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Fujii H, Noguchi T, Miura T, Fujii N, Isozaki T, Fujita A, Niki T, Matsuki M, Mori H. Magnetic resonance imaging findings of sclerosing microcystic adenocarcinoma: A case report and review of the literature. Radiol Case Rep 2023; 18:3626-3631. [PMID: 37593335 PMCID: PMC10427983 DOI: 10.1016/j.radcr.2023.07.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 07/13/2023] [Accepted: 07/21/2023] [Indexed: 08/19/2023] Open
Abstract
Sclerosing microcystic adenocarcinoma (SMA) is a rare malignant tumor of the salivary glands that closely resembles cutaneous microcystic adnexal carcinoma (MAC). It was newly listed in the 5th edition of the WHO classification of head and neck tumors. This report describes the case of a 61-year-old woman who presented with masses on the floor of the mouth. The masses showed low signal intensity on T2-weighted images (T2WI) and with low apparent diffusion coefficient (ADC) values. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) revealed a plateau or persistence after rapid initial enhancement. Histopathologically, the tumors comprised small infiltrating strands of cells that formed small ducts and cysts embedded in thick fibrous stroma, consistent with SMA. Low signal intensity on T2WI with a low ADC value and a plateau or persistence after rapid initial enhancement on DCE-MRI reflect the fibrous and cellular components of the tumor and can be considered characteristic MRI findings of SMA.
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Affiliation(s)
- Hiroyuki Fujii
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Tadahide Noguchi
- Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan
| | - Tamaki Miura
- Department of Integrative Pathology, Jichi Medical University, Tochigi, Japan
| | - Nana Fujii
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Takenori Isozaki
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Akifumi Fujita
- Department of Radiology, Haga Red Cross Hospital, Tochigi, Japan
| | - Toshiro Niki
- Department of Integrative Pathology, Jichi Medical University, Tochigi, Japan
| | - Mitsuru Matsuki
- Department of Radiology, Jichi Medical University, Tochigi, Japan
| | - Harushi Mori
- Department of Radiology, Jichi Medical University, Tochigi, Japan
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2
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Jalaly JB, Baloch ZW. Salivary gland neoplasms in small biopsies and fine needle aspirations. Semin Diagn Pathol 2023; 40:340-348. [PMID: 37085434 DOI: 10.1053/j.semdp.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 03/31/2023] [Accepted: 04/13/2023] [Indexed: 04/23/2023]
Abstract
Salivary gland neoplasms are rare and represent a diverse group of head and neck tumors. Their diagnosis in limited cellularity specimens can be challenging as many of these have overlapping clinical, radiological presentation, and pathologic features. Fine needle aspiration and/or core biopsies are more of a norm than rarity to be performed preoperatively to provide invaluable information that can guide clinical management including surgery. Even though these limited specimens may not always provide a definitive diagnosis; they have high sensitivity in confirming primary neoplasia, assessing the tumor grade, and ruling out non-surgical disease. An algorithmic pattern based approach can help narrow the differential diagnosis; leading to a definitive diagnosis with the help of specific ancillary studies.
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Affiliation(s)
- Jalal B Jalaly
- Perelman School of Medicine Department of Pathology, Hospital of the University of Pennsylvania, 6 Founders, 3400 Spruce Street, Philadelphia, PA 19103 United States.
| | - Zubair W Baloch
- Perelman School of Medicine Department of Pathology, Hospital of the University of Pennsylvania, 6 Founders, 3400 Spruce Street, Philadelphia, PA 19103 United States
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[Salivary gland tumors-an overview : Advances in molecular characterization: Part II]. PATHOLOGIE (HEIDELBERG, GERMANY) 2023; 44:70-77. [PMID: 36622399 PMCID: PMC9877055 DOI: 10.1007/s00292-022-01171-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/02/2022] [Indexed: 01/10/2023]
Abstract
The second part of the article is devoted to the molecular characteristics of epithelial-myoepithelial carcinoma, polymorphous adenocarcinoma, myoepithelial carcinoma, basal cell adenocarcinoma, and salivary duct carcinoma. In addition, the new entities mucinous adenocarcinoma, sclerosing microcystic adenocarcinoma, and microsecretory adenocarcinoma are summarized. The molecular genotype can also be very helpful in diagnosing most of these entities. In this regard, overexpression of the androgen receptor and/or human epidermal growth factor receptor 2 (HER2)/neu can support diagnosis in the appropriate histopathologic context and may serve as a potential target for therapy in salivary duct carcinoma.
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Lee YY, Hwang TZ, Jin YT, Chen CC. Sclerosing Microcystic Adenocarcinoma Arising from the Tongue: A Case Report and Literature Review. Diagnostics (Basel) 2022; 12:diagnostics12051288. [PMID: 35626443 PMCID: PMC9140568 DOI: 10.3390/diagnostics12051288] [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: 04/25/2022] [Revised: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 11/28/2022] Open
Abstract
Sclerosing microcystic adenocarcinoma is a rare and recently characterized cancer that affects the mucosal surfaces of the head and neck without adnexal involvement. Histologically, microcystic adnexal carcinoma of the skin resembles it. It does, however, contain unique characteristics that merit our attention for potential diagnostic errors. Therefore, we present a 48-year-old male with sclerosing microcystic adenocarcinoma of the tongue, along with a full discussion and a brief review of pertinent literature.
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Affiliation(s)
- Yi-Ying Lee
- Department of Pathology, E-DA Hospital, I-Shou University, Kaohsiung 82445, Taiwan;
| | - Tzer-Zen Hwang
- Department of Otolaryngology-Head and Neck Surgery, E-DA Hospital, I-Shou University, Kaohsiung 82445, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
- Correspondence: (T.-Z.H.); (C.-C.C.); Tel.: +886-76-150-011 (T.-Z.H.); +886-52-765-041 (ext. 7521) (C.-C.C.)
| | - Ying-Tai Jin
- Department of Pathology, Taiwan Adventist Hospital, Taipei 10556, Taiwan;
- Department of Pathology, National Cheng Kung University Hospital, Tainan 704, Taiwan
| | - Chien-Chin Chen
- Department of Pathology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi 600, Taiwan
- Department of Cosmetic Science, Chia Nan University of Pharmacy and Science, Tainan 717, Taiwan
- Department of Biotechnology and Bioindustry Sciences, College of Bioscience and Biotechnology, National Cheng Kung University, Tainan 701, Taiwan
- Correspondence: (T.-Z.H.); (C.-C.C.); Tel.: +886-76-150-011 (T.-Z.H.); +886-52-765-041 (ext. 7521) (C.-C.C.)
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Tan GZL, Goh GH, Loh KS, Petersson F. Sclerosing microcystic adenocarcinoma of the parotid gland - The first recorded case with histo-cytopathologic correlation and a brief review of the literature. Ann Diagn Pathol 2021; 54:151806. [PMID: 34418769 DOI: 10.1016/j.anndiagpath.2021.151806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 10/20/2022]
Abstract
We present a case of a 1.0 cm primary tumor of the left parotid gland that meets the histological criteria for the recently described entity sclerosing microcystic adenocarcinoma. The patient was a 73-year-old man with a concurrent tonsillar squamous cell carcinoma, and a history of nasopharyngeal carcinoma treated with radiotherapy 23 years prior. Fine needle aspiration cytology demonstrated low-grade biphasic basaloid neoplastic cells arranged in branching sheets and clusters with minimal nuclear pleomorphism. A biphasic appearance was apparent and some of the cell clusters were bordered by a layer of flattened cells with ovoid bland nuclei. On histology, the tumor comprised small bilayered infiltrative tubules, nests, cords, and microcysts. On immunohistochemistry, EMA, SOX-10, P63, and S-100 protein highlighted a dual cell population of luminal and abluminal cells. The cells were negative for CD117, and the Ki-67 proliferation index was low (<5%).
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Affiliation(s)
- Gideon Ze Lin Tan
- Department of Pathology, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
| | - Giap Hean Goh
- Department of Pathology, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
| | - Kwok Seng Loh
- Department of Otolaryngology-Head and Neck Surgery, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
| | - Fredrik Petersson
- Department of Pathology, National University Hospital, National University Health System, Singapore 119074, 5 Lower Kent Ridge Road, Singapore.
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Rubio Gonzalez B, Ortiz MV, Ross DS, Busam KJ. Skin adnexal carcinoma with BRD3-NUTM2B fusion. J Cutan Pathol 2021; 48:1508-1513. [PMID: 34296453 PMCID: PMC10392614 DOI: 10.1111/cup.14107] [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] [Received: 04/11/2021] [Revised: 07/15/2021] [Accepted: 07/16/2021] [Indexed: 01/01/2023]
Abstract
NUT carcinomas are genetically defined epithelial neoplasms. Most tumors harbor fusions of NUTM1 with BRD4 or BRD3. Their histopathologic features have been predominantly reported as undifferentiated or poorly differentiated squamous cell carcinoma, and clinically they tend to be aggressive cancers. However, recent studies have revealed a broader spectrum of NUTM1-rearranged neoplasms with several new fusion partners and associated variable histopathologic phenotypes and clinical behaviors, including benign and malignant cutaneous poroid tumors. We report herein a primary invasive carcinoma of skin adnexal origin with a previously undescribed fusion between BRD3 and NUTM2B. The tumor occurred on the shoulder of a 7-year-old girl and was excised with negative margins. A sentinel lymph node was positive. After follow-up of 23 months, and without systemic treatment, the child remains free of tumor. This case expands the spectrum of NUT carcinomas by including a skin adnexal variant with follicular infundibular differentiation, a novel genomic aberration, and preliminary evidence of a less aggressive clinical course.
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Affiliation(s)
- Belen Rubio Gonzalez
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Michael V Ortiz
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Dara S Ross
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York, USA
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Current Diagnosis and Treatment Options for Cutaneous Adnexal Neoplasms with Apocrine and Eccrine Differentiation. Int J Mol Sci 2021; 22:ijms22105077. [PMID: 34064849 PMCID: PMC8151110 DOI: 10.3390/ijms22105077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2021] [Revised: 04/15/2021] [Accepted: 05/02/2021] [Indexed: 12/16/2022] Open
Abstract
Adnexal tumors of the skin are a rare group of benign and malignant neoplasms that exhibit morphological differentiation toward one or more of the adnexal epithelium types present in normal skin. Tumors deriving from apocrine or eccrine glands are highly heterogeneous and represent various histological entities. Macroscopic and dermatoscopic features of these tumors are unspecific; therefore, a specialized pathological examination is required to correctly diagnose patients. Limited treatment guidelines of adnexal tumor cases are available; thus, therapy is still challenging. Patients should be referred to high-volume skin cancer centers to receive an appropriate multidisciplinary treatment, affecting their outcome. The purpose of this review is to summarize currently available data on pathogenesis, diagnosis, and treatment approach for apocrine and eccrine tumors.
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