UI - 21328265
AU - Tullio A; Bianchi B; Sesenna E
[Lymphatic metastases in the parotid region from malignant skin neoplasm
of the head: considerations for surgical treatment based on personal
SO - Acta Otorhinolaryngol Ital 2001 Feb;21(1):44-9
AD - Cattedra e Divisione di Chirurgia Maxillo-Facciale, Universita ed
Ospedale di Parma.
The present paper considers some of the problems linked to the surgical
treatment of parotid metastases. The authors base these considerations
on their limited personal cases and on the most accredited literature.
In the presence of cutaneous malignancies of the upper portion of the
face, accurate clinical-radiological evaluation must be made of the
parotid and neck region. Elective parotidectomy is performed when the
cutaneous carcinoma is quite extensive or located in proximity of the
gland or when the case involves a melanoma. Depending on the oncological
margins, a sub-total parotidectomy may be enough; however, the facial
nerve must be sacrificed if there is a clinical deficit or if it is
directly affected by the tumor. As the dimensions of the neoplasm
increase, the feasibility of saving the nerve decreases. Prophylactic
treatment of the neck is advisable in parotid metastases from cutaneous
malignancies, particularly melanoma. Nevertheless, it is possible to
perform a selective dissection, avoiding the V level of the neck as the
incidence of its involvement is quite low. Prognosis for these tumors is
extremely poor. Of the eleven patients surgically treated, only 4 (36%)
survived: 2 passed away from other causes not involved in the base
pathology; 2 for distant metastases but with no signs of local
recurrence and 1 other for recurrence of the primary pathology in the
maxillary sinus mucosa. There is no difference in the survival of the
two main histological groups: 2 out of 3 of the patients with melanoma
(67%) died as did 3 out of 5 (60%) of those with epidermal carcinoma.
This does not, obviously, include the two patients who died from other
UI - 21357157
AU - Solomonov A; Rosenblatt E; Ben-Izhak O; Goralnik L; Yigla M
High-dose-rate endobronchial brachytherapy in endobronchial metastatic
malignant chondroid syringoma.
SO - Respiration 2001;68(4):406-10
AD - Division of Pulmonary Medicine, Department of Oncology, Rambam Medical
Center, 31096 Haifa, Israel.
A 65-year-old man with malignant chondroid syringoma (MCS) was found to
have pulmonary metastases in the form of multiple pulmonary nodules 4
years after wide excision and adjuvant radiotherapy of a primary
abdominal wall tumor. Atelectasis of the lingula due to obstructive
endobronchial metastasis, resistant to combination chemotherapy, led us
to perform high-dose rate (HDR) endobronchial brachytherapy for the
first time in this rare tumor with a favorable response. This case
emphasizes the role of HDR brachytherapy as a palliative procedure in
endobronchial tumors not responding to other treatment modalities, even
those considered to be radioresistant. Copyright 2001 S. Karger AG,
UI - 21385658
AU - El-Rifai W; Rutherford S; Knuutila S; Frierson HF Jr; Moskaluk CA
Novel DNA copy number losses in chromosome 12q12--q13 in adenoid cystic
SO - Neoplasia 2001 May-Jun;3(3):173-8
AD - Division of Gastroenterology, Department of Medicine, University of
Virginia Health System, Charlottesville, 22908-0708, USA.
In order to find common genetic abnormalities that may identify loci of
genes involved in the development of adenoid cystic carcinoma (ACC), we
investigated DNA copy number changes in 24 of these tumors by
comparative genomic hybridization (CGH). Our results indicate that
unlike many carcinomas, ACCs have relatively few changes in DNA copy
number overall. Twenty tumors had DNA copy number changes, which were
mostly restricted to a few chromosomal arms. A frequent novel finding
was the loss of DNA copy number in chromosome 12q (eight tumors, 33%)
with the minimal common overlapping region at 12q12--q13. Deletion in
this region has not been reported to be frequent in other types of
cancer analyzed by CGH. In addition, deletions in 6q23-qter and
13q21--q22 and gains of chromosome 19 were observed in 25% to 38% of
ACCs. Deletion of 19q, previously reported in a small series of ACC, was
not identified in the current group of carcinomas. The current CGH
results for chromosomes 12 and 19 were confirmed by microsatellite
allelotyping. These results indicate that DNA copy number losses in 12q
may be important in the oncogenesis of ACC and suggest that the
12q12--q13 region may harbor a new tumor-suppressor gene.
UI - 21396147
AU - Olsen KD; Lewis JE
Carcinoma ex pleomorphic adenoma: a clinicopathologic review.
SO - Head Neck 2001 Sep;23(9):705-12
AD - Department of Otorhinolaryngology, Mayo Clinic, 200 First Street SW,
Rochester, MN 55905, USA.
BACKGROUND: Carcinoma ex pleomorphic adenoma (CXPA) is an aggressive,
poorly understood salivary gland malignancy. Misdiagnosis is common,
because the residual mixed tumor component may be small, and various
carcinoma subtypes are possible. METHODS: We retrospectively reviewed
the medical records of 73 patients with major salivary gland CXPA
treated at our institution from 1960 to 1994. Of the 73 patients, 66 had
primary tumors and 7 had recurrent tumors; 47 were men, and 26 were
women; the mean age was 61 years. RESULTS: Adenocarcinoma (31 cases) and
salivary duct carcinoma (24 cases) were the most common malignant
subtypes. All patients were treated surgically, and 32 also had
radiation therapy. Of 66 patients with primary tumors, 23% had local
recurrence. Metastasis (either initial or delayed) occurred regionally
in 56% and distantly in 44%. Thirty-six patients (55%) died of the
disease. At 3 years, overall survival was 39% and at 5 years, 30%.
CONCLUSIONS: Important prognostic factors include tumor size, grade, and
clinical and pathologic stage. Patients with minimally invasive tumors
(<5 mm) should do well with appropriate surgical treatment. Copyright
2001 John Wiley & Sons, Inc.
UI - 21396153
AU - O'Brien CJ; McNeil EB; McMahon JD; Pathak I; Lauer CS
Incidence of cervical node involvement in metastatic cutaneous
malignancy involving the parotid gland.
SO - Head Neck 2001 Sep;23(9):744-8
AD - Department of Head and Neck Surgery, Royal Prince Alfred Hospital, 100
Carillon Avenue, Newtown, Sydney, NSW Australia 2042.
BACKGROUND: The parotid lymph nodes represent an important group of
nodes at risk for metastatic involvement from cutaneous malignancies of
the head and neck. When treating patients with metastatic disease in the
parotid gland it has been our custom to also remove the lymph nodes of
the neck on the basis that these nodes represent other nodal groups at
risk for metastatic involvement. The aim of this study is to determine
the incidence of cervical node involvement among patients with clinical
metastatic SCC or melanoma of the parotid to determine whether treatment
of the clinically negative neck is warranted. METHODS: The study group
consists of 123 prospectively accessioned patients with clinical
metastatic cutaneous squamous cell carcinoma (SCC) (n = 73) or melanoma
(n = 50) involving the parotid gland and a minimum of 2 years of follow
up, irrespective of the clinical status of the neck. RESULTS: Among 73
patients with metastatic SCC in the parotid, 19 (26%) had clinical neck
involvement, and 16 of these were pathologically positive (84%). A total
of 37 patients had elective neck dissections, and 13 were pathologically
positive, which is an overall rate of 52% neck involvement among
patients having neck dissection. Among 50 patients with metastatic
melanoma in the parotid, 19 (38%) patients were initially seen with
clinical neck disease, and all were pathologically positive. Among 31
patients with clinically negative necks, 26 had neck dissections and
seven had positive nodes (27%). Overall, 58% of patients with melanoma
who had a neck dissection had positive nodes. CONCLUSION: Patients with
metastatic cutaneous SCC and melanoma involving the parotid gland had a
high incidence of clinical (26% and 38%, respectively) and occult neck
disease (35% and 27%). Treatment of the clinically negative neck in the
presence of clinical metastatic parotid cancer should be considered to
reduce the likelihood of failure in cervical nodes, to define the extent
of disease, and to assist with patient selection for adjuvant therapy.
Copyright 2001 John Wiley & Sons, Inc.
UI - 21439602
AU - Debiec-Rychter M; Van Valckenborgh I; Van den Broeck C; Hagemeijer A;
Van de Ven WJ; Kas K; Van Damme B; Voz ML
Histologic localization of PLAG1 (pleomorphic adenoma gene 1) in
pleomorphic adenoma of the salivary gland: cytogenetic evidence of
common origin of phenotypically diverse cells.
SO - Lab Invest 2001 Sep;81(9):1289-97
AD - Laboratory for Cytogenetics and Molecular Genetics of Human
Malignancies, Center for Human Genetics, Katholieke Universiteit Leuven,
Leuven, Belgium. firstname.lastname@example.org
Pleomorphic adenoma gene 1 (PLAG1), a zinc finger transcription factor
gene, is consistently rearranged and overexpressed in human pleomorphic
adenomas of the salivary glands with 8q12 translocations. In this
report, we describe the immunohistochemical localization of PLAG1
protein in pleomorphic adenomas of the salivary gland and corresponding
normal tissue, in relation to cytokeratin, vimentin, and BCL-2
expression. Normal salivary gland tissue was not immunoreactive for
PLAG1. In primary pleomorphic adenomas, cells strongly immunoreactive
for PLAG1 were detected in the outer layer of tubulo-ductal structures,
which are thought to be the origin of cells with bi-directional,
epithelial, and mesenchymal phenotypes. In contrast, epithelial cells
with abundant cytokeratin in the inner tubulo-ductal structures only
sporadically expressed PLAG1. BCL-2 immunoreactivity was found mainly in
the cells surrounding the tubulo-ductal structures and in the solid
undifferentiated cellular masses, within the areas that had moderate
PLAG1 immunoreactivity. The variability of PLAG1 expression in
neoplastic cells seemed to reflect the morphologic heterogeneity that
correlated with the stage of differentiation of the tumor cells.
Immunohistochemical/cytogenetic evaluation of two pleomorphic adenomas
with t(3;8)(p21;q12) or t(5;8)(p13;q12) translocations demonstrated the
clonal nature of immunophenotypically diverse cells. This finding
confirms the theory that pleomorphic adenoma cells share a common
single-cell origin, most likely from the epithelial progenitor basal
UI - 21268644
AU - Carinci F; Farina A; Pelucchi S; Calearo C; Fini-Storchi O; Merlo R;
Parotid gland carcinoma: 1987 and 1997 UICC T classifications compared
for prognostic accuracy at 5 years.
SO - Eur Arch Otorhinolaryngol 2001 Mar;258(3):150-4
AD - ENT Clinic, University of Ferrara, Arcispedale S. Anna, C.so Giovecca
203, 44100 Ferrara, Italy.
In order to compare the correlation of 1987 and 1997 UICC T categories
with the survival rate in parotid gland carcinoma, 134 patients
attending the ENT clinics at the University of Ferrara (from 1970 and
1993) and Firenze (from 1970 to 1990) were analyzed by means of survival
analyses (Kaplan-Meier and Cox algorithms). This study demonstrated that
both systems showed a significant correlation with the survival rate,
but T 1997 resulted in a more reliable prognostic value by means of a
higher odds ratio. We conclude that the newer (1997) UICC T category
better defines the prognosis for cancer of the parotid gland and should
have a higher impact on the clinical evaluation of patients.
UI - 21268645
AU - Imauchi Y; Nakashima M; Nigauri T
Metastasis of lung adenocarcinoma to parotid lymph node as initial
SO - Eur Arch Otorhinolaryngol 2001 Mar;258(3):155-6
AD - Department of Otolaryngology, Faculty of Medicine, University of Tokyo,
Hongo 7-3-1, Bunkyo-ku, Tokyo 113-0033, Japan. email@example.com
A 74-year-old male patient presented with increasing pain in the left
preauricular region. On investigation he was diagnosed as having
metastasis of a lung adenocarcinoma to the left parotid lymph node.
UI - 21262957
AU - Becelli R; Frati R; Cerulli G; Perugini M; Frati A; Lannetti G
Pleomorphic adenoma of the minor salivary glands of the palate.
SO - J Exp Clin Cancer Res 2001 Mar;20(1):25-8
AD - Dept. of Maxillofacial Surgery, University of Rome La Sapienza, Italy.
A retrospective test was carried out on a sample of 11 patients, 8 women
and 3 men, suffering from pleomorphic adenoma of the minor salivary
glands of the palate. These sample patients were treated at the
Department of Maxillofacial Surgery at the University of Rome "La
Sapienza" between 1/1/90 and 31/12/95. Some diagnostic methodologies
have been analysed, such as incisional biopsy and instrumental research
(X-ray Orthopantomography and CT of the maxillofacial district with and
without contrast medium in axial and coronal projections), surgical
techniques for the removal of the neoformation and techniques for an
immediate reconstruction. The surgical treatment foresaw, during the
same operation, removal of the neoformation, reconstruction of the
resulting defect and complete restoration of functions and aesthetics.
The patients of the examined sample underwent a 5-year follow-up, based
on clinical examinations and instrumental research. No immediate or
delayed postoperative complications were evident, nor recurrence of the
neoplasia. The purpose of this assignment is to compare the results that
transpired from the retrospective test with those reported in the
UI - 21332879
AU - Nutting CM; Rowbottom CG; Cosgrove VP; Henk JM; Dearnaley DP; Robinson
MH; Conway J; Webb S
Optimisation of radiotherapy for carcinoma of the parotid gland: a
comparison of conventional, three-dimensional conformal, and
SO - Radiother Oncol 2001 Aug;60(2):163-72
AD - Department of Radiotherapy, Institute of Cancer Research and Royal
Marsden NHS Trust, Downs Road, Surrey, Sutton, UK.
BACKGROUND AND PURPOSE: To compare external beam radiotherapy techniques
for parotid gland tumours using conventional radiotherapy (RT),
three-dimensional conformal radiotherapy (3DCRT), and
intensity-modulated radiotherapy (IMRT). To optimise the IMRT
techniques, and to produce an IMRT class solution. MATERIALS AND
METHODS: The planning target volume (PTV), contra-lateral parotid gland,
oral cavity, brain-stem, brain and cochlea were outlined on CT planning
scans of six patients with parotid gland tumours. Optimised conventional
RT and 3DCRT plans were created and compared with inverse-planned IMRT
dose distributions using dose-volume histograms. The aim was to reduce
the radiation dose to organs at risk and improve the PTV dose
distribution. A beam-direction optimisation algorithm was used to
improve the dose distribution of the IMRT plans, and a class solution
for parotid gland IMRT was investigated. RESULTS: 3DCRT plans produced
an equivalent PTV irradiation and reduced the dose to the cochlea, oral
cavity, brain, and other normal tissues compared with conventional RT.
IMRT further reduced the radiation dose to the cochlea and oral cavity
compared with 3DCRT. For nine- and seven-field IMRT techniques, there
was an increase in low-dose radiation to non-target tissue and the
contra-lateral parotid gland. IMRT plans produced using three to five
optimised intensity-modulated beam directions maintained the advantages
of the more complex IMRT plans, and reduced the contra-lateral parotid
gland dose to acceptable levels. Three- and four-field non-coplanar beam
arrangements increased the volume of brain irradiated, and increased PTV
dose inhomogeneity. A four-field class solution consisting of paired
ipsilateral coplanar anterior and posterior oblique beams (15, 45, 145
and 170 degrees from the anterior plane) was developed which maintained
the benefits without the complexity of individual patient optimisation.
CONCLUSIONS: For patients with parotid gland tumours, reduction in the
radiation dose to critical normal tissues was demonstrated with 3DCRT
compared with conventional RT. IMRT produced a further reduction in the
dose to the cochlea and oral cavity. With nine and seven fields, the
dose to the contra-lateral parotid gland was increased, but this was
avoided by optimisation of the beam directions. The benefits of IMRT
were maintained with three or four fields when the beam angles were
optimised, but were also achieved using a four-field class solution.
Clinical trials are required to confirm the clinical benefits of these
improved dose distributions.
UI - 21400267
AU - Abbondanzo SL
Extranodal marginal-zone B-cell lymphoma of the salivary gland.
SO - Ann Diagn Pathol 2001 Aug;5(4):246-54
AD - Department of Hematopathology, Armed Forces Institute of Pathology,
Washington, DC 20306-6000, USA.
Primary non-Hodgkin's lymphoma of the salivary gland is an uncommon
tumor that most often occurs in the parotid gland. The most common
subtype is marginal-zone B-cell lymphoma, extranodal, mucosa-associated
lymphoid tissue type. This subtype has recently been included in the
Revised European-American Classification of Lymphoid Neoplasms, as well
as in the upcoming World Health Organization classification of
hematopoietic and lymphoid neoplasms. This low-grade lymphoma usually
arises in a background of benign lymphoepithelial lesion or
myoepithelial sialadenitis that is associated with the autoimmune
disease Sjogren's syndrome. It occasionally develops in patients who do
not have a history of autoimmune disease. When mucosa-associated
lymphoid tissue lymphoma occurs in the salivary gland, as in other
extranodal sites such as the stomach, it is usually an indolent neoplasm
that tends to remain localized for long periods of time, even without
treatment. Eventually, however, the tumor may disseminate or transform
to a higher grade. The histologic distinction of myoepithelial
sialadenitis from low-grade B-cell mucosa-associated lymphoid tissue
lymphoma can be a difficult diagnostic challenge and many of these
lesions continue to be ambiguously diagnosed as "pseudolymphoma."
Immunophenotypic or flow cytometric analysis may be useful in showing an
aberrant phenotype or immunoglobulin light-chain restriction, which
helps to support a diagnosis of malignant lymphoma in most cases.
Molecular genetic analysis for immunoglobulin gene rearrangements also
may be useful in showing monoclonality, although the exact significance
of this finding in some cases remains controversial.
UI - 21442856
AU - Zaffar A; Tauqir RA; Sohail Z; Malik S
Parapharyngeal tumor presenting as acute airway obstruction.
SO - J Pak Med Assoc 2001 Jul;51(7):264-5
AD - Department of ENT Head and Neck Surgery, Karachi Medical and Dental
College, Abbasi Shaheed Hospital, Karachi.
UI - 21453602
AU - Schramm VL Jr; Imola MJ
Management of nasopharyngeal salivary gland malignancy.
SO - Laryngoscope 2001 Sep;111(9):1533-44
AD - Center for Craniofacial-Skull Base Surgery, Denver, Colorado, USA.
OBJECTIVE: The objective of this study was to evaluate the oncological
outcome and complication rate following surgical treatment of
nasopharyngeal salivary gland malignancy. STUDY DESIGN: Retrospective
case review at tertiary care skull base center. METHODS: Pertinent
medical records were reviewed from 23 patients presenting with minor
salivary gland malignancy. Clinical presentation, prior treatment,
histological type and grade, clinical stage, details of surgical
treatment, and postoperative adjuvant radiation therapy were studied.
Survival and recurrence data were analyzed using the Kaplan-Meier and
Cox proportional hazards methods. RESULTS: Histological types included
11 adenoid cystic carcinomas, 8 mucoepidermoid carcinomas, and 4 cases
of adenocarcinoma not otherwise specified. All patients underwent
primary surgical resection, and the lateral infratemporal middle fossa
approach was used in 20 patients. Prior radiation therapy had been
administered in 6 patients who presented for treatment of recurrent
disease, and the remaining 17 patients underwent planned postoperative
radiation therapy. Elective neck dissection was undertaken in 15
patients, and occult neck disease was present in 47%. Disease specific
survival was 67% at 5 years and 48% at 10 years. High-grade tumors had a
significantly poorer outcome (P =.035) with a relative risk of 4.6
compared with low-grade disease. Local control was seen to be 77% at 5
years. CONCLUSIONS: Planned combined surgery and radiation therapy
achieves survival outcomes and recurrence rates in nasopharyngeal
salivary gland malignancy comparable to results reported using the same
treatment for minor salivary gland tumors cancer originating elsewhere
in the head and neck. Because of the high rate of occult neck
metastases, we recommend elective neck dissection as part of the
surgical treatment with this disease entity. The lateral infratemporal
middle fossa approach provides safe and adequate access to resect the
vast majority of these tumors with acceptable complication rates. A
reliable form of vascularized reconstruction is necessary to prevent
serious postoperative complications, and we currently prefer the
gastro-omental free flap.
UI - 21348618
AU - Preisegger KH; Beham A; Kopp S; Jessernigg G; Gugl A; Stammberger H
Prognostic impact of molecular analyses in adenoid cystic carcinomas of
the salivary gland.
SO - Onkologie 2001 Jun;24(3):273-7
AD - Institut fur Pathologie, Karl-Franzens-Universitat Graz,
Auenbruggerplatz 20, A-80326 Graz, Austria.
BACKGROUND: Adenoid cystic carcinoma (ACC) of the salivary gland is a
generally slow-growing but highly malignant neoplasm with a remarkable
capacity for recurrence. Prognosis is greatly influenced by the
histological subtype (tubular, cribriform or solid), presence of tumour
at the margins, anatomic size, and lymph node metastases. However, none
of these parameters has proven to be an unequivocal predictor of disease
activity. Therefore, the current study was undertaken to investigate the
prognostic value of molecular markers. PATIENTS AND METHODS: Samples
from 22 patients, including 4 patients with recurrent disease, were
included in the study. By means of immunohistochemistry, the staining
pattern of p53, bcl-2, P-glycoprotein, glutathione S-transferase, and
topoisomerase as well as sequence analyses of p53 were performed. These
molecules were chosen because of their proven association with poor
prognosis and therapy resistance in other malignancies. RESULTS:
Homozygous p53 mutations were found in all of the 4 recurrent tumors.
The other proteins were detected in some tumors, but showed no
correlation with histological subtype or recurrence of tumor.
CONCLUSION: The results of the current study emphasize the prognostic
value of a p53 alteration as an independent prognostic marker. Further,
it could be demonstrated for the first time that proteins known for
their association with radio- and chemotherapy resistance can be
overexpressed in some ACCs suggesting that those molecules could
influence the outcome of new therapeutical approaches. Copyright 2001 S.
Karger GmbH, Freiburg
UI - 21438055
AU - Lowe LH; Stokes LS; Johnson JE; Heller RM; Royal SA; Wushensky C;
Swelling at the angle of the mandible: imaging of the pediatric parotid
gland and periparotid region.
SO - Radiographics 2001 Sep-Oct;21(5):1211-27
AD - Department of Radiology, Children's Mercy Hospital, University of
Missouri-Kansas City, 2401 Gillham Rd, Kansas City, MO 64108, USA.
The pediatric parotid gland and periparotid region are subject to a
variety of lesions and are most often evaluated with ultrasonography
(US), contrast material-enhanced computed tomography (CT), and magnetic
resonance (MR) imaging. US may be used to assess the size of the parotid
gland, distinguish diffuse from focal disease, assess vascularity and
adjacent vascular structures, distinguish cystic from solid lesions, and
guide fine-needle aspiration. However, further evaluation with CT or MR
imaging may be needed to better define the nature and extent of disease.
CT is the imaging modality of choice for most pediatric parotid disease
(including acute inflammation, abscess, calculi, and major salivary duct
obstruction) and most solid masses and may obviate sedation. However, a
mass associated with facial nerve symptoms should be evaluated with MR
imaging because it is the only modality that can consistently
demonstrate the facial nerve. Findings at US, CT, and MR imaging allow
localization of parotid lesions and may suggest a specific cause.
Clinical information, familiarity with normal parotid anatomy at various
stages of its development, and knowledge of the imaging characteristics
of parotid and periparotid lesions are essential for appropriate
radiologic evaluation. This information can be used to guide therapy and
plan a surgical approach.
UI - 21459481
AU - Tse GM; To EW; Yuen EH; Chen M
Basal cell adenocarcinoma of the salivary gland: report of a case with
morphology on fine needle aspiration cytology.
SO - Acta Cytol 2001 Sep-Oct;45(5):775-8
AD - Department of Anatomical and Cellular Pathology, Prince of Wales
Hospital, Chinese University of Hong Kong, Shatin, NT.
BACKGROUND: Basal cell adenocarcinoma of the parotid is rare and prone
to recur. CASE: A 54-year-old woman had a history of afacial mass 12
years earlier that had been excised and was diagnosed as low grade
adenocarcinoma of the parotid. Over the years, the patient had multiple
local and lymph node recurrences. Histology of the excised local
recurrent tumor showed basal cell adenocarcinoma, and FNAC of a separate
recurrent nodule was performed. The aspirate showed moderate cellularity
of basaloid cells with mildly pleomorphic nuclei, small nucleoli and
occasional mitotic figures. The cells were mostly single, but some
formed clusters with a rosettelike pattern of tumor cells surrounding
central eosinophilic globules. A second, less prominent population of
smaller cells with dark-staining nuclei was also noted. The differential
diagnosis included adenoid cystic carcinoma, polymorphous low grade
adenocarcinoma, and basal cell and pleomorphic adenoma. CONCLUSION: The
cytologic features of basal cell adenocarcinoma are not distinctive, but
the presence of two cell populations with moderate pleomorphism and a
rosettelike pattern with central, eosinophilic globules may assist with
its differentiation from other salivary gland neoplasms.
UI - 21459493
AU - Ramakrishnan R; Krishnamurthy SC
Fine needle aspiration appearance of clear cell myoepithelioma of the
SO - Acta Cytol 2001 Sep-Oct;45(5):896-7
UI - 21302227
AU - Aynaci O; Onder C; Yildiz K
Malignant mixed tumor of salivary gland with a solitary metastasis to
SO - Arch Orthop Trauma Surg 2001 May;121(5):294-6
AD - Karadeniz Technical University, Faculty of Medicine, Department of
Orthopedics, Trabzon, Turkey.
A 23-year-old, male patient previously operated on four times for a
recurring, benign, paranasal mass was admitted to our clinic with pain
and swelling under the knee. Physical and radiological examination
revealed a malignant process. The histopathological examination of the
fine-needle biopsy specimen of the tibia was a malignant mixed tumor.
Then. en-bloc resection, free fibular grafting, and fixation with blade
plate was performed for one-third of the tibia, conserving the knee
joint. Recurrences and metastasis were not observed after surgery and
UI - 21301910
AU - Bradley PJ
Distant metastases from salivary glands cancer.
SO - ORL J Otorhinolaryngol Relat Spec 2001 Jul-Aug;63(4):233-42
AD - Department of Otorhinolaryngology--Head and Neck Surgery, Queens Medical
Centre, Nottingham, UK. firstname.lastname@example.org
Patients who present with malignant salivary glands should at their
initial assessment have an X-ray of the chest to exclude the possibility
of distant metastases. Patients who have other symptoms, bone pain etc.,
should be appropriately investigated. The likelihood of patients
developing distant metastases is associated with high-grade tumors, most
commonly adenoid cystic carcinoma, high-grade mucoepidermoid carcinoma,
salivary duct carcinoma and tumors sited in the submandibular gland,
posterior tongue and pharyngeal tumors. Patients who have had a
high-grade tumor treated and survived without locoregional recurrence
have the same risk of developing distant metastases as those patients
who have locoregional recurrence. Other histological types of salivary
tumors are associated with a lower risk of developing distant metastases
but a real risk remains lifelong. It is recommended that all patients
who have a malignant salivary gland tumor treated, any histology, should
be followed up and clinically assessed at least once every 12 months for
life. Copyright 2001 S. Karger AG, Basel
UI - 21418653
AU - Garcia-Ortega FP; Carcases Ortiz MJ; Martinez Reig S; Bevia Gonzalez MC;
Duran R; Malluguiza Calvo JR
[Salivary gland myoepithelioma]
SO - Acta Otorrinolaringol Esp 2001 Apr;52(3):269-72
AD - Servicio de ORL, Hospital General de Elda, Alicante.
Myoepithelioma is a rare salivary gland tumor (less than 1%) which are
usually located in parotid gland and minor salivary glands. Histology
and immunohistochemical features of this tumors are reviewed. We report
2 cases arising in parotid and hard palate.
UI - 21418431
AU - Damborenea Tajada J; Ibanez Carreras R; Samperiz LC; Naya Galvez M;
Fraile Rodrigo J; Yus Gotor C; Alvarez Alegret R
[Parotid metastases of a neuroendocrine cutaneous carcinoma]
SO - Acta Otorrinolaringol Esp 2001 Jun-Jul;52(5):427-30
AD - Servicio de ORL, Hospital Miguel Servet, Zaragoza.
A case of metastatic Merkel-cell carcinoma to lymph nodes on the left
side of the neck nad left parotid is described. Neuroendocrine cutaneous
carcinoma, also called Merkel cell carcinoma (MCC), is an uncommon
primary skin tumor most often seen in elderly. Literature is reviewed
and comment about more important features of these lesions, like
differential diagnosis, prognosis and treatment.
UI - 21351307
AU - Brannon RB; Sciubba JJ; Giulani M
Ductal papillomas of salivary gland origin: A report of 19 cases and a
review of the literature.
SO - Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2001 Jul;92(1):68-77
AD - Oral and Maxillofacial Pathology Department, Louisiana State University
School of Dentistry, LSU Health Sciences Center, New Orleans, LA 70119,
The term ductal papilloma is used to identify a group of 3 rare benign
papillary salivary gland tumors known as inverted ductal papilloma,
sialadenoma papilliferum, and intraductal papilloma. They represent
adenomas with unique papillary features and arise from the salivary
gland duct system. We describe the clinical and microscopic features of
19 new cases of ductal papillomas and combine them with 116 cases
previously published in the English-language medical literature. These
19 cases were composed of 13 inverted ductal papillomas, 3 sialadenoma
papilliferums, and 3 intraductal papillomas. Collectively, these 19
ductal papillomas occurred most commonly in the sixth to eighth decade
of life, with an average patient age of 54 years. Men predominated
1.37:1. The sialadenoma papilliferums presented as papillary lesions
clinically with all 3 misinterpreted as squamous papillomas by the
surgeons. The inverted ductal papillomas and intraductal papillomas
appeared as submucosal nodules. The lip and the palate were the most
common locations for inverted ductal papilloma and sialadenoma
papilliferum, respectively. The sites for the 3 intraductal papillomas
were the parotid papilla of the Stensen's duct, the upper lip, and the
buccal mucosa. With light microscopy, inverted ductal papillomas
appeared to arise from the excretory ducts near the mucosal surface,
whereas intraductal papillomas appeared to arise from the excretory
ducts at a deeper level. Sialadenoma papilliferum had a more complex
histology, with a biphasic growth pattern of exophytic papillary and
endophytic components. All 19 cases were treated by surgical excision.
Follow-up information was available in only 2 cases, both inverted
ductal papillomas. Neither case recurred during a 20-year period.
Sialadenoma papilliferum, with a literature-derived recurrence rate of
10% to 15%, seems to assert a more significant biological behavior than
inverted ductal papilloma and intraductal papilloma. Our findings
justify the separation of these 3 entities based on clinical and
histologic parameters. They are tumors of adulthood and, in addition,
have in common their relationship to the excretory duct system, their
anatomical distribution, and their general behavior.
UI - 21380596
AU - Kusafuka K; Yamaguchi A; Kayano T; Takemura T
Immunohistochemical localization of members of the transforming growth
factor (TGF)-beta superfamily in normal human salivary glands and
SO - J Oral Pathol Med 2001 Aug;30(7):413-20
AD - Department of Pathology, Japanese Red Cross Medical Center, Tokyo.
Although pleomorphic adenoma is the most common type of salivary gland
epithelial tumor, it frequently contains "mesenchymal"-like components,
including myxoid or chondroid tissues. We reported previously that
chondroid tissue formation in pleomorphic adenoma was associated with
overexpression of bone morphogenetic proteins (BMPs) by neoplastic
myoepithelial cells. BMPs belong to the transforming growth factor
(TGF)-beta superfamily, so we hypothesized that pleomorphic adenoma may
express TGF-betas and that these molecules may regulate mesenchymal-like
tissue formation. To evaluate this hypothesis, we immunohistochemically
examined TGF-beta1, -beta2 and -beta3 expression and localization in
normal salivary glands and in 43 cases of pleomorphic adenomas. There
was no evidence of TGF-beta1 expression in normal salivary glands or
pleomorphic adenomas. Signals for TGF-beta2 in the normal salivary
glands were observed in the intercalated ducts, while in pleomorphic
adenomas they were observed in the inner ductal cells of the
tubulo-glandular structures. Signals for TGF-beta3 in the normal
salivary glands were observed in mucous cells, whereas in pleomorphic
adenomas they were observed in the solid nests of neoplastic
myoepithelial cells, in the portion showing squamous metaplasia, and in
the inner ductal cells of tubulo-glandular structures. TGF-betas induce
ectopic cartilage formation in vivo, but chondroid tissues in
pleomorphic adenomas showed only weak TGF-beta3 expression. TGF-beta may
be related to differentiation of the inner ductal cells and the
neoplastic myoepithelial cells. In conclusion, pleomorphic adenomas
expressed TGF-beta2 and -beta3, which may be associated with
differentiation of the inner ductal cells and neoplastic myoepithelial
UI - 21380600
AU - Sumida T; Hamakawa H; Imaoka M; Okamoto N; Takarada M; Tanioka H; Ueda
N; Nose M
A case of submandibular malignant rhabdoid tumor transformed from
papillary thyroid carcinoma.
SO - J Oral Pathol Med 2001 Aug;30(7):443-7
AD - Department of Oral Surgery, Ehime University School of Medicine, Japan.
Malignant rhabdoid tumor (MRT) in the neck region is very rare. We
report a case of MRT in a 60-year-old woman who had a history of
papillary carcinoma of the thyroid gland 7 years previously. One year
before admission, in 1995, thyroid carcinoma recurred, and the tumor
contained a small undifferentiated region with rhabdoid features. The
tumor in 1996 consisted of round to oval rhabdoid cells with abundant
cytoplasm, and the growth pattern was diffuse and infiltrative, with no
papillary structures. We therefore concluded that the lesion was MRT,
transformed from papillary thyroid carcinoma.
UI - 21453578
AU - Gibbons MD; Manne U; Carroll WR; Peters GE; Weiss HL; Grizzle WE
Molecular differences in mucoepidermoid carcinoma and adenoid cystic
carcinoma of the major salivary glands.
SO - Laryngoscope 2001 Aug;111(8):1373-8
AD - Department of Surgery, Division of Otolaryngology-Head and Neck Surgery,
University of Alabama at Birmingham, 1501 Fifth Avenue South,
Birmingham, AL 35249-6889, U.S.A.
OBJECTIVE/HYPOTHESIS: Mucoepidermoid carcinoma (MEC) and adenoid cystic
carcinoma (ACC), the most common malignancies of the major salivary
glands, are clinically and pathologically different. To determine
whether MEC and ACC have different molecular characteristics, we
examined the expression of erbB-2, erbB-3, epidermal growth factor
receptor (EGFR), and transforming growth factor-alpha (TGF-alpha),
important molecular features in other malignancies. STUDY
DESIGN/METHODS: Archival tissue sections of 22 MEC and 6 ACC tumors of
the major salivary glands were evaluated immunohistochemically for
expression of erbB-2, erbB-3, EGRF, and TGF-alpha. A differential
immunostaining score, reflecting the difference in immunostaining
between carcinoma and uninvolved salivary gland tissue, was calculated
for cytoplasmic and membranous staining. RESULTS: Positive
immunostaining for all biomarkers was observed in the cytoplasm and
membrane of both tumors. However, expression was higher in MEC than in
ACC tumors and was statistically significant for cytoplasmic EGFR (P
=.009), TGF-alpha (P =.041), and membranous EGFR (P =.004). A
significantly higher percentage of MEC cells also demonstrated positive
immunostaining for cytoplasmic erbB-3 (P =.022), EGFR (P =.005),
membranous erbB-3 (P =.022), and EGFR (P =.013). The differential
immunostaining score was significantly higher for MEC compared with
uninvolved alveolar tissue and the membranes of uninvolved ductal
tissue. There were no statistically positive differential immunostaining
scores for ACC. CONCLUSIONS: There is a clear difference in the
molecular phenotypes of MEC and ACC. The lack of statistically
significant expression in ACC, when compared with similar uninvolved
salivary gland tissue, suggests minimal involvement for these molecular
structures in the pathogenesis of ACC. Conversely, erbB-2, erbB-3, EGFR,
and TGF-alpha may have a role in the development and progression of MEC.
These results have therapeutic implications for MEC of the major
UI - 21453588
AU - Hocwald E; Korkmaz H; Yoo GH; Adsay V; Shibuya TY; Abrams J; Jacobs JR
Prognostic factors in major salivary gland cancer.
SO - Laryngoscope 2001 Aug;111(8):1434-9
AD - Department of Otolaryngology-Head and Neck Surgery, Wayne State
University, 540 East Canfield Avenue, Detroit, MI 48201, U.S.A.
OBJECTIVE: To identify features of major salivary gland cancers that are
prognostic for disease-free survival. STUDY DESIGN: A retrospective
study of 78 patients with major salivary gland cancer (64 parotid and 14
submandibular gland) who underwent surgery for definitive treatment from
1976 to 1996. A select group of patients also received adjuvant
radiation (56%) and/or chemotherapy (13%). METHOD: Clinical and
pathological risk factors were obtained from patients' charts and
pathology reports. Age, gender, tumor site, T-stage, facial paralysis,
histologic neck involvement, perineural invasion, and cancer grade were
analyzed with respect to disease-free survival. The role of adjuvant
treatment in terms of clinical outcome was also investigated. RESULTS:
In our series, the 5-year disease-free survival was 65%. Examining
clinical and histologic features one at a time, we found poorer
prognosis was associated with submandibular tumors compared with parotid
(P =.02), higher T-stage (P =.001), positive cervical nodes (P <.001),
perineural invasion (P =.002), and high-grade or adenoid cystic tumors
(P =.002). A multivariable analysis indicated that positive lymph nodes
(P =.07) and perineural invasion (P =.03) were important histologic
predictors of shorter disease-free survival. Receipt of both adjuvant
radiation and cisplatin-based chemotherapy (P =.05) was an independent
predictor of longer disease-free survival. CONCLUSION: Our study
indicated that the presence of positive lymph nodes and perineural
invasion is important independent predictors of disease-free survival.
Our limited data also suggest that adjuvant chemotherapy and radiation
therapy may improve disease-free survival.
UI - 21406423
AU - Shimoyama T; Wakabayashi M; Kato T; Kaneko T; Horie N; Ide F
Adenomatoid hyperplasia of the palate mimicking clinically as a salivary
SO - J Oral Sci 2001 Jun;43(2):135-8
AD - Department of Oral Surgery, Saitama Medical Center, Saitama Medical
School, Kawagoe, Japan.
This report describes an illustrative case of adenomatoid hyperplasia
(AH) of the minor salivary glands on the palate of a 31-year-old man.
The clinical features of the present lesion corresponded with those of
pleomorphic adenoma, but histologically large lobules of
normal-appearing mucous acini were found. The cell proliferative
activity demonstrated in histological sections, by an
immunohistochemical staining of proliferating cell nuclear antigen and
Ki-67, showed no statistically significant differences among AH and a
matched control group of normal palatal salivary glands. This case
suggests that AH apparently exhibits an idiopathic, focal hypertrophic
lesion of intraoral mucous glands with limited growth potential.
UI - 21439847
AU - Choi G; Choi CS; Choi JS; Choi JO
Intraductal papilloma of the parotid gland in a child.
SO - Otolaryngol Head Neck Surg 2001 Sep;125(3):280
AD - Department of Otolaryngology-Head and Neck Surgery, Korea University
College of Medicine, Seoul. email@example.com
UI - 21441212
AU - Fan CY; Melhem MF; Hosal AS; Grandis JR; Barnes EL
Expression of androgen receptor, epidermal growth factor receptor, and
transforming growth factor alpha in salivary duct carcinoma.
SO - Arch Otolaryngol Head Neck Surg 2001 Sep;127(9):1075-9
AD - Department of Pathology, University of Arkansas for Medical Sciences,
Little Rock, USA.
BACKGROUND: Salivary duct carcinoma (SDC) is a rare, highly aggressive
neoplasm that primarily affects the major salivary glands. It is a
distinct clinicopathological entity characterized by its morphologic
resemblance to ductal carcinoma of the breast, a high incidence of
regional lymph node metastasis, and distant dissemination. Frequent
expression of androgen receptor (AR) but not estrogen receptor or
progesterone receptor in SDCs suggests that SDC bears a close
immunophenotypic homology with prostatic carcinoma. An AR-mediated
autocrine growth pathway consisting of epidermal growth factor receptor
(EGFR) and its ligand, transforming growth factor alpha (TGF-alpha), has
been implicated in the carcinogenesis of prostatic carcinoma. Androgens,
in the presence of AR, mediate their mitogenic effects on prostatic
cancer cells by up-regulating the transcriptional and translational
activities of EGFR and TGF-alpha. Through an autocrine mode of action,
TGF-alpha produced in the tumor cells binds to its receptor, EGFR, which
is also expressed by these cells, resulting in a proliferative response.
OBJECTIVE: To investigate whether a TGF-alpha/EGFR autocrine pathway is
present in SDCs. DESIGN: Retrospective analysis of the expression of AR,
EGFR, and TGF-alpha in 12 SDCs. SETTING: An academic medical center.
RESULTS: Salivary duct carcinoma expresses AR, TGF-alpha, and EGFR in 11
(92%), 8 (67%), and 11 (92%) of 12 cases, respectively. CONCLUSION: An
AR-mediated TGF-alpha/EGFR autocrine pathway may be implicated in the
tumorigenesis of SDC.
UI - 98183640
AU - Hern HE Jr; Koenig BA; Moore LJ; Marshall PA
The difference that culture can make in end-of-life decisionmaking.
SO - Camb Q Healthc Ethics 1998 Winter;7(1):27-40
AD - Highland Hospital, Oakland, CA, USA.
UI - 21321253
AU - Rosenstiel DB; Carroll WR; Listinsky CM
MALT lymphoma presenting as a cystic salivary gland mass.
SO - Head Neck 2001 Mar;23(3):254-8
AD - Department of Surgery, University of Alabama at Birmingham, 35233, USA.
BACKGROUND: Mucosa associated lymphoid tissue (MALT) lymphoma has been
noted to involve the salivary glands in chronic inflammatory conditions
such as Sjogren's syndrome and in HIV infection. METHODS AND RESULTS:
The authors encountered a patient with bilateral cystic changes in the
parotid glands which proved to be due to MALT lymphoma. The clinical
course, histopathology, and treatment options of MALT lymphoma in the
salivary gland are discussed in detail. CONCLUSION: This malignant
entity should be considered in the differential diagnosis of refractory
cystic lesions of the salivary glands.
UI - 21369556
AU - Henke AC; Cooley ML; Hughes JH; Timmerman TG
Fine-needle aspiration cytology of small-cell carcinoma of the parotid.
SO - Diagn Cytopathol 2001 Aug;25(2):126-9
AD - Department of Pathology, University of Iowa Hospitals and Clinics, Iowa
City, Iowa, USA.
Small-cell carcinomas arise uncommonly in extrapulmonary sites and are
rare primary neoplasms in the salivary glands. We report on the
aspiration cytology and immunohistochemical findings of a small-cell
carcinoma of the parotid gland in an 81-yr-old man. Copyright 2001
UI - 21395480
AU - Gonzalez Lagunas J; Rodado C; Raspall G; Bermejo B; Huguet P; Giralt J
Malignant tumors of the minor salivary glands. Retrospective study on 59
SO - Med Oral 2001 Mar-Apr;6(2):142-7