, Mhamed RB, Akkari K, Benzarti S. Synchronous carcinoma of head and neck: 2 cases report. World J Otorhinolaryngol 2015; 5:74-77. [DOI: 10.5319/wjo.v5.i2.74] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/23/2015] [Accepted: 02/11/2015] [Indexed: 02/06/2023] Open
Abstract
Multiple primary cancers are becoming an increasingly frequent situation and are often the source of many diagnostic and therapeutic difficulties. We report the case of two patients diagnosed with head and neck synchronous carcinomas. The first case is a 33-year-old man with a history of a keratinizing squamous cell carcinoma of the eye lid and who was operated 4 mo later from a mucoepidermoid carcinoma of the submandibular salivary gland. The second case is a 71-year-old woman who underwent a total parotidectomy for a mucoepidermoïd carcinoma of the left parotid gland and who consulted 2 mo later for epistaxis. The explorations concluded to a squamous cell carcinoma of the nasopharynx. The patient had a complementary radiotherapy. No local neither distant recurrence of the two tumors has been detected after a follow-up of 36 mo in the first case and 24 mo in the second one.
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Bavle RM, Makarla S, Nadaf A, Narasimhamurthy S. Solid blue dot tumour: minor salivary gland acinic cell carcinoma. BMJ Case Rep 2014; 2014:bcr-2013-200885. [PMID: 24928927 DOI: 10.1136/bcr-2013-200885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Acinic cell adenocarcinoma (ACC) is a low-grade malignant salivary neoplasm that constitutes approximately 17% of all primary salivary gland malignancies. In the head and neck region, the parotid gland is the predominant site of origin and ACC is usually more frequent in women than men. Previous radiation exposure and familial predisposition are some of the risk factors for ACC. ACCs rarely involve minor salivary glands constituting only 13-17% of all minor salivary gland tumours. Generally, a slowly enlarging mass lesion in the tail of the parotid gland is the most frequent presentation. ACC has a significant tendency to recur, metastasise and may have an aggressive evolution. Therefore, a long-term follow-up is mandatory after treatment. Here we report the case of a woman in her 60s with an ACC in association with the labial minor salivary gland, presenting in the post-treatment period of squamous cell carcinoma of the tongue.
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Affiliation(s)
- Radhika M Bavle
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Soumya Makarla
- Department of Oral Pathology, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
| | - Afreen Nadaf
- Department of Oral Pathology, Government Dental College & Hospital, Srinagar, Jammu & Kashmir, India
| | - Srinath Narasimhamurthy
- Department of Oral Surgery, Krishnadevaraya College of Dental Sciences, Bangalore, Karnataka, India
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