Papillary Adenocarcinoma of Minor Salivary Gland Origin in a Child

Abstract

\s=b\A papillary adenocarcinoma with metastasis occurred in a 5-year-old child. The neoplasm arose on the anterolateral sublingual aspect of the tongue and metastasized to a submandibular lymph node. Histologically, the tumor contained broad glandular papillary projections. The tumor cells were cuboidal and had vesicular, "ground glass" nuclei. Colloidlike material was found within the stroma and lumen of the glands. To determine whether the papillary adenocarcinoma was of minor salivary gland or ectopic thyroid in origin, ultrastructural, histochemical, and immunohistochemical techniques were applied to make this clinically important distinction. Ultrastructural and immunohistochemical studies did not indicate the site of origin. Histochemical methods, however, demonstrated the colloidlike material to be sulfated mucopolysaccharide, which was nonreducible by ferric ferrocyanide. These histochemical properties and the anterolateral location identified the tumor as salivary gland in origin.Tumors of minor salivary glands and mucous membranes of the oral cavity and upper respiratory tract have a diversity of histopathologic appearances and a variety of clinical courses. The vast majority of these tumors occurs in older adults.The present case of papillary adeno¬ carcinoma is a rare variety of carcinoma of the minor salivary gland, and its occurrence in a child of 5 years is unique. Because of its rarity, histolog¬ ie features, and location on the tongue, it presented a problem in dif¬ ferentiating between a salivary gland tumor and the more common papil¬ lary carcinoma of ectopie thyroid gland. The diagnostic criteria for Fig 1.-Sublingual tumor was composed of broad papillary projections with sparsely cellular collagenous stroma. Papillary projections formed almost solid tumor mass (hematoxylin-eosin, original magnification X40).

Cribriform adenocarcinoma of the tongue: a hitherto unrecognized type of adenocarcinoma characteristically occurring in the tongue

“…reported a tumour of the tongue in a 59‐year old man which was called ‘tubular adenocarcinoma’, 20 and Crocker et al . described a 5‐year‐old boy with an adenocarcinoma, which they called ‘papillary adenocarcinoma of minor salivary gland’ 21 . Even allowing for the difficulties of proper assessment of figures in reprints, there are many similarities to the microscopic appearance of our cases.…”

Epithelial Salivary Gland Tumors in Children and Adolescents

“…Both tumors were highly differentiated cysladcnocarcinomas with mucus production. The youngest patient with an adenocarci noma was a 5-ycar-old boy with a tumor in the sublingual glands [10], Epidermoid carcinomas in children are rare [1.5. 22], We observed 2 cases of mod erately differentiated squamous cell carcino mas metastasizing to lymph nodes.…”

Cribriform Adenocarcinoma of the Tongue and Minor Salivary Glands: A Review

“…Even allowing for the difficulties of proper assessment of figures in reprints, there are many similarities to the microscopic appearance of our cases. Particularly reminiscent are the pallor and ground glass quality of the nuclei as seen in both tumors, the solid and cribriform arrangement in the first tumor [18] and the papillary appearance resulting from tumor cell detachment from the stroma as seen in the other report [19]. As a consequence therefore, we strongly suspect that if cases of CATMSG were to be excluded from the figures for PLGA, then the metastatic rate of true PLGA would be much lower.…”

“…Two other possible candidates for CATMSG were published under different names, and both carcinomas metastasized to the cervical lymph nodes. Yajima et al [18] reported a tumor of the tongue in a 59-year old man which was called ''tubular adenocarcinoma'', and Crocker et al [19] described a 5-year-old boy with an adenocarcinoma, which the authors designated ''papillary adenocarcinoma of minor salivary gland''. Even allowing for the difficulties of proper assessment of figures in reprints, there are many similarities to the microscopic appearance of our cases.…”