Cribriform adenocarcinoma of the base of the tongue and low-grade, polymorphic adenocarcinomas of the salivary glands

Abstract

Abstract. Low-grade, polymorphic adenocarcinomas occur mainly in females and are usually associated with the small salivary glands of the palate. The tumors are malignant, but not aggressive. Regional neck as well as distant metastasis is rare and the mortality rate is low. Cribriform adenocarcinoma of the salivary glands is a rare tumor, currently ranked among low-grade, polymorphic adenocarcinomas of the salivary glands. However, it differs from carcinomas in this group as it metastasizes to the cervical lymph nodes and exhibits frequent primary localization in the small salivary glands at the base of the tongue. Despite the tendency to metastasize, patient prognosis remains favorable. A case of a 72-year-old woman with neck metastases of cribriform adenocarcinoma, of unknown primary origin, is reported. The primary tumor origin was ultimately determined using nuclear magnetic resonance, histological verification was difficult due to the presence of an intact mucosal cover over the tumor. Cribriform adenocarcinoma is known to have a number of characteristics in common with a typical low-grade, salivary gland adenocarcinoma. However, in contrast to low-grade adenocarcinomas, the tumor presented with neck lymph node metastasis.

Giant cribriform adenocarcinoma of the tongue showing PRKD3 rearrangement

“…Therefore, thyroglossal duct anlage was considered as a potential source of origin of this malignancy [1]. Since then, more that 40 well-documented cases have been described in the English literature [3,4,5,6,7,8,14,15,16]. In Poland the first case of this tumor was described by Borowski-Borowy et al in 2011 [5].…”

“…Clinically, it is an infiltrative, poorly circumscribed lesion, presenting as a submucosal tumor. All but one CAMSG developed in adults, with a wide age range (from 21 to 85 years of age) [1,5,6,7,15,16]. Recently, a CAT in a 13-year-old patient was reported [15].…”

“…Differential diagnosis of CAMSG includes papillary thyroid carcinoma (PTC, either metastatic or developing within the lingual thyroid), polymorphous low grade adenocarcinoma (PLGA) and adenoid cystic carcinoma [1,3,4,6,9].…”

“…In the 2005 World Health Organization Classification of Tumors the entity was classified as a possible variant of polymorphous lowgrade adenocarcinoma (PLGA) [2]. Since then, more than 40 cases have been described in the English literature [1,3,4,5,6,7,8]. Although originally designated as CAT and considered to be restricted to the tongue, it was later shown to arise from the minor salivary glands of the soft palate, buccal mucosa, area of the palatine tonsils, upper lip and even epiglottis [4].…”

Cribriform Adenocarcinoma of the Tongue and Minor Salivary Gland: Transoral Robotic Surgical Resection

“…Of 31 published cases, CATMSG occurred on the tongue in 21 patients. It was also found on the soft palate, retromolar trigone, upper lip, floor of the mouth, and lingual tonsils [3,4,5,6,7]. Of the 31 published cases, 19 had synchronous cervical lymph node metastases.…”