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.

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Last Updated 1/15/2004

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