Orbital and skin metastases in a polymorphous low grade adenocarcinoma of the salivary gland

Abstract

We report the previously undocumented development of an orbital metastasis and skin metastases in a patient with polymorphous low grade adenocarcinoma (PLGA) 15 years after initial presentation. The clinical course, treatment and changing histological features are discussed.

Polymorphous low grade adenocarcinoma

“…There have been previous reports in the literature of distant metastasis of PLGA other than to cervical lymph nodes. 18,38 The long average follow-up in our series supports the previous assertion that patients need to be followed for more than 5 years. 25 Patients in our series developed recurrences from 2-14 years after the initial presentation, with an average 7.2 years to discovery of a recurrence.…”

Fine-needle aspiration findings in patients with polymorphous low grade adenocarcinoma of the salivary glands

“…4 -8 Its behavior is indolent, with a 10 -15 % rate of local recurrence, a regional lymph node metastasis rate of approximately 10%, and rare reports of distant spread. 9,10 These tumors are characterized by architectural diversity and cytologic uniformity. The nuclei are oval to spindled with fine chromatin and inconspicuous nucleoli.…”

Low-Grade Papillary Adenocarcinoma of the Palate: The Significance of Distinguishing it from Polymorphous Low-Grade Adenocarcinoma

“…Similarly, Colmenero et al [8] also did not find that papillary architecture was predictive of outcome. Table 2 compiles and summarizes the rates of local recurrence, regional and distant metastases, and disease-related mortality for PLGA and LGPA [7,8,12,20,21,[28][29][30][31]. We see that LGPA has significantly greater rates of local recurrence (45%) and regional metastases (35%) as compared to PLGA (23% and 10%, respectively).…”

“…With respect to the development of distant metastases, we found reports on eight patients with PLGA and two with LGPA [6] who developed DM, most commonly to the lungs, including the pleura [31], as well as the vertebrae [6], ilium [7], orbit [30], and skin [7,30] (see Table 3). However, we suspect that the rates and sites of distant metastases may be underestimated as cases of PGLA with distant metastases probably go unreported.…”