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.
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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
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
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.
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Last Updated 1/15/2004
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