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Background

This category of malignant tumors of the salivary glands is a diagnosis of exclusion, that is, all adenocarcinomas that do not fit into any previously described tumors of the salivary gland are classified here. The tumors are usually solitary and asymptomatic with 20% of tumors presenting with pain. About half of the tumors are fixed to the underlying tissue.

OUTLINE

Epidemiology  
Disease Associations  
Pathogenesis  
Laboratory/Radiologic/Other Diagnostic Testing  
Gross Appearance and Clinical Variants  
Histopathological Features and Variants  
Special Stains/Immunohistochemistry/Electron Microscopy  
Differential Diagnosis  
Prognosis  
Treatment  
Commonly Used Terms  
Internet Links  

EPIDEMIOLOGY CHARACTERIZATION
SYNONYMS Adenocarcinoma, not otherwise specified
INCIDENCE Second most common malignancy of salivary gland tumors
9% of all salivary gland tumors
16.8% of all salivary gland malignancies
AGE RANGE-MEDIAN Average is 58 years
Range of 10-93 years
3% <10 years
SEX (M:F)
46:54

 

GROSS APPEARANCE/
CLINICAL VARIANTS
CHARACTERIZATION
General 40-60% occur in the minor and major glands
VARIANTS  

 

HISTOLOGICAL TYPES CHARACTERIZATION
General Neoplastic cells form cords, sheets, nests, and islands
Ductal or glandular differentiation present in all cases
May have clear cells or oncocytic cells
VARIANTS  
MUCIN PRODUCING  

Signet-ring Cell (Mucin-Producing) Adenocarcinomas of Minor Salivary Glands.

Ghannoum JE, Freedman PD.

Department of Oral and Maxillofacial Pathology and dagger Section of Oral Pathology, New York Hospital Medical Center of Queens, Flushing, NY.
Am J Surg Pathol. 2004 Jan; 28(1): 89-93. Abstract quote  


SUMMARY: We report seven cases of minor salivary gland carcinomas characterized by the marked presence of mucin-containing signet-ring cells.

These tumors were distinctive in their microscopic appearance and displayed features not seen in any other type of salivary gland malignancy. They typically exhibited invasive growth by narrow parallel strands, randomly scattered small nests, or individually infiltrating cells. Solid, cribriform, or targetoid areas were absent, as well as papillary components. Ductal differentiation was minimal, and seen in only four cases. Degrees of cellularity varied from one area to another. The tumors were cytologically bland.

We think that these tumors represent a unique subset of intraoral minor salivary gland carcinomas.

 

DIFFERENTIAL DIAGNOSIS KEY DIFFERENTIATING FEATURES
Low grade polymorphous adenocarcinoma  
Metastatic adenocarcinoma  

 

PROGNOSIS AND TREATMENT CHARACTERIZATION
Prognostic Factors Tumors of oral cavity have more favorable prognosis
Low grade disease have longer disease free intervals and less cervical lymph node and distant metastases
Survival 15 year survival dependent upon grade

Low grade 54%
Intermediate grade 31%
High grade 3%
Metastasis 26% of cases
Usually in high grade tumors and tumors previously treated
Treatment

Surgery

Adjuvant postoperative radiation in intermediate and high grade tumors

Atlas of Tumor Pathology-Tumors of the Salivary Glands.Third Series. Fascicle 17. Ellis GL and Auclair PL. AFIP. 1996.


Commonly Used Terms

Basic Principles of Disease
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Commonly Used Terms
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Diagnostic Process
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Last Updated 1/15/2004

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