scholarly journals Current Concepts on Dedifferentiation/High-Grade Transformation in Salivary Gland Tumors

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Ana Flávia Costa ◽  
Albina Altemani ◽  
Mario Hermsen

The concept of dedifferentiation had previously been used in salivary gland carcinomas. Recently, the term “high-grade transformation” was introduced for adenoid cystic carcinoma, acinic cell carcinoma, epithelial-myoepithelial carcinoma, and polymorphous low-grade adenocarcinoma and may better reflect this phenomenon, although transformation into moderately differentiated adenocarcinoma (i.e., not “high grade”) has also been described. Among the immunohistochemical markers, Ki-67 seems to be the only one that can help distinguish between the conventional and transformed components; however, the combination of morphological criteria is still sovereign. The overexpression of p53 was observed in the transformed component in all tumor types studied, despite few cases having been demonstrated to carry mutations or deletions in TP53 gene. Genetic studies in salivary gland tumors with dedifferentiation/high-grade transformation are rare and deserve further investigation. This paper aims at providing an overview on the recent concepts in histopathological classification of salivary gland tumors, complemented by immunohistochemical and genetic findings.

2020 ◽  
Vol 9 (4) ◽  
pp. 298-302
Author(s):  
Zainab Niazi

Background: To find the frequency and clinico-pathological presentation of mucoepidermoid carcinoma (MEC).Materials and Methods:In this study, we included all the malignant salivary gland tumors. Among these the frequency of mucoepidermoid carcinoma was considered. Age, gender, histopathological grading and anatomical site of tumor were included in data analysis.Results:Out of 60 malignant salivary gland tumors reported to the histopathology department, 30 tumors were diagnosed as mucoepidermoid carcinomas. The patient’s age having mucoepidermoid carcinoma ranged from 6 to 88 years, mean age of 44.9±19.2SD. The male patients were 23 in number while female were 7. Out of 30 cases, 73.3% patients had tumor in parotid gland, while13.3% patients in submandibular gland . Other tumors were in palate, retromolar area, and in posterior 1/3rdof tongue (13.3%). According to histopathological grading 26.6% cases of MEC were of high grade, 26.6 % were intermediate grade and 36.6% were low grade.Conclusions:According to this study, the frequency of MEC was 50% among all salivary gland tumors. MEC was mostly found in parotid gland and histopathologically low grade type was the most common.


2021 ◽  
Vol 28 (3) ◽  
pp. 107-118
Author(s):  
Alena Skalova ◽  
Ilmo Leivo ◽  
Henrik Hellquist ◽  
Abbas Agaimy ◽  
Roderick H.W. Simpson ◽  
...  

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 6
Author(s):  
Kiyofumi Takabatake ◽  
Keisuke Nakano ◽  
Hotaka Kawai ◽  
Saori Yoshida ◽  
Haruka Omori ◽  
...  

Secretory carcinoma (SC) is a recently described salivary gland tumor reported in the fourth edition of World Health Organization classification of head and neck tumors. SC is characterized by strong S-100 protein, mammaglobin, and vimentin immunoexpression, and harbors a t(12;15)(p13;q25) translocation which leads to ETV6-NTRK3 fusion product. Histologically, SC displays a lobulated growth pattern and is often composed of microcystic, tubular, and solid structures with abundant eosinophilic homogenous or bubbly secretion. SC is generally recognized as low-grade malignancy with low-grade histopathologic features, and metastasis is relatively uncommon. In this case, we described a SC of hard palate that underwent high grade transformation and metastasis to the cervical lymph node in a 54-year-old patient. In addition, this case showed different histological findings between primary lesion and metastasis lesion. Therefore, the diagnosis was confirmed by the presence of ETV6 translocation. Here, we report a case that occurred SC with high-grade transformation in the palate, and a review of the relevant literature is also presented.


2017 ◽  
Vol 25 (7) ◽  
pp. 613-618 ◽  
Author(s):  
Nicole A. Cipriani ◽  
Elizabeth A. Blair ◽  
Joshua Finkle ◽  
Jennifer L. Kraninger ◽  
Christopher M. Straus ◽  
...  

Background. Salivary gland secretory carcinoma is usually a low-grade neoplasm. However, high-grade transformation can occur and has important implications for clinical outcome. Methods. A patient presented with an enlarging buccal mass. Magnetic resonance imaging (MRI) showed a tumor with a biphasic appearance along the right parotid duct. Local excision and histopathologic examination confirmed the diagnosis of secretory carcinoma with high-grade transformation. ETV6-NTRK3 translocation and loss of CDKN2A/B were identified. Results. The patient subsequently presented with cough and dyspnea and was found to have pleural metastases. Carboplatin and paclitaxel exacerbated the symptoms. Crizotinib resulted in initial symptomatic and radiographic improvement; however, the patient soon succumbed to progressive intrathoracic disease. Conclusions. High-grade salivary gland secretory carcinoma can have a biphasic appearance on MRI. Diagnosis is confirmed by the histologic appearance and associated ETV6-NTRK3 fusion. Additional molecular genetic events leading to transformation are unknown; however, loss of CDKN2A/B may have contributed. Treatment with multimodal chemotherapy was of limited benefit.


2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 245-245
Author(s):  
Namrata Vijayvergia ◽  
Patrick McKay Boland ◽  
Steven J. Cohen ◽  
Karen S. Gustafson ◽  
Harry S. Cooper ◽  
...  

245 Background: The rarity of NETs can limit clinical trial accrual to develop new therapies. Given fewer approved treatments, a better understanding of underlying biology is critical to development of and assignment of patients (pts) to clinical trials. Methods: Pts with NETs (excluding small/large cell lung cancer) of all grades at FCCC were enrolled onto a prospective IRB approved protocol that utilized an NGS platform to detect somatic mutations (SM) in 50 cancer-related genes (Cancer Code) on archived tissue from primary or metastatic sites. Genes tested included ABL1, AKT1, ALK, APC, ATM, BRAF, CDH1, CDKN2A, CSF1R, CTNNB1, EGFR, ERBB2, ERBB4, EZH2, FBXW7, FGFR1, FGFR2, FGFR3, FLT3, GNA11, GNAQ, GNAS, HNF1A, HRAS, IDH1, IDH2, JAK2, JAK3, KDR, KIT, KRAS, MET, MLH1, MPL, NOTCH1, NPM1, NRAS, PDGFRA, PIK3CA, PTEN, PTPN11, RB1, RET, SMAD4, SMARCB1, SMO,SRC, STK11, TP53 and VHL. Review of pathology specimens for grade and Ki -67 was also performed. Results: Thirty-nine pts (median age 59 y, males 46%) were enrolled from October 2013 to July 2014. Gene profiling results are available on thirty-five pts. Ki-67 score was reviewed for 31/35 tumors. 6 (20%) pts had high grade (HG) tumors (Ki-67 > 20%) and 25 (80%) had low/intermediate grade (LIG) tumors (Ki-67 ≤20%). Thirteen (37%) pts were found to have SMs and 22 (63%) did not, with 4 (12%) pts’ tumors having >1 SMs (2 HG and 2 LIG tumors). Incidence of SM was 41% (12/29) in Caucasians, 16% (1/6) in other races, 46% (6/13) in smokers and 30% (6/20) in non-smokers. Incidence of SM was 24% (6/25) in LIG NETs and 84% (5/6) in the HG NETs. Among HG tumors, 66% (4/6) harbored TP53 gene mutation and 33% (2/6) were BRAF mutation positive. Conclusions: Tumor-specific mutations are seen in a minority of low grade NETs but are common in high grade tumors. Interestingly, no mutations were identified in pts with unknown primary. Analysis of clinical outcomes based on treatment received is ongoing to assess for possible prognostic/therapeutic implications of these mutations. [Table: see text]


2021 ◽  
Vol 10 (1) ◽  
pp. 329-336
Author(s):  
Faiz Rasul ◽  
Sultan Muhammad Wahid ◽  
Iman Imran ◽  
Zainab Rizvi ◽  
Rozina Jaffar ◽  
...  

Background: Malignant salivary gland tumors (MSGTs) consist of a heterogeneous group of neoplasms with complex clinicopathological features and biological behaviors. The purpose of this study was to determine the expression of Bcl-2 antiapoptotic protein in mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ADCC), acinic cell carcinoma (ACC) and polymorphous low-grade adenocarcinoma (PLGA) of salivary glands and to find out its association with different grades of these tumors. Material and Methods: This descriptive study included 55 cases of MSGTs. Tissue sections were stained with routine hematoxylin and eosin stain as well as Bcl-2 immunostain. MSGTs were graded as low grade (Low grade MEC, ACC, PLGA, and tubular pattern of ADCC), intermediate grade (cribriform pattern of ADCC, and intermediate grade of MEC) and high grade (high grade of MEC and solid pattern of ADCC) tumors on H&E sections. Bcl-2 expression was scored as ‘negative’ (<5% of neoplastic cells), ‘1’ (5-19% of neoplastic cells), ‘2’ (20-49% of neoplastic cells), and ‘3’ (>50% of neoplastic cells), respectively. Results: MSGTs most commonly involved the parotid gland (52.7%), while ADCC (40%) and MEC (38.2%) were the most common tumors. Expression of Bcl-2 was strongly positive in 56.4% cases of MSGTs which included ADCC (71%), MEC (19.4%) and ACC (9.7%), respectively. A significant association was found between Bcl-2 staining and types of MSGTs i.e., MEC, ADCC, ACC (P = .001) as well as between Bcl-2 staining and grades of MSGTs (P = .013). Conclusions: Bcl-2 protein is expressed in malignant salivary gland tumors. Its expression maybe helpful in grading small biopsies, predicting behavior, and planning targeted therapy of MSGTs.    


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