Low-Grade Cribriform Cystadenocarcinoma of the Parotid Gland: A Neoplasm With Favorable Prognosis, Distinct From Salivary Duct Carcinoma

Laco, Ján; Podhola, Miroslav; Doležalová, Helena

doi:10.1177/1066896910367649

Cited by 30 publications

(34 citation statements)

References 14 publications

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“…Delgado et al [1] detailed many salient similarities and differences between LG-SDC and conventional SDC and concluded ''that LG-SDC represents the low grade end of the spectrum of salivary duct neoplasms''. LG-SDC and conventional SDC are composed of neoplastic cells with ductal phenotype and varying degree of apocrine differentiation and AR expression [1,6,14,31,41] but exhibit significant clinicopathologic differences including the expression of S100 protein, with 84 % of LG-SDCs positive for S100 protein. In contrast, the data regarding S100 protein expression in conventional SDC is more controversial with Lewis et al [30] reporting expression in only 4 % while Brandwein et al [42] reported reaction in 100 % of cases.…”

Section: Discussionmentioning

confidence: 99%

“…In tumors with areas of invasion, this myoepithelial layer appeared discontinuous [4]. Cytokeratin 5/6 (CK5/6) also highlighted myoepithelial cells in one additional case [6].…”

Section: Immunohistochemistrymentioning

confidence: 99%

“…LG-SDC is an exceedingly rare neoplasm with approximately 39 cases published in the English literature since 1996 [1,[3][4][5][6][7][8][9][10][11][12][13].…”

Section: Clinical Featuresmentioning

confidence: 99%

“…In only three cases has S100 protein been reported as negative [7,14]. Estrogen receptor (ER), progesterone receptor (PR) and HER-2/neu are usually absent [4,6,8]. Expression of androgen receptor (AR) Fig.…”

Section: Immunohistochemistrymentioning

confidence: 99%

“…No expression of p53, epidermal growth factor receptor (EGFR), or HER-2/neu has been found in the few cases investigated [6,14].…”

Section: Molecular Pathologymentioning

confidence: 99%

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Low-Grade Salivary Duct Carcinoma or Low-Grade Intraductal Carcinoma? Review of the Literature

Kuo¹,

Weinreb²,

Perez-Ordonez³

2013

Head and Neck Pathol

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Low-grade salivary duct carcinoma (LG-SDC) is a rare neoplasm characterized by predominant intraductal growth, luminal ductal phenotype, bland microscopic features, and favorable clinical behavior with an appearance reminiscent of florid to atypical ductal hyperplasia to low grade intraductal breast carcinoma. LG-SDC is composed of multiple cysts, cribriform architecture with ''Roman Bridges'', ''pseudocribriform'' proliferations with floppy fenestrations or irregular slits, micropapillae with epithelial tufts, fibrovascular cores, and solid areas. Most of the tumor cells are small to medium sized with pale eosinophilic cytoplasm, and round to oval nuclei, which may contain finely dispersed or dark condensed chromatin. Foci of intermediate to high grade atypia, and invasive carcinoma or micro-invasion have been reported in up to 23 % of cases. The neoplastic cells have a ductal phenotype with coexpression of keratins and S100 protein and are surrounded by a layer of myoepithelial cells in noninvasive cases. The main differential diagnosis of LG-SDC includes cystadenoma, cystadenocarcinoma, sclerosing polycystic adenosis, salivary duct carcinoma in situ/highgrade intraductal carcinoma, and papillary-cystic variant of acinic cell carcinoma. There is no published data supporting the continuous classification of LG-SDC as a variant of cystadenocarcinoma. Given that most LG-SDC are noninvasive neoplasms; the terms ''cribriform cystadenocarcinoma'' and LG-SDC should be replaced by ''low-grade intraductal carcinoma'' (LG-IDC) of salivary gland or ''lowgrade intraductal carcinoma with areas of invasive carcinoma'' in those cases with evidence of invasive carcinoma.

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Section: Discussionmentioning

confidence: 99%

“…In tumors with areas of invasion, this myoepithelial layer appeared discontinuous [4]. Cytokeratin 5/6 (CK5/6) also highlighted myoepithelial cells in one additional case [6].…”

Section: Immunohistochemistrymentioning

confidence: 99%

“…LG-SDC is an exceedingly rare neoplasm with approximately 39 cases published in the English literature since 1996 [1,[3][4][5][6][7][8][9][10][11][12][13].…”

Section: Clinical Featuresmentioning

confidence: 99%

Section: Immunohistochemistrymentioning

confidence: 99%

“…No expression of p53, epidermal growth factor receptor (EGFR), or HER-2/neu has been found in the few cases investigated [6,14].…”

Section: Molecular Pathologymentioning

confidence: 99%

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Low-Grade Salivary Duct Carcinoma or Low-Grade Intraductal Carcinoma? Review of the Literature

Kuo¹,

Weinreb²,

Perez-Ordonez³

2013

Head and Neck Pathol

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A 20-Year Review of 75 Cases of Salivary Duct Carcinoma

Gilbert

Sharma

Schmitt

et al. 2016

JAMA Otolaryngol Head Neck Surg

132

144

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IMPORTANCE Salivary duct carcinoma is a rare, aggressive malignancy of the salivary glands. Owing to its rare nature, clinical data are limited, and only a few clinical studies comprise more than 50 patients. OBJECTIVE To review the University of Pittsburgh Medical Center’s experience with salivary duct carcinoma over a 20-year period, focusing on demographics, presentation, treatment, and outcome. DESIGN, SETTING, AND PARTICIPANTS This investigation was a retrospective cohort study in a multihospital institution with tertiary referral. A pathology database was reviewed for all cases of histopathologically diagnosed salivary duct carcinoma from January 1, 1995, to October 20, 2014. Patients who were referrals for pathology review only and were never seen at the institution were excluded. In total, 75 study patients were identified. The electronic medical record was reviewed for details regarding demographics, presentation, treatment, and outcome, including overall survival (OS) and disease-free survival (DFS). This study was supplemented with a review of the institution’s Head and Neck Oncology Database for further clinical details. MAIN OUTCOMES AND MEASURES Primary outcome measures consisted of OS and DFS. RESULTS The study sample comprised 75 participants with a mean age at diagnosis of 66.0 years (age range, 33–93 years), and 29% (n = 22) were female. Most primary tumors were from the parotid gland (83%), with the next most frequent site being the submandibular gland (12%). Overall, 41% of the cases were carcinoma ex pleomorphic adenoma. Rates of other histologic features included the following: perineural invasion (69%), extracapsular spread (58%), ERBB2 (formerly HER2) positivity (31%) (62% of those who were tested), and vascular invasion (61%). The median OS was 3.1 years, and the median DFS was 2.7 years. Univariate Kaplan-Meier survival analyses demonstrated that facial nerve sacrifice and extracapsular spread were associated with lower OS (2.38 vs 5.11 years and 2.29 vs 6.56 years, respectively) and DFS (2.4 vs 3.88 years and 1.44 vs 4.5 years, respectively). Although underpowered, multivariable analysis demonstrated significantly worse OS in patients with N2 and N3 disease (hazard ratio [HR] 8.42, 95% CI, 1.84–38.5) but did not show significantly worse DFS or OS for facial nerve sacrifice or extracapsular spread. There was no association between ERBB2 positivity and survival and no difference in survival between patients receiving radiation therapy vs radiation therapy plus chemotherapy. No patients had recurrence or distant metastasis after 5 disease-free years. CONCLUSIONS AND RELEVANCE Salivary duct carcinoma is an aggressive disease. A large number of cases in this review were carcinoma ex pleomorphic adenoma and had classic negative prognostic indicators, such as perineural invasion, vascular invasion, and extracapsular spread. ERBB2 positivity was not associated with any difference in survival. Facial nerve involvement appears to indicate worse prognosis, as does nodal stage higher th...

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Cytopathology approach to rare salivary gland lesions with oncocytic features

Hussein

Khader

2019

Diagnostic Cytopathology

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Salivary glands located in the head and neck area are known to have different lesions with prominent oncocytic features. Fine needle aspiration is usually the initial approach in the management of these lesions, whether they represent neoplastic or non‐neoplastic processes. Owing to the limited material present upon cytopathologic examination, knowledge of variants and subtypes of various oncocytic lesions that can occur in this area is of major importance to provide the most accurate interpretation to the patients and clinicians. In this article, we selected rare lesions of the salivary glands that may exhibit oncocytic changes, and provided a brief discussion of each one of them, with emphasis on challenges in navigating the differential diagnosis that these cases may pose, from the cytopathology standpoint.

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Low-Grade Cribriform Cystadenocarcinoma of the Parotid Gland: A Neoplasm With Favorable Prognosis, Distinct From Salivary Duct Carcinoma

Cited by 30 publications

References 14 publications

Low-Grade Salivary Duct Carcinoma or Low-Grade Intraductal Carcinoma? Review of the Literature

Low-Grade Salivary Duct Carcinoma or Low-Grade Intraductal Carcinoma? Review of the Literature

A 20-Year Review of 75 Cases of Salivary Duct Carcinoma

Cytopathology approach to rare salivary gland lesions with oncocytic features

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