Clear Cell Carcinoma Arising in Pleomorphic Adenoma of the Salivary Gland

Abstract

Malignant change in pleomorphic adenoma of the salivary gland is not common. Clear cell carcinoma is an extremely rare form of malignant salivary gland tumor. A case of clear cell carcinoma of the submandibular gland arising in pleomorphic adenoma is reported.

Clear Cell Carcinoma Arising from Pleomorphic Adenoma of a Minor Salivary Gland

“…1 The malignant component usually is in the form of undifferentiated carcinoma or adenocarcinoma not otherwise specified, but mucoepidermoid carcinoma, adenoid cystic carcinoma, polymorphous low grade carcinoma, CCC and acinic cell carcinoma had been reported. [1][2][3][4] This histologic subclassification has prognostic significance. 1 The above case met both criteria required for a diagnosis of carcinoma ex PA.…”

“…1 In this case, as well as in most other CCC cases and all 3 previously reported cases of CCC ex PA, tumor cells showed immunoreactivity for cytokeratin and S-100 and were negative for desmin, actin and vimentin. [1][2][3][4] Fine needle aspiration biopsy (FNAB) can appropriately categorize the majority of salivary gland neoplasms with different prognoses and treatments; however, the presence of overlapping cytologic features may lead to diagnostic confusion. This problem is more prominent in salivary gland neoplasms with a clear cell component.…”

“…1 Only 3 cases of CCC arising in PA have been described; all of them have been in extraparotid locations (2 in the submandibular region and 1 in the palate), and all patients were female. [2][3][4] Here we describe the fourth case of CCC arising in PA and the first cytologic report on this entity.…”

Low-Grade Clear Cell Carcinoma with Myoepithelial Features in the Submandibular Gland

“…CCC is now recognized as a distinct tumor species, although it had previously designated as glycogen-rich adenoma, glycogen-rich adenocarcinoma, clear cell myoepithelioma, adenomyoepithelioma, and epithelial-myoepithelial carcinoma of the intercalated ducts [1][2][3][5][6][7]. Clear cells are observed as a component of numerous benign and malignant salivary gland tumors, so this type of clear cell carcinoma in the salivary gland has been reported under various names.…”

Clear cell carcinoma of the minor salivary glands. Report of a case

“…4 The occurrence of clear cell carcinoma in a pleomorphic adenoma is not unexpected because both tumours are probably derived from intercalated ducts. [12][13][14] Although most tumours with a major clear cell component are classified as low-grade malignancy t u m o u rs, close follow-up is advisable. In the literature there are few cases of recurrence, as in this the epidermoid cells produced areas of clear cells and these were the predominant feature (Fig.…”