Salivary adenocarcinoma, not otherwise specified: A collection of orphans

ArticleinArchives of pathology & laboratory medicine 128(12):1385-94 · January 2005with49 Reads
DOI: 10.1043/1543-2165(2004)128<1385:SANOSA>2.0.CO;2 · Source: PubMed
Abstract
Salivary adenocarcinoma, not otherwise specified, refers to gland-forming malignancies that do not satisfy the diagnostic requirements of other "named" malignancies. To review the features of 11 patients with salivary adenocarcinoma, not otherwise specified. To also compare the diagnostic frequencies of 2 databases, one from the Mount Sinai Medical Center (New York, NY), the other from the Shanghai Ninth People's Hospital (Shanghai, People's Republic of China). Pathology files were searched to establish a database of salivary tumors. All available hematoxylin-eosin- stained slides from the resection specimens diagnosed as either adenocarcinoma, not otherwise specified, or with vague or unusual diagnoses (eg, probable carcinoma-ex-pleomorphic adenoma) were pulled from our files and reexamined. Dates of death were confirmed with the Social Security Death Index. We identified 11 patients with salivary adenocarcinoma, not otherwise specified, ranging in age from 49 to 80 years (median, 67 years), with a male preponderance. The parotid gland was the most common site of tumor origin. Ten of these tumors were high grade, and 1 was intermediate grade. Two patients were diagnosed at stage II, while the remaining patients were diagnosed at stage III or IV. Histologically, all tumors were invasive, with variable glandular differentiation and diverse architectural patterns. The diverse cytologic tumor cell types included cuboidal, columnar, epithelioid, polygonal, oncocytoid, clear, melanoma-like, mucinous, sebaceous, and plasmacytoid. Four patients died after 4 to 27 months (mean, 15 months), 1 patient is alive with disease at 12 months, 1 patient is disease-free at 14 years, and 3 patients remain disease-free after short follow-ups (10, 12, and 12 months). One patient had surgery just recently, and the remaining patient had no follow-up. Salivary adenocarcinoma, not otherwise specified, is an aggressive, high-grade malignancy, with a predisposition for the parotid gland. It is characterized by cytologic and architectural diversity and an invasive growth pattern.
    • "Li et al. published a study on salivary adenocarcinoma NOS, presenting seven cases of mucinous adenocarcinoma from 5416 salivary gland tumors (database recorded at Shanghai Ninth People's Hospital). The only data provided were their location [17] . A later publication by Tian et al. from the same Hospital added 5 cases of mucinous adenocarcinoma from 6982 salivary gland tumors [2]. "
    [Show abstract] [Hide abstract] ABSTRACT: Primary mucinous adenocarcinomas of salivary glands are very uncommon tumors. This tumor is generally localized in minor salivary glands and has usually an aggressive behavior. We present the case of a 47-year-old man with an extensive tumor in the palate, left maxillary sinus, nasal cavity and sphenoid, developed along a period of 6 months. A maxillectomy was performed and mucinous adenocarcinoma was diagnosed. Despite the rapid growth ofthe lesion, 20 months after surgery the patient showed neither metastasis nor local recurrence
    Full-text · Article · Dec 2014
    • "Data concerning the relative frequency of adenocarcinoma (NOS) vary from 1.2% to 17.8% of all salivary gland carcinomas [6,8], since in previous classifications tumours, which are currently established as more specific histologies like salivary duct carcinoma, epithelial-myoepithelial carcinoma or polymorphous low-grade adenocarcinoma, were often categorized as adenocarcinoma (NOS) [6,8]. About 40% of adenocarcinomas (NOS) are located in the minor salivary glands [7], with a relative frequency of 4.3%–10.3% of all minor gland carcinomas [3-5]. "
    [Show abstract] [Hide abstract] ABSTRACT: With the 2005 WHO classification of salivary gland tumours and its increasingly recognized diagnostic entities, the frequency of adenocarcinoma (NOS) has decreased significantly. This paper describes a fast growing adenocarcinoma (NOS), originating from the minor salivary glands of the left buccal mucosa with a rapid onset of multiple local and distant metastases, especially in the lung. A lung primary was unlikely as the tumour was characterized by positivity for cytokeratin 20 and negativity for the thyroid transcription factor-1 protein (TTF-1) in immunohistochemistry. A rare case of an adenocarcinoma (NOS) of the minor salivary glands with a rapid development and an unfavourable clinical course is reported. It shows that additional immunohistochemical analysis can decisively contribute to determine the site of the primary tumour in cases with unknown primary.
    Full-text · Article · Feb 2008
  • [Show abstract] [Hide abstract] ABSTRACT: Major salivary gland cancers are rare, with many histologic types and subtypes. The low incidence and heterogeneity of primary parotid carcinomas makes their outcome difficult to evaluate. Treatment remains primarily surgical, but optimal therapeutic regimens have yet to be fully realized. The present study reviews the experience of three Italian institutions in the treatment of primary parotid carcinomas in order to describe the clinicopathological presentation and treatment options with emphasis on radiotherapy and to analyze the factors influencing survival. The records of 110 patients with primary parotid neoplastic lesions treated at three Italian institutions from 1993 to 2004 were retrospectively reviewed. Six patients were excluded from the study: 3 received surgery alone and 3 were not assessable, for a total of 104 assessable patients. Acute and late toxicity of radiotherapy was quantified following the recommendations of the RTOG/EORTC. Survival was analyzed by the actuarial Kaplan-Meier product-limit method. The influence of selected factors on 10-year disease-specific survival was analyzed. The 104 assessable patients were treated as follows: 11 patients received radiotherapy as their only treatment (3 with a palliative purpose) and 93 had postoperative radiotherapy. Thirty-two patients underwent neck dissection: neck lymph node metastases were found in all them. Their mean age was 60 years (range, 14-92). According to the UICC/2002 TNM Classification, 8 patients were stage I, 19 stage II, 34 stage III, 25 stage IVA, 5 stage IVB, 3 recurrent and 10 not assessable (Tx). The most frequent histologies were adenoid cystic carcinoma (n = 16), mucoepidermoid carcinoma (n = 15), and acinic cell carcinoma (n = 15). Twenty-three patients had recurrences: 10 had local recurrences, 3 neck recurrences, 9 distant metastases, and 1 patient had both local recurrence and distant metastases. No factors were observed that would negatively influence the prognosis. Actuarial 10-year disease-specific survival was 71% and actuarial 10-year local control 82%. The treatment of salivary gland malignancies remains primarily surgical. Our study confirms the results of the literature with surgery and adjunctive radiotherapy in patients with advanced-stage disease. No variables were observed to influence the prognosis.
    Article · Feb 2007
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