Polymorphous low-grade adenocarcinoma of the parotid gland.
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Abstract:
Polymorphous low-grade adenocarcinoma of the salivary glands is a well-defined clinico-pathological entity which occurs almost exclusively in the oral cavity. Only few reports have documented it in the parotid gland. The authors report an additional case of de novo polymorphous low-grade adenocarcinoma of the parotid and describe the histological and immunocytochemical features of the neoplasm. The current literature is also reviewed.Keywords:
Neoplasm
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Polymorphous low-grade adenocarcinoma of the salivary glands is a well-defined clinico-pathological entity which occurs almost exclusively in the oral cavity. Only few reports have documented it in the parotid gland. The authors report an additional case of de novo polymorphous low-grade adenocarcinoma of the parotid and describe the histological and immunocytochemical features of the neoplasm. The current literature is also reviewed.
Neoplasm
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We present a rare case of metastatic adenocarcinoma of the parotid gland to the skin. Reviewing the histologic features of the primary parotid gland and comparing the microscopic sections and immunohistochemical studies, we concluded the skin tumor to be metastases from the parotid adenocarcinoma. By histologic examination alone, it is difficult to distinguish an eccrine sweat gland carcinoma from a metastatic carcinoma of the salivary gland. Immunohistochemical analysis may not be conclusive. Therefore, clinical history and clinicopathologic correlation are essential in arriving at an accurate diagnosis in these cases.
Eccrine sweat gland
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PURPOSE:To study the histopathological types of cysts of the parotid gland.METHODS:35 histological specimens of cysts of the parotid gland were observed under microscope.The histopathological types of the cysts of parotid gland were classified according to their histopathological features.RESULTS:The cysts of parotid gland were classified into 4 histopathological types.14 cases(14/35,40.0%)were simple cysts of the parotid gland,15(15/35,42.9%)were lymphoepithelial cysts,4(4/35,11.4%)were polycystic disease of the parotid gland and 2(2/35,5.7%)were epidermoid cysts or keratocysts.CONCLUSION:Cysts of the parotid gland can be classified into four histopathological types.
Histopathology
Histopathological examination
Epidermoid cyst
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Acinic cell adenocarcinoma is a malignant salivary gland neoplasm with a relatively low rate of lymphangitic spread to regional lymph nodes. Distant metastases are rare and their occurrence typically indicates an unfavorable outcome. We encountered an unusual example of acinic cell adenocarcinoma that initially presented in the lung, whereas the primary parotid carcinoma, despite extensive clinical evaluation, only became apparent 1 year after initial diagnosis. The histologic, immunohistochemical, and ultrastructural features of the tumor in the parotid gland and lung were similar. The tumor displayed an aggressive behavior resulting in death within 2 years of the initial presentation. This presentation is unique, showing that peripheral lung tumors of salivary gland type are likely to be metastatic, and careful clinical evaluation is warranted in establishing their primary site of origin.
Acinic cell carcinoma
Occult
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Basal cell adenocarcinoma, a new type of malignant tumor, was added to the classification of a salivary gland tumor by WHO in 1991. Most cases develop in major salivary glands, especially parotid glands.We report here a case of basal cell adenocarcinoma which developed in the submandibular gland of a 52 year-old man. A pathological diagnosis was based upon Haematoxylin-Eosin staining and immunohistochemistry. The specimen was obtained from total resection of the submandibular gland and upper neck dissection. The patient has survived for 3 years after operation without any signs of local recurrence of regional or distant lymph node metastasis.Clitical points at pathological diagnosis were also discussed.
Neck dissection
Basal (medicine)
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Abstract Acinic cell adenocarcinoma is a malignant salivary gland neoplasm with a relatively low rate of lymphangitic spread to regional lymph nodes. Distant metastases are rare and their occurrence typically indicates an unfavorable outcome. We encountered an unusual example of acinic cell adenocarcinoma that initially presented in the lung, whereas the primary parotid carcinoma, despite extensive clinical evaluation, only became apparent 1 year after initial diagnosis. The histologic, immunohistochemical, and ultrastructural features of the tumor in the parotid gland and lung were similar. The tumor displayed an aggressive behavior resulting in death within 2 years of the initial presentation. This presentation is unique, showing that peripheral lung tumors of salivary gland type are likely to be metastatic, and careful clinical evaluation is warranted in establishing their primary site of origin.
Acinic cell carcinoma
Occult
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The nature of adenocarcinomas of parotid gland origin seems to be still unclear because of the rarity of this lesion. A 65-year-old man with a "polymorphous adenocarcinoma" of the parotid gland is presented. This tumor is characterized by a marked diversity in the histologic manifestations, presenting dominantly solid, tubular, pseudoadenoid cystic sarcomatoid patterns. The tumor cells showed distinctive signs of high grade malignancy such as the occurrence of mitotic figures and involvements of lymphatic vessels and/or blood vessels. "Polymorphous adenocarcinoma" is a histologically distinctive neoplasm unlike other adenocarcinomas of parotid gland origin.
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Carcinosarcoma (true malignant mixed tumor) is an extremely rare tumor of the salivary gland. It is a biphasic tumor and is composed of both malignant epithelial and malignant mesenchymal component. Commonly, squamous cell carcinoma and adenocarcinoma forms the epithelial component and chondrosarcoma forms the mesenchymal component. We, hereby, report a parotid lesion in a 47 year old female that contained adenocarcinoma as epithelial component and chondrosarcoma as mesenchymal component. We report this unusual case of carcinosarcoma of parotid gland due to its rarity. It mimics benign lesions on ultrasonographic examination. On fine needle aspiration, the diagnosis of carcinosarcoma can be missed, as was in our case where it was reported as pleomorphic adenoma with atypical features. Histopathology only gives confirmatory diagnosis. In addition, a short review of literature along with possible pathogenesis of malignant mixed tumor of salivary gland is also presented. Keywords: Adenocarcinoma, Carcinosarcoma, Chondrosarcoma, Malignant mixed tumor, Salivary gland
Carcinosarcoma
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