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Balgobind S, Cheung VKY, Luk P, Low THH, Wykes J, Wu R, Lee J, Ch'ng S, Palme CE, Clark JR, Gupta R. Prognostic and predictive biomarkers in head and neck cancer: something old, something new, something borrowed, something blue and a sixpence in your shoe. Pathology 2024; 56:170-185. [PMID: 38218691 DOI: 10.1016/j.pathol.2023.11.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 11/26/2023] [Accepted: 11/28/2023] [Indexed: 01/15/2024]
Abstract
A biomarker is a measurable indicator of biological or pathological processes or the response to an exposure or intervention and is used to guide management decisions. In head and neck pathology, biomarkers are assessed by histological criteria and immunohistochemical and molecular studies. Surgical resection remains the mainstay of management of many head and neck malignancies. Adjuvant radiotherapy and/or systemic therapy may be administered depending on the presence of adverse prognostic factors identified on histopathological or immunohistochemical examination. In this review, we outline the clinically relevant prognostic and predictive factors in head and neck malignancies including conventionally recognised factors such as tumour size, depth of invasion, lymphovascular and perineural invasion and margin status as well as novel evolving factors such as recurrent genetic rearrangements and assessment of immune checkpoints. Practical issues are discussed to assist with recognising and reporting of these factors. A summary of useful tools such as structured pathology report formats is also included to assist with comprehensive reporting of all clinically relevant parameters, minimise risk and improve workflow efficiencies.
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Affiliation(s)
- Sapna Balgobind
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia.
| | - Veronica K Y Cheung
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia
| | - Peter Luk
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia
| | - Tsu-Hui Hubert Low
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - James Wykes
- Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Raymond Wu
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Radiation Oncology, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Jenny Lee
- Macquarie Medical School, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia; Melanoma Institute Australia, University of Sydney, Sydney, NSW, Australia; Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Sydney Ch'ng
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Carsten E Palme
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Jonathan R Clark
- Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia; Department of Head and Neck Surgery, Chris O'Brien Lifehouse, Camperdown, NSW, Australia; Sydney Facial Nerve Service, Chris O'Brien Lifehouse, Camperdown, NSW, Australia
| | - Ruta Gupta
- Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, NSW Health Pathology, Sydney, NSW, Australia; Faculty of Medicine and Health, Central Clinical School, University of Sydney, Sydney, NSW, Australia
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Huang S, Peng X, Li H, Zhao J, Hou J. Successful endotracheal intervention for primary tracheal acinic cell carcinoma: A case report and literature review. Medicine (Baltimore) 2024; 103:e37033. [PMID: 38335397 PMCID: PMC10860940 DOI: 10.1097/md.0000000000037033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/03/2024] [Indexed: 02/12/2024] Open
Abstract
INTRODUCTION Primary tracheal acinic cell carcinoma (ACC) is an exceptionally rare malignancy, posing challenges in understanding its clinical behavior and optimal management. Surgical resection has traditionally been the primary treatment modality, but we present a compelling case of tracheal ACC managed with endotracheal intervention, challenging conventional approaches. PATIENT CONCERNS A 53-year-old woman presented with shortness of breath, cough, and hemoptysis. Enhanced computed tomography revealed an obstructive tracheal lesion, leading to her referral for further assessment. DIAGNOSIS Microscopic evaluation, immunohistochemistry, and clinical assessments confirmed primary tracheal ACC, an exceedingly rare condition with limited clinical insights. INTERVENTIONS We utilized rigid bronchoscopy to perform endotracheal intervention, successfully resecting the tumor and restoring tracheal patency. Postoperatively, the patient received no radiotherapy or chemotherapy. OUTCOMES The patient achieved complete recovery, with 24-month follow-up examinations indicating no recurrence or metastatic disease. Only minimal scar tissue remained at the resection site. CONCLUSION This case demonstrates the potential of endotracheal intervention as a curative approach for primary tracheal ACC, minimizing invasiveness and preserving tracheal function. Collaborative research efforts and extensive case reporting are crucial for advancing our understanding of this rare malignancy and optimizing treatment strategies for improved patient outcomes.
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Affiliation(s)
| | - Xinru Peng
- Ningxia Medical University, Ningxia, China
| | - Hailong Li
- Department of Respiratory Medicine, Ningxia Hospital of Integrated Traditional Chinese and Western Medicine, Ningxia, China
| | - Jiale Zhao
- Department of Respiratory Medicine, Ningxia Hospital of Integrated Traditional Chinese and Western Medicine, Ningxia, China
| | - Jia Hou
- Department of Respiratory and Critical Care Medicine, General Hospital of Ningxia Medical University, Ningxia, China
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Naso JR, Roden AC. Recent developments in the pathology of primary pulmonary salivary gland-type tumours. Histopathology 2024; 84:102-123. [PMID: 37694812 DOI: 10.1111/his.15039] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/08/2023] [Accepted: 08/17/2023] [Indexed: 09/12/2023]
Abstract
Primary pulmonary salivary gland-type tumours are rare neoplasms that are thought to arise from seromucinous glands that are located in the submucosa of large airways. These neoplasms have clinical and pathologic features that are distinct from other pulmonary neoplasms. The majority of primary pulmonary salivary gland-type tumours are malignant, with the most common entities being mucoepidermoid carcinoma, adenoid cystic carcinoma, and epithelial-myoepithelial carcinoma. Less commonly seen are myoepithelial carcinoma, hyalinizing clear cell carcinoma, acinic cell carcinoma, secretory carcinoma, salivary duct carcinoma, intraductal carcinoma, and polymorphous adenocarcinoma. Benign salivary gland-type tumours of the lung include pleomorphic adenoma and sialadenoma papilliferum. Morphologic, immunophenotypic, and molecular features of these neoplasms are largely similar to salivary gland tumours elsewhere, and therefore the exclusion of metastatic disease requires clinical and radiologic correlation. However, the differential diagnostic considerations are different in the lung. The distinction of salivary gland-type tumours from their histologic mimics is important for both prognostication and treatment decisions. Overall, salivary gland type-tumours tend to have a more favourable outcome than other pulmonary carcinomas, although high-grade variants exist for many of these tumour types. Recent advances in our understanding of the spectrum of salivary gland-type tumours reported in the lung and their diversity of molecular and immunohistochemical features have helped to refine the classification of these tumours and have highlighted a few differences between salivary gland-type tumours of the lung and those primary to other sites.
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Affiliation(s)
- Julia R Naso
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA
| | - Anja C Roden
- Department of Laboratory Medicine and Pathology, Mayo Clinic Rochester, Rochester, MN, USA
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Baujat B, Vergez S, Jegoux F, Barry B, Verillaud B, Pham Dang N, Fakhry N, Chabrillac E. Lymph node surgery for salivary gland cancer: REFCOR recommendations by the formal consensus method. Eur Ann Otorhinolaryngol Head Neck Dis 2023:S1879-7296(23)00153-9. [PMID: 38036313 DOI: 10.1016/j.anorl.2023.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
OBJECTIVE To determine the indications for neck dissection in the management of parotid, submandibular or minor salivary gland cancers depending on the clinical situation: i.e., clinical lymph node involvement (cN+) or not (cN0); low or high risk of occult nodal metastasis; diagnosis of malignancy before, during or after surgery. MATERIAL AND METHODS The French Network of Rare Head and Neck Tumors (REFCOR) formed a steering group which drafted a narrative review of the literature published on Medline and proposed recommendations. The level of adherence to the recommendations was then assessed by a rating group according to the formal consensus method. RESULTS In cN+ salivary gland cancer, ipsilateral neck dissection is recommended. In cN0 salivary gland cancer, ipsilateral neck dissection is recommended, except for tumors at low risk of occult nodal metastasis. If definitive pathology reveals a high risk of occult nodal involvement, additional neck treatment is recommended: ipsilateral neck dissection or elective nodal irradiation. CONCLUSION The rate of occult lymph node involvement, and therefore the indication for elective neck dissection, depends primarily on the pathologic grade of the salivary gland cancer.
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Affiliation(s)
- B Baujat
- Département d'ORL et chirurgie cervicofaciale, hôpital Tenon, Sorbonne université, AP-HP, Paris, France
| | - S Vergez
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France; Département de chirurgie ORL et cervicofaciale, CHU de Toulouse-Larrey, université Toulouse III Paul-Sabatier, Toulouse, France
| | - F Jegoux
- Département d'ORL et chirurgie cervicofaciale, CHU de Rennes, Rennes, France
| | - B Barry
- Département d'ORL et chirurgie cervicofaciale, hôpital Bichat, AP-HP, Paris, France
| | - B Verillaud
- Inserm U1141, département d'ORL et de chirurgie cervico-faciale, hôpital Lariboisière, université Paris-Cité, AP-HP, Paris, France
| | - N Pham Dang
- Inserm, Neuro-Dol, service de chirurgie maxillofaciale, université Clermont Auvergne, CHU de Clermont-Ferrand, 63000 Clermont-Ferrand, France
| | - N Fakhry
- Département d'ORL et chirurgie cervicofaciale, hôpital La Conception, AP-HM, Marseille, France
| | - E Chabrillac
- Département de chirurgie, institut universitaire du cancer Toulouse - Oncopole, Toulouse, France.
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Ahmed F, Khan SR, Dawood T, Naeem A, Moosajee M, Rashid YA. Chaotic transformation of parotid acinic cell carcinoma to metastatic dedifferentiated high-grade pathology - A rare case with clinical and emotional challenge. Int J Surg Case Rep 2023; 110:108784. [PMID: 37672826 PMCID: PMC10510077 DOI: 10.1016/j.ijscr.2023.108784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 08/30/2023] [Accepted: 08/31/2023] [Indexed: 09/08/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE Acinic cell carcinoma (AciCC) is a rare entity in which high-grade transformation (HGT), formerly dedifferentiation, is uncommon. This case report presents a rare case of AciCC, with rapid transformation to metastatic high-grade dedifferentiated pathology after initial curative treatment. CASE PRESENTATION A 58-year-old woman presented in the medical oncology clinic with a progressive swelling on the right side of her face. Magnetic resonance imaging revealed a 5 × 5 cm lobulated parotid gland lesion, and fine needle aspiration biopsy was consistent with carcinoma. After informed consent, a Modified-Blair incision was given as a standard approach to the right preauricular area under general anaesthesia, and a right superficial parotidectomy with the removal of the tumor and selective lymph node dissection was performed. Histopathology of the resected mass was reported as parotid AciCC. She was given adjuvant radiation therapy. A repeat PET CT scan ten weeks after the completion of her adjuvant radiation treatment showed local disease recurrence as well as multiple pulmonary deposits. A repeat biopsy was reported as DOG-1 positive dedifferentiated (high-grade) acinic cell carcinoma, and she was offered platinum-based palliative systemic chemotherapy. CLINICAL DISCUSSION Parotid acinic cell carcinomas with high-grade transformation are rare. This case highlights its critical diagnostic markers, curative and palliative management and long-term follow-up. CONCLUSION The transformation of parotid AciCC to high-grade, dedifferentiated pathology is unusual and belligerent. Hence, these tumors need intense treatment with a multimodality approach. Close follow-ups with history and physical examination, along with periodic imaging, should be considered for these patients.
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Affiliation(s)
- Faiza Ahmed
- Aga Khan University Hospital, Karachi, Pakistan.
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Dogan S, Xu B, Rana S, Chen H, Ghossein RA, Berger MF, Ho AL, Katabi N. Loss of CDKN2A/B is a Molecular Marker of High-grade Histology and is Associated with Aggressive Behavior in Acinic Cell Carcinoma. Mod Pathol 2023; 36:100150. [PMID: 36841437 PMCID: PMC10447625 DOI: 10.1016/j.modpat.2023.100150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Revised: 01/26/2023] [Accepted: 02/16/2023] [Indexed: 02/27/2023]
Abstract
Acinic cell carcinoma (AciCC) is a rare salivary gland cancer with excellent prognosis in most cases. However, a subset of patients will develop distant metastasis and die of disease. Recently, a 2-tiered grading scheme in AciCC was proposed to recognize patients at risk of poor outcome. We performed a genetic analysis of AciCC to explore the underlying molecular correlates of the tumor grade and examined programmed death ligand 1 (PD-L1) expression to identify potential candidates for immunotherapy. A retrospective cohort of 55 patients included 34 high-grade (HG) and 21 low-grade AciCCs. Forty-three cases were subjected to targeted exome sequencing by Memorial Sloan Kettering-Integrated Mutation Profiling of Actionable Cancer Targets. PD-L1 immunohistochemistry was performed in 33 cases. Tumor mutation burden was low with a median of 1 and 2 mutations in low-grade and HG AciCCs, respectively. CDKN2A/B was the most frequently altered gene, and loss-of-function mutations were found only in HG but not in low-grade AciCCs (18/31 [58.1%] vs 0/12 [0%], P < .001). CDKN2A/B alterations were significantly associated with distant metastasis, which occurred in 16/18 (88.9%) CDKN2A/B mutants versus 11/25 (44%) wild-type cases (P = .004, Fisher exact test). Sequential profiling of multiple temporally distant samples from the same patient demonstrated intratumor heterogeneity, including the detection of CDKN2A/B deletion in the second, in HG metastasis only. ATM and PTEN mutations were detected in 6/31 (19.4%) and 5/31 (16.1%); ARID2, BIRC3, and FBXW7 mutations each in 4/31 (12.9%); and TP53, MTAP, and FAT1 each in 3/31 (9.7%) HG AciCC. PD-L1-positive labeling was more common in HG AciCC (9/17, 52.9% vs 3/16, 18.9%, P = .071). CDKN2A/B mutations in AciCC represent a molecular marker of HG histology and disease progression, providing a rationale for further studies to determine their prognostic and therapeutic significance in this salivary gland cancer. AciCC with ATM mutations may be amenable to targeted therapy. Immunotherapy can be considered to be a treatment option for a subset of patients with AciCC.
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Affiliation(s)
- Snjezana Dogan
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
| | - Bin Xu
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Satshil Rana
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Hui Chen
- Department of Pathology, MD Anderson Cancer Center, Houston, Texas
| | - Ronald A Ghossein
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Michael F Berger
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York; Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Alan L Ho
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Nora Katabi
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
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Baněčková M, Thompson LDR, Hyrcza MD, Vaněček T, Agaimy A, Laco J, Simpson RHW, Di Palma S, Stevens TM, Brcic L, Etebarian A, Dimnik K, Majewska H, Stárek I, O'Regan E, Salviato T, Helliwell T, Horáková M, Biernat W, Onyuma T, Michal M, Leivo I, Skalova A. Salivary Gland Secretory Carcinoma: Clinicopathologic and Genetic Characteristics of 215 Cases and Proposal for a Grading System. Am J Surg Pathol 2023; 47:661-677. [PMID: 37070739 DOI: 10.1097/pas.0000000000002043] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
Salivary gland secretory carcinoma (SC), previously mammary analog SC, is a low-grade malignancy characterized by well-defined morphology and an immunohistochemical and genetic profile identical to SC of the breast. Translocation t(12;15)(p13;q25) resulting in the ETV6 :: NTRK3 gene fusion is a characteristic feature of SC along with S100 protein and mammaglobin immunopositivity. The spectrum of genetic alterations for SC continues to evolve. The aim of this retrospective study was to collect data of salivary gland SCs and to correlate their histologic, immunohistochemical, and molecular genetic data with clinical behavior and long-term follow-up. In this large retrospective study, we aimed to establish a histologic grading scheme and scoring system. A total of 215 cases of salivary gland SCs diagnosed between 1994 and 2021 were obtained from the tumor registries of the authors. Eighty cases were originally diagnosed as something other than SC, most frequently acinic cell carcinoma. Lymph node metastases were identified in 17.1% (20/117 cases with available data), with distant metastasis in 5.1% (6/117). Disease recurrence was seen in 15% (n=17/113 cases with available data). The molecular genetic profile showed ETV6 :: NTRK3 gene fusion in 95.4%, including 1 case with a dual fusion of ETV6 :: NTRK3 and MYB :: SMR3B . Less frequent fusion transcripts included ETV6 :: RET (n=12) and VIM :: RET (n=1). A 3-tiered grading scheme using 6 pathologic parameters (prevailing architecture, pleomorphism, tumor necrosis, perineural invasion (PNI), lymphovascular invasion (LVI), and mitotic count and/or Ki-67 labeling index) was applied. Grade 1 histology was observed in 44.7% (n=96), grade 2 in 41.9% (n=90), and grade 3 in 13.5% (n=29) of cases. Compared with low-grade and intermediate-grade SC, high-grade tumors were associated with a solid architecture, more prominent hyalinization, infiltrative tumor borders, nuclear pleomorphism, presence of PNI and/or LVI, and Ki-67 proliferative index >30%. High-grade transformation, a subset of grade 2 or 3 tumors, seen in 8.8% (n=19), was defined as an abrupt transformation of conventional SC into high-grade morphology, sheet-like growth, and a tumor lacking distinctive features of SC. Both overall survival and disease-free survival (5 and 10 y) were negatively affected by tumor grade, stage, and TNM status (each P <0.0001). SC is a low-grade malignancy with predominantly solid-microcystic growth patterns, driven by a gene fusion, most commonly ETV6 :: NTRK3 . There is a low risk for local recurrence and a good overall long-term survival, with a low risk for distant metastasis but a higher risk for locoregional lymph node metastasis. The presence of tumor necrosis, hyalinization, PNI and/or LVI, and positive resection margins correlate with higher tumor grade, less favorable prognosis, and increased mortality. The statistical results allowed us to design a 3-tiered grading system for salivary SC.
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Affiliation(s)
- Martina Baněčková
- Department of Pathology, Charles University, Faculty of Medicine in Plzen
- Bioptic Laboratory Ltd Plzen
| | | | - Martin D Hyrcza
- Department of Pathology and Laboratory Medicine, University of Calgary, Arnie Charbonneau Cancer Institute
| | - Tomáš Vaněček
- Molecular Genetic Laboratory, Bioptic Laboratory Ltd, Plzen
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Comprehensive Cancer Center (CCC) Erlangen-EMN, Erlangen, Germany
| | - Jan Laco
- The Fingerland Department of Pathology, Charles University, Faculty of Medicine and University Hospital Hradec Kralove, Hradec Kralove
| | - Roderick H W Simpson
- Department of Pathology and Laboratory Medicine, University of Calgary, Calgary Laboratory Services, Foothills Medical Centre, Calgary, AB, Canada
| | - Silvana Di Palma
- Division of Clinical Medicine, Department of Histopathology, University of Surrey, Royal Surrey County Hospital, Guildford, Surrey
| | - Todd M Stevens
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL
| | - Luka Brcic
- Diagnostic and Research Institute of Pathology, Medical University of Graz, Graz, Austria
| | - Arghavan Etebarian
- Department of Oral and Maxillofacial Pathology, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Katarina Dimnik
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Hanna Majewska
- Department of Pathology, Warmia and Mazury University, Olsztyn
| | - Ivo Stárek
- Department of Otorhinolaryngology, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Olomouc, Czech Republic
| | - Esther O'Regan
- Department of Histopathology, St. James's Hospital & Dublin Dental Hospital, Trinity College Dublin, Dublin, Ireland
| | - Tiziana Salviato
- Division of Pathology, Department of Medical and Surgical Sciences for Children & Adults, University-Hospital of Modena and Reggio Emilia, Modena, Italy
| | - Tim Helliwell
- Department of Cellular Pathology, University of Liverpool, Liverpool, UK
| | - Markéta Horáková
- Department of Pathology, Charles University, Faculty of Medicine in Plzen
- Bioptic Laboratory Ltd Plzen
| | - Wojciech Biernat
- Department of Pathology, Medical University of Gdansk, Gdansk, Poland
| | - Timothy Onyuma
- Department of Pathology, Kenyatta National Hospital, Nairobi, Kenya
| | - Michal Michal
- Department of Pathology, Charles University, Faculty of Medicine in Plzen
- Bioptic Laboratory Ltd Plzen
| | - Ilmo Leivo
- Institute of Biomedicine, Pathology, University of Turku and Turku University Hospital, Turku, Finland
| | - Alena Skalova
- Department of Pathology, Charles University, Faculty of Medicine in Plzen
- Bioptic Laboratory Ltd Plzen
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Veneroni MV, Festa BM, Costantino A, Spriano G, Mercante G, De Virgilio A, Di Tommaso L. Prognostic Impact of Tumor Immune Microenvironment and Its Predictive Role in Salivary Gland Cancer. Head Neck Pathol 2023; 17:515-527. [PMID: 36723850 PMCID: PMC10293532 DOI: 10.1007/s12105-023-01528-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/09/2023] [Indexed: 02/02/2023]
Abstract
BACKGROUND Recently, many studies have investigated the role of tumor immune microenvironment (TIME) in carcinogenesis, highlighting its relation to both tumor regression and progression. In particular, the "inflammatory system", made of innate and adaptive immune cells, interacts with cancer cells and their surrounding stroma. In this setting, the aim of this review is to summarize the current literature regarding the TIME of major salivary gland carcinomas (MSGCs), with particular attention on the characteristics and prognostic role of tumor infiltrating lymphocytes (TILs), the mechanisms that lead to TILs exhaustion and the important additional immune infiltrating factors that help SGC progression or remission. METHODS A comprehensive literature search was performed concerning published articles on the role of TIME in MSGCs. RESULTS In this work we summarize the advancing knowledge on TIME in SGCs by demonstrating the key prognostic and/or predictive value of specific immune features. CONCLUSION From the analysis of the current 'status of the art' it clearly emerges a need for precise, unambiguous phenotyping of immune cell populations, as well as a more thorough understanding of the frequencies and interactions of multiple immune cell types inside the TIME and their spatial localization (intratumoral vs. stromal).
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Affiliation(s)
- Maria Vittoria Veneroni
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
| | - Bianca Maria Festa
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy
| | - Andrea Costantino
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy
| | - Giuseppe Spriano
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy
| | - Giuseppe Mercante
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy
| | - Armando De Virgilio
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy.
- Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy.
| | - Luca Di Tommaso
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy
- Pathology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy
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9
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Kirschnick LB, Silveira FM, Schuch LF, Vasconcelos ACU, Gomes AP, Santos JND, Santana DA, Fonseca FP, Mesquita RA, Mendonça EFD, Sousa-Neto SS, Pontes HAR, Robinson L, Heerden WV, Carlos-Bregni R, Tager EMJR, Silva LCD, Zanella VG, Rivero LF, Bittencourt R, Martins MAT, Lopes MA, Wagner VP, Vargas PA, Martins MD. Acinic cell carcinoma of the oral and maxillofacial region: an international multicenter study. Braz Oral Res 2023; 37:e050. [PMID: 37255070 DOI: 10.1590/1807-3107bor-2023.vol37.0050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 12/12/2022] [Indexed: 06/01/2023] Open
Abstract
The aim of this study was to describe the prevalence, clinicopathological, and prognostic features of acinic cell carcinoma (AciCC) of the oral and maxillofacial region. AciCC cases were retrospectively retrieved from 11 pathology centers of three different countries. Medical records were examined to extract demographic, clinical, pathologic, and follow-up information. A total of 75 cases were included. Females (65.33%) with a mean age of 45.51 years were mostly affected. The lesions usually presented as an asymptomatic (64.28%) nodule (95.66%) in the parotid gland (70.68%). The association of two histopathological patterns was the most common finding (48.93%) and the tumors presented mainly conventional histopathological grades (86.11%). Surgical treatment was performed in the majority of the cases (59.19%). Local recurrence was observed in 20% of the informed cases, regional metastasis in 30.43%, and distant metastasis in 12.50%. The statistical analysis showed that the cases with a solid histopathological pattern (p=0.01), high-grade transformation (p=0.008), recurrence (p=0.007), and regional metastasis (p=0.03) were associated with poor survival. In conclusion, high histopathological transformation, presence of nodal metastasis, and recurrence were prognostic factors for AciCC of the oral and maxillofacial region.
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Affiliation(s)
- Laura Borges Kirschnick
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Felipe Martins Silveira
- Universidad de la República - UDELAR, School of Dentistry, Division of Molecular Pathology, Montevideo, Uruguay
| | - Lauren Frenzel Schuch
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | | | - Ana Paula Gomes
- Universidade Federal de Pelotas - UFPel, School of Dentistry, Diagnostic Center for Oral Diseases, Pelotas, RS, Brazil
| | - Jean Nunes Dos Santos
- Universidade Federal da Bahia - UFBA, School of Dentistry, Department of Pathology, Graduate Program in Dentistry and Health, Salvador, BA, Brazil
| | - Dandara Andrade Santana
- Universidade Federal da Bahia - UFBA, School of Dentistry, Department of Pathology, Graduate Program in Dentistry and Health, Salvador, BA, Brazil
| | - Felipe Paiva Fonseca
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | - Ricardo Alves Mesquita
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Oral Surgery and Pathology, Belo Horizonte, MG, Brazil
| | | | | | - Hélder Antônio Rebelo Pontes
- Universidade Federal do Pará - UFPA, João de Barros Barreto University Hospital, Department of Oral Pathology, Belém, PA, Brazil
| | - Liam Robinson
- University of Pretoria - UP, School of Dentistry, Department of Oral Pathology and Oral Biology, Pretoria, South Africa
| | - Willie van Heerden
- University of Pretoria - UP, School of Dentistry, Department of Oral Pathology and Oral Biology, Pretoria, South Africa
| | - Román Carlos-Bregni
- Clinical Center of Head and Neck/Hospital Herrera Llerandi, Division of Pathology, Guatemala City, Guatemala
| | | | - Luan César da Silva
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Virgílio Gonzales Zanella
- Santa Casa de Misericórdia de Porto Alegre, Santa Rita Hospital, Department of Head and Neck Surgery, Porto Alegre, RS, Brazil
| | - Luis Fernando Rivero
- Universidade Federal do Rio Grande do Sul - UFRGS, Faculty of Medicine, Department of Pathology, Porto Alegre, RS, Brazil
| | - Raquel Bittencourt
- Universidade Federal do Rio Grande do Sul - UFRGS, Faculty of Medicine, Department of Pathology, Porto Alegre, RS, Brazil
| | - Marco Antonio Trevizani Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, Hospital de Clínicas de Porto Alegre, Department of Oral Medicine, Porto Alegre, RS, Brazil
| | - Márcio Ajudarte Lopes
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Vivian Petersen Wagner
- University of Sheffield, Academic Unit of Oral and Maxillofacial Medicine and Pathology, Department of Clinical Dentistry, Sheffield, UK
| | - Pablo Agustin Vargas
- Universidade Estadual de Campinas - UNICAMP, Piracicaba Dental School, Department of Oral Diagnosis, Piracicaba, SP, Brazil
| | - Manoela Domingues Martins
- Universidade Federal do Rio Grande do Sul - UFRGS, School of Dentistry, Department of Oral Pathology, Porto Alegre, RS, Brazil
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10
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Chatelet F, Ferrand FR, Atallah S, Thariat J, Mouawad F, Fakhry N, Malard O, Even C, de Monès E, Uro-Coste E, Benzerdjeb N, Hans S, Testelin S, Mauvais O, Evrard D, Bastit V, Salas S, Espitalier F, Classe M, Digue L, Doré M, Wong S, Dupin C, Nguyen F, Bettoni J, Lapierre A, Colin E, Philouze P, Vergez S, Baujat B, Herman P, Verillaud B. Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients. Eur J Cancer 2023; 185:11-27. [PMID: 36947928 DOI: 10.1016/j.ejca.2023.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/05/2023]
Abstract
BACKGROUND Acinic cell carcinomas (AciCCs) are malignant tumours of the salivary glands. The aim of this work was to analyse data from the national REFCOR multicenter cohort (i) to investigate the prognostic factors influencing survival outcomes in AciCC, (ii) to assess the impact on survival of postoperative radiotherapy (RT) in patients treated for AciCC without high-grade transformation and (iii) to explore the prognostic impact of prophylactic neck dissection (ND) in patients treated for AciCC of the major salivary glands. PATIENTS AND METHODS Data from all the patients treated for salivary AciCC between 2009 and 2020 were extracted from the REFCOR database. Survival outcomes and prognostic factors influencing Disease-Free Survival (DFS) and Overall Survival (OS) were investigated using univariate and multivariate analyses. Propensity score matching was used to assess the impact of postoperative RT and prophylactic ND on DFS. RESULTS A total of 187 patients were included. After a median follow-up of 53 months, their 5-year OS and DFS rates were 92.8% and 76.2%, respectively. In multivariate analysis, male sex, older age, higher T and N status, and high grade were independently associated with a worse DFS. In the subpopulation analysed after propensity score matching, patients with cN0 AciCC without high-grade transformation who were treated by surgery and RT did not have an improved DFS compared to patients who were treated by surgery alone (hazard ratio (HR) = 0.87, p = 0.8). Factors associated with nodal invasion were T3-T4 status and intermediate/high histological grade. After propensity score matching, prophylactic ND was associated with a trend toward a better DFS (HR = 0.46, p = 0.16). CONCLUSIONS These results suggest that (i) long-term follow-up (>5 years) should be considered in patients with AciCC, (ii) treatment by surgery alone could be an option in selected cN0 patients with AciCC without high-grade transformation and (iii) prophylactic ND may be considered preferentially in patients with T3-T4 status and/or intermediate/high histological grade.
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Affiliation(s)
- Florian Chatelet
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France.
| | - François Régis Ferrand
- French Armed Forces Biomedical Research Institute, F-91220 Brétigny sur Orge, France; Head and Neck Oncology Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | - Sarah Atallah
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la chine, F-75020 Paris, France; Doctoral School of Public Health, CESP, University of Paris Sud, 16 Avenue Paul Vaillant Couturier, F-94807 Villejuif, France
| | - Juliette Thariat
- Department of Radiation Oncology, Centre Francois Baclesse, F-14000 Caen, France; ARCHADE Research Community, F-14000 Caen, France; Laboratoire de physique Corpusculaire IN2P3/ENSICAEN/CNRS UMR 6534-Normandie Université, F-14000 Caen, France
| | - François Mouawad
- Department of ENT-Head and Neck Surgery, Université de Lille, Hôpital Huriez, CHU de Lille, Rue Michel Polonovski, 59000 Lille, France; Inserm U 908, Université des Sciences et Technologies de Lille, UFR de Biologie - SN3, 59655 Villeneuve d'Ascq, France
| | - Nicolas Fakhry
- Department of ENT-Head and Neck Surgery, CHU La Conception, AP-HM. Aix-Marseille Univ (AMU), Marseille, France
| | - Olivier Malard
- Service d'ORL et de chirurgie cervico-faciale CHU 1, INSERM U1229-RMeS, Place A. Ricordeau Hôtel-Dieu, F-44093 Nantes Cedex, France
| | - Caroline Even
- Head and Neck Oncology Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | | | - Emmanuelle Uro-Coste
- Department of Pathological Anatomy and Histology-Cytology, Rangueil Hospital, Toulouse, France
| | - Nazim Benzerdjeb
- Department of Otolaryngology-Head Neck Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France; Claude Bernard University, Lyon 1, France
| | - Stéphane Hans
- Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Sylvie Testelin
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Olivier Mauvais
- Department of ENT-Head and Neck Surgery, Centre Hospitalier Universitaire de Besançon, Besançon, France
| | - Diane Evrard
- Université de Paris, Department of ENT-Head and Neck Surgery, Hôpital Bichat, AP-HP, 46 Rue Henri Huchard, F-75018 Paris, France
| | - Vianney Bastit
- Department of ENT-Head and Neck Surgery, François Baclesse Centre, 3 rue du Général Harris, 14000, Caen, France
| | - Sébastien Salas
- Medical Oncology Department, Centre Hospitalier (CHU) La Timone, F-13000, Marseille, France
| | - Florent Espitalier
- Department of Otolaryngology-Head and Neck Surgery, CHU de Nantes, F-44093 Nantes, France
| | - Marion Classe
- Pathology Department, Gustave Roussy Cancer Campus, France
| | | | - Mélanie Doré
- Institut de cancérologie de l'Ouest Nantes, 2 boulevard Jacques Monod, F-44805 Saint Herblain, France
| | - Stéphanie Wong
- Radiation Oncology Department, Hôpital Timone Adultes, 264 Rue Saint-Pierre, F-13005 Marseille, France
| | - Charles Dupin
- Department of Radiation Therapy, Hôpital de Haut Lévèque, Bordeaux University Hospital-CHU, F-33000 Bordeaux, France
| | - France Nguyen
- Onco-radiotherapy Department, Gustave Roussy Cancer Campus, 114 Rue Edouard Vaillant, F-94807 Villejuif, France
| | - Jeremie Bettoni
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Ariane Lapierre
- Claude Bernard University, Lyon 1, France; Department of Radiation Oncology, Centre Hospitalier Lyon Sud, 165 Chem. du Grand Revoyet, F-69310 Pierre-Bénite, France
| | - Emilien Colin
- EA 7516 CHIMERE, Université de Picardie Jules Verne, Amiens, France; Department of Maxillofacial Surgery, Amiens-Picardy University Hospital, Université de Picardie Jules Verne, Amiens, France
| | - Pierre Philouze
- Claude Bernard University, Lyon 1, France; Department of Otolaryngology-Head Neck Surgery, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Sébastien Vergez
- Department of Surgery, University Cancer Institute Toulouse - Oncopôle, University Hospital of Toulouse, F-31100 Toulouse, France
| | - Bertrand Baujat
- Sorbonne University, APHP, Department of ENT-Head and Neck Surgery, Tenon Hospital, 4 rue de la chine, F-75020 Paris, France
| | - Philippe Herman
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France; Université de Paris, INSERM U1141, Unité"NeuroDiderot", Université de Paris, F-75006 Paris, France
| | - Benjamin Verillaud
- Department of ENT-Head and Neck Surgery, AP-HP, Hôpital Lariboisière, 2 Rue Ambroise Paré, F-75010 Paris, France; Université de Paris, INSERM U1141, Unité"NeuroDiderot", Université de Paris, F-75006 Paris, France
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11
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Mantsopoulos K, Thimsen V, Sievert M, Balk M, Grundtner P, Gostian AO, Koch M, Iro H. Limited parotid surgery as sole form of treatment for carefully selected malignant tumours of the parotid gland: Still sufficient on the long-term? Am J Otolaryngol 2023; 44:103735. [PMID: 36535225 DOI: 10.1016/j.amjoto.2022.103735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 12/02/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The aim of the study was to investigate the oncological and functional outcome following extracapsular dissection as the sole form of treatment in locally limited low-grade malignant parotid tumours in the long term. METHODS The records of all patients treated for T1-T2 low-grade malignant tumours of the parotid gland solely by means of extracapsular dissection between 2005 and 2017 were studied retrospectively. RESULTS A total of 16 cases formed our study sample (7 men, 9 women). Their mean age was 50.2 years (21-84 years). Mean follow-up was 107 months (60-201 months). In 6 cases the tumour was an acinic cell carcinoma, in 9 cases a mucoepidermoid carcinoma and in one case a basal cell adenocarcinoma. Regarding the T category, the tumour was Tis in one case, T1 in 12 cases and T2 in three cases. The five-year disease-specific survival rate was 100 %, as was local disease control. Facial nerve function was House-Brackmann grade I without exception. CONCLUSIONS Our study showed very encouraging long-term results following primary extracapsular dissection as the sole surgical therapy for carefully selected low-stage, low-grade, inferiorly located lesions in patients with high compliance. LAY SUMMARY The "one-size-fits-all" strategy of complete parotidectomy with neck dissection might be tantamount to overtreatment by less aggressive cases of parotid cancer. Extracapsular dissection seems to be oncologically sufficient for carefully selected T1-T2 low-grade cases in the long-term in patients with ensured follow-up.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
| | - Vivian Thimsen
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matti Sievert
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Matthias Balk
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Philipp Grundtner
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Antoniu-Oreste Gostian
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Koch
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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12
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van Herpen C, Vander Poorten V, Skalova A, Terhaard C, Maroldi R, van Engen A, Baujat B, Locati LD, Jensen AD, Smeele L, Hardillo J, Martineau VC, Trama A, Kinloch E, Even C, Machiels JP. Salivary gland cancer: ESMO-European Reference Network on Rare Adult Solid Cancers (EURACAN) Clinical Practice Guideline for diagnosis, treatment and follow-up. ESMO Open 2022; 7:100602. [PMID: 36567082 PMCID: PMC9808465 DOI: 10.1016/j.esmoop.2022.100602] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/10/2022] [Accepted: 09/16/2022] [Indexed: 11/07/2022] Open
Abstract
•This ESMO–EURACAN Clinical Practice Guideline provides key recommendations for managing salivary gland cancer. •The guideline covers clinical and pathological diagnosis, staging and risk assessment, treatment and follow-up. •Treatment algorithms for parotid, submandibular, sublingual and minor salivary gland cancer are provided. •The author group encompasses a multidisciplinary group of experts from different institutions and countries in Europe. •Recommendations are based on available scientific data and the authors’ collective expert opinion.
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Affiliation(s)
- C van Herpen
- Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands; Multidisciplinary Salivary Gland Society, Geneva, Switzerland. https://twitter.com/myESMO
| | - V Vander Poorten
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Oncology, Section Head and Neck Oncology, KU Leuven, Leuven; Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium
| | - A Skalova
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
| | - C Terhaard
- Multidisciplinary Salivary Gland Society, Geneva, Switzerland; Department of Radiotherapy, University Medical Center, Utrecht, The Netherlands
| | - R Maroldi
- Department of Radiology, ASST Spedali Civili Brescia-University of Brescia, Brescia, Italy
| | - A van Engen
- Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - B Baujat
- Department of Otorhinolaryngology, Head and Neck Surgery, Sorbonne Université Hôpital Tenon, Assistance Publique Hôpitaux de Paris, Paris, France
| | - L D Locati
- Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - A D Jensen
- Faculty of Medicine, Philipps-University Marburg, Marburg; Department of Radiation Oncology, University Hospitals Gießen and Marburg (UKGM) Ltd, Gießen, Germany
| | - L Smeele
- Department of Head and Neck Oncology and Surgery, Antoni van Leeuwenhoek Ziekenhuis & Amsterdam UMC, Amsterdam
| | - J Hardillo
- Department of Otorhinolaryngology, Head and Neck Surgery, Erasmus University Medical Center, Rotterdam, The Netherlands
| | | | - A Trama
- Evaluative Epidemiology, Department of Research, Fondazione IRCSS Istituto Nazionale dei Tumori, Milan, Italy
| | - E Kinloch
- Salivary Gland Cancer UK, London, UK
| | - C Even
- Head and Neck Department, Gustave Roussy, Paris; French Network for Rare Head and Neck Cancers, Paris, France
| | - J-P Machiels
- Service d'Oncologie Médicale, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Brussels; Institut de Recherche Clinique et Expérimentale, Université Catholique de Louvain (UCLouvain), Brussels, Belgium
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13
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Millan N, Tjendra Y, Zuo Y, Jorda M, Garcia-Buitrago M, Velez-Torres JM, Gomez-Fernandez C. Utility of NR4A3 on FNA cytology smears and liquid-based preparations of salivary gland. Cancer Cytopathol 2022; 130:949-954. [PMID: 35913415 DOI: 10.1002/cncy.22632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/03/2022] [Accepted: 07/13/2022] [Indexed: 01/04/2023]
Abstract
BACKGROUND Fine-needle aspiration cytology (FNAC) is generally the initial sampling method for salivary gland neoplasms. The cytomorphologic features of acinic cell carcinoma (AciCC) of salivary gland can overlap with other neoplastic and nonneoplastic entities. AciCCs harbor a recurrent t(4;9) rearrangement with upregulation of nuclear receptor subfamily 4 group A member 3 (NR4A3). NR4A3 protein overexpression has been shown to be highly sensitive and specific for the diagnosis of AciCC in histologic specimens and cell block preparations. However, data on NR4A3 immunocytochemistry (ICC) on conventional smears or liquid-based cytology are limited. METHODS The authors identified 18 FNAC of histologically proven AciCC cases between 2013 and 2019. FNAC samples of diagnostic mimickers were likewise retrieved and included in the study cohort for comparison. The NOR1/NR4A3 mouse monoclonal antibody was applied directly to FNAC slides using a standard ICC technique. RESULTS The cohort included ethanol-fixed Papanicolaou-stained cytologic smears and liquid-based preparations from 18 AciCC, one secretory carcinoma, four mucoepidermoid carcinomas, four salivary duct carcinomas, five pleomorphic adenomas (PA), five Warthin tumors, five oncocytomas, one oncocytic hyperplasia, and five nonneoplastic salivary gland cases. Strong nuclear staining for NR4A3 was present in all AciCC, weak nuclear staining was present in one PA, and all other non-AciCC were negative (sensitivity, 100%; specificity, 97%). CONCLUSIONS NR4A3 ICC can be used directly on FNAC conventional smears and liquid-based cytology to reliably distinguish AciCC from its mimickers. This marker may be useful in cases where a cell block preparation is unavailable or inadequate.
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Affiliation(s)
- Nicolas Millan
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pathology and Laboratory Medicine, Jackson Memorial Hospital, Miami, Florida, USA
| | - Youley Tjendra
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA.,Department of Pathology and Laboratory Medicine, Jackson Memorial Hospital, Miami, Florida, USA
| | - Yiqin Zuo
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Merce Jorda
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Monica Garcia-Buitrago
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Jaylou M Velez-Torres
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Carmen Gomez-Fernandez
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida, USA
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14
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Adhikary T, Kumar H, Mahapatra N, Panda A, Bhuyan L. An Exquisite Case Report of Follicular Variant of Acinic Cell Carcinoma of the Parotid Gland With Review of Literature. Cureus 2022; 14:e29559. [PMID: 36312662 PMCID: PMC9595272 DOI: 10.7759/cureus.29559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/05/2022] Open
Abstract
Acinic cell carcinoma (ACC), previously called acinic cell tumor, is an uncommon malignant neoplasm that tends to recur locally without proper treatment measures. This low-grade neoplasm has four histological subtypes. We hereby report a case of a follicular variant of ACC, which is a rare subtype. A 20-year literature search encompassing this variant of ACC of the parotid region was also performed, which showed four reported cases. A 60-year-old woman reported to our college, Kalinga Institute of Dental Sciences, with the chief complaint of pain and swelling in her upper right back tooth region for the past three months. Upon incisional biopsy, histopathological examination revealed a follicular variant of ACC. Further, immunohistochemistry was also performed using markers such as DOG-1, CK7, S-100, and thyroglobulin, which showed CK7 marker positivity. Subtotal parotidectomy was performed and the tissue was sent for histopathological analysis. Although ACCs are slow-growing and indolent in character, they can frequently recur locally decades later and spread to distant organs. Long-term follow-up is necessary following therapy as ACC has a noticeably high propensity to relapse and create latent metastases.
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15
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Xu B, Saliba M, Ho A, Viswanathan K, Alzumaili B, Dogan S, Ghossein R, Katabi N. Head and Neck Acinic Cell Carcinoma: A New Grading System Proposal and Diagnostic Utility of NR4A3 Immunohistochemistry. Am J Surg Pathol 2022; 46:933-941. [PMID: 35034042 PMCID: PMC10569115 DOI: 10.1097/pas.0000000000001867] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Acinic cell carcinoma (AciCC) is traditionally considered as a low-grade salivary gland carcinoma. However, a subset demonstrates high-grade features with a higher mortality rate and distant metastasis. In this large retrospective study of 117 cases, we aimed to establish a histologic grading scheme for AciCC. Adverse independent prognostic factors identified on the multivariate analysis included older age, tumor necrosis, nuclear anaplasia, lymphovascular invasion, absence of tumor-associated lymphoid stroma, and high American Joint Committee on Cancer (AJCC) pT and pN stages. A 3-tiered grading scheme using 4 pathologic parameters (mitotic index, necrosis, tumor border, and fibrosis at the frankly invasive front) was subsequently applied. Compared with low/intermediate-grade, high-grade AciCC defined as a mitotic index ≥5/10 HPFs and/or necrosis was an independently adverse prognostic factor. The 5-year overall survival was 50% in high-grade AciCCs, and 100% in low-grade or intermediate-grade AciCCs. Compared with low-grade or intermediate-grade AciCC, high-grade tumors were associated with older age, larger tumor size, focal rather than diffuse zymogen granules, solid architecture, infiltrative tumor border, fibrosis at the frankly invasive front, lymphovascular invasion, perineural invasion, positive margin, high pT, and pN stages. NR4A3 was a highly sensitive and specific immunohistochemical stain for diagnosing AciCC with a sensitivity and specificity of 96% and 93%, respectively. In conclusion, although we proposed a 2-tiered grading system for AciCC with high-grade tumors defined by a mitotic count ≥5/10 HPFs and/or necrosis, more studies are needed to assess the prognostic value of intermediate grade. NR4A3 immunohistochemical stain is a useful diagnostic marker for AciCC.
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Affiliation(s)
- Bin Xu
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Maelle Saliba
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Alan Ho
- Medical Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Kartik Viswanathan
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Bayan Alzumaili
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Snjezana Dogan
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Ronald Ghossein
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
| | - Nora Katabi
- Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, NY, USA
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Shi Q, Zhang B, Bsirini C, Li L, Giampoli EJ, Magliocca KR, Reid M, Zhou Z. NR4A3 Fluorescence In Situ Hybridization Analysis in Cytologic and Surgical Specimens of acinic cell carcinoma. Hum Pathol 2022; 127:86-91. [PMID: 35700750 DOI: 10.1016/j.humpath.2022.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 05/17/2022] [Accepted: 06/07/2022] [Indexed: 11/28/2022]
Abstract
BACKGROUND Acinic cell carcinoma (AciCC) may pose a diagnostic challenge, particularly on small biopsies and fine needle aspiration (FNA) because of its variable histology including potential high grade transformation and its mimickers. Immunoreactivity with circumferential membranous staining for DOG1 can support the diagnosis of AciCC but is not entirely specific. A novel rearrangement t(4;9)(q13;q31) leading to upregulation of nuclear receptor subfamily 4 group A member 3 (NR4A3) has been described in AciCC, is potentially detectable by Fluorescence in situ hybridization (FISH) and may be useful in the evaluation for AciCC. METHODS Using NR4A3 Dual Color Break Apart Probe (Zytovision, Germany) FISH was performed on AciCCs from three large academic institutions. NR4A3 rearrangement was defined as positive signal patterns in 15% of tissue interphase nuclei. RESULTS 52 AciCCs including 47 resections and 5 FNAs (including 5 paired FNA/resections) were analyzed. 5 non-AciCC salivary gland tumors and 2 sialadenitis cases were used as controls. 8 (15%) (8/52) AciCCs failed FISH testing. FISH was positive in 23 AciCCs (sensitivity 59%, 23/39) with 100% concordance between five matched resection/FNAs (three were positive for FISH and two were negative). FISH was negative in all non-AciCCs (specificity: 100%, 0/7). CONCLUSION NR4A3 FISH has a sensitivity of 59% and specificity of 100% in detecting AciCC which suggests that NR4A3 rearrangement-driven upregulation is a recurrent, specific oncogenic event in AciCC, consistent with prior results. 100% concordance between matched FNA/resection samples validate its potential utility on cytology samples.
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Affiliation(s)
- Qiuying Shi
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta GA 30308, USA
| | - Bin Zhang
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 626, Rochester, NY 14642, USA
| | - Caroline Bsirini
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta GA 30308, USA
| | - Liqiong Li
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 626, Rochester, NY 14642, USA
| | - Ellen J Giampoli
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, 601 Elmwood Avenue, Box 626, Rochester, NY 14642, USA
| | - Kelly R Magliocca
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta GA 30308, USA
| | - Michelle Reid
- Department of Pathology and Laboratory Medicine, Emory University Hospital, Atlanta GA 30308, USA
| | - Zhongren Zhou
- Department of Pathology, Robert Wood Johnson Medical School and New Jersey Medical School, Rutgers University, New Brunswick, NJ 08901, USA.
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Algharyani AS, Maghrabi MM, Ezzat SK, Shakweer MM, Esmaeil D. Diagnostic Value of Nuclear Receptor Subfamily 4 Group A Member 3 in Salivary Gland Carcinomas. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.9831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Salivary gland carcinomas are diagnostically challenging lesions in heterogeneous groups. However, recently described genomic alterations may be helpful and have future therapeutic implications. The molecular investigation is becoming useful tool to help diagnosis and provide prognostic information. Diagnosis of acinic cell carcinoma (AcCC) is challenging due to its rarity and similarity with other SGCs or normal acinar cells.
Herein, the diagnostic performance of transcription factor nuclear receptor subfamily 4 group A member3 (NR4A3) was analysed immunohistochemically. This study was done on 68 cases of SCCs, including 32 of AcCC, 14 of adenoid cystic carcinoma (AdCC), 8 of mucoepidermoid carcinoma (MEC), 7 of epithelial myoepithelial carcinoma (EMC), 4 of salivary duct carcinoma (SDC), and only one case from each of carcinoma ex pleomorphic adenoma (CXPA), polymorphous adenocarcinoma (PAC) and secretory carcinoma (SC) for detecting NR4A3.
All stained samples of AcCC (100%) responded positively to the NR4A3 antibody. However, only one case of AdCC and MEC demonstrated NR4A3 immunostaining in less than 10% of cells. On the other hand, the different types of SGCs, including EMC, SDC, CXPA, PAC, and SC, revealed negative expressions. Therefore, we can conclude that NR4A3 can be used as a potential marker for AcCC rather than other SGCs.
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Wang H, Zhai C, Zhang C, Liu Q, Zhang H, Sun X, Lin L, Yu H, Wang D. Analysis of clinicopathologic features and expression of NR4A3 in sinonasal acinic cell carcinoma. Mod Pathol 2022; 35:594-600. [PMID: 34873305 DOI: 10.1038/s41379-021-00959-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/13/2021] [Accepted: 10/14/2021] [Indexed: 11/09/2022]
Abstract
Acinic cell carcinoma (AiCC) in the nasal cavity and paranasal sinuses has rarely been reported in literature. A recent study demonstrated that recurrent genomic rearrangement [t(4;9) (q13;q31)] is a driver event in AiCC of the salivary glands that could promote the upregulation of transcription factor nuclear receptor subfamily 4 group A member 3 (NR4A3). In the current study, we evaluated the clinicopathological characteristics and expression of NR4A3 in four new cases of sinonasal AiCC. All four patients were men (range, 27-70 years). The tumor involved only the nasal cavity in two patients, while the other two patients showed involvement of both the nasal cavity and ethmoid sinus. Histologically, the tumor displayed a predominantly solid growth pattern and was composed of hematoxyphilic serous-like cells and scattered intercalated duct-like cells. Immunohistochemically, all cases expressed DOG-1. However, staining for mammaglobin, S-100, CA9, and P63 was absent in all patients. All four cases showed positive nuclear staining for NR4A3. In contrast, none of the other 39 sinonasal tumors, including secretory carcinomas, pleomorphic adenomas, mucoepidermoid carcinomas, adenoid cystic carcinomas, renal cell-like adenocarcinomas, intestinal-type adenocarcinomas, non-intestinal-type adenocarcinomas, extraskeletal myxoid chondrosarcoma, and carcinoma ex pleomorphic adenomas, presented with any positive NR4A3 nuclear staining. Additionally, NR4A3 rearrangements were observed in three cases with sinonasal AiCC by fluorescence in situ hybridization, and the expression level of NR4A3 mRNA was significantly increased in sinonasal AiCC compared with that in normal parotid tissue. Our study demonstrated that sinonasal AiCCs are characterized by an indolent nature and histopathological similarity to parotid AiCCs. Moreover, NR4A3 is a reliable biomarker for distinguishing sinonasal AiCCs from other sinonasal carcinomas.
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Maghami E, Afkhami M, Villaflor V, Bell D. Heterotopic SMARCB1-deficient high-grade transformed/dedifferentiated acinic cell carcinoma and sine-qua-non radiology- pathology with TNM challenge. Ann Diagn Pathol 2022; 57:151900. [DOI: 10.1016/j.anndiagpath.2022.151900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 11/15/2022]
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Mueller SK, Haderlein M, Lettmaier S, Agaimy A, Haller F, Hecht M, Fietkau R, Iro H, Mantsopoulos K. Targeted Therapy, Chemotherapy, Immunotherapy and Novel Treatment Options for Different Subtypes of Salivary Gland Cancer. J Clin Med 2022; 11:jcm11030720. [PMID: 35160172 PMCID: PMC8836387 DOI: 10.3390/jcm11030720] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 12/04/2022] Open
Abstract
Surgical resection remains the first line treatment for salivary gland cancer (SGC). In the case of locally advanced disease, surgery is followed by adjuvant radiotherapy. Surgical resection should be favored in resectable locoregional recurrent disease as well, and even the complete resection of all distant oligometastases has clinical benefit for the patients. For inoperable and disseminated metastatic disease, a multitude of systemic therapies including chemotherapy, targeted therapy, and immunotherapy are available. In this review, the current therapeutic options for inoperable recurrent or metastatic SGCs are summarized. Systemic treatment can achieve prolonged progression-free and overall survival, while the overall prognosis remains poor. Current clinical trials include only a limited number of patients and mostly combine different histologic subtypes. Additionally, no randomized controlled trial comparing different therapeutic options has been performed. In the future, further studies with a larger patient cohort and ideally only one histologic subtype are needed in order to improve the outcome for SGC patients. However, this may be difficult to accomplish due to the rarity and diversity of the disease. Additionally, molecular analyses need to be performed routinely in order to individualize treatment and to go one step further towards precision medicine.
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Affiliation(s)
- Sarina K. Mueller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Correspondence:
| | - Marlen Haderlein
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Sebastian Lettmaier
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Abbas Agaimy
- Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.A.); (F.H.)
| | - Florian Haller
- Department of Pathology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (A.A.); (F.H.)
| | - Markus Hecht
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Rainer Fietkau
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
- Department of Radiation Oncology, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
| | - Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (H.I.); (K.M.)
- Working Group Salivary Glands and Thyroid Glands, Germany Otolaryngologic Society, Head and Neck Surgery, 53113 Bonn, Germany
- Comprehensive Cancer Center, Interdisciplinary Oncologic Clinic, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 91054 Erlangen, Germany; (M.H.); (S.L.); (M.H.); (R.F.)
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21
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Rodrigues de Sousa M, Martins S, Soares N, Coelho L, Neto T, Balhau R. Acinic cell carcinoma emerging as a paraneoplastic Cushing's syndrome: A systematic review. Advances in Oral and Maxillofacial Surgery 2022. [DOI: 10.1016/j.adoms.2021.100236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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22
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De Luca P, de Campora L, Tassone D, Atturo F, Colangeli R, Petruzzi G, Fermi M, Molinari G, Abeshi A, Cintoli G, Lo Manto A, Togo G, Ricciardiello F, Condorelli P, Raso F, Di Stadio A, Salzano G, Esposito E, D’Ecclesia A, Radici M, Iemma M, Vigili MG, Salzano FA, Magaldi L, Cassano M, Dallan I, Pellini R, Presutti L, Ionna F, de Campora E, Camaioni A. Acinic cell carcinoma of the parotid gland: Timeo Danaos et dona ferentes? A multicenter retrospective analysis focusing on survival outcome. Eur Arch Otorhinolaryngol 2022; 279:5821-5829. [PMID: 35678874 PMCID: PMC9649501 DOI: 10.1007/s00405-022-07481-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 05/30/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES To analyze the demographic data, surgical and adjuvant treatment data and the survival outcomes in adult patients affected by acinic cell carcinoma of the parotid gland (AciCC). METHODS A retrospective multicenter analysis of patients treated for AciCC of the parotid gland from 2000 to 2021 was performed. Exclusion criteria were pediatric (0-18 years) patients, the absence of follow-up and patients with secondary metastatic disease to the parotid gland. Multivariable logistic regression was used to determine factors associated with survival. RESULTS The study included 81 adult patients with AciCC of the parotid gland. The median age was 46.3 years (SD 15.81, range 19-84 years), with a gender female prevalence (F = 48, M = 33). The mean follow-up was 77.7 months (min 4-max 361, SD 72.46). The 5 years overall survival (OS) was 97.5%. The 5 years disease-free survival (DFS) was 60%. No statistical differences have been found in prognosis for age (< 65 or ≥ 65 years), sex, surgery type (superficial vs profound parotid surgery), radicality (R0 vs R1 + Rclose), neck dissection, early pathologic T and N stages and adjuvant therapy (p > 0.05). CONCLUSION This study did not find prognostic factor for poorest outcome. In contrast with the existing literature, our results showed how also high-grade tumours cannot be considered predictive of recurrence or aggressive behaviour.
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Affiliation(s)
- Pietro De Luca
- Department of Medicine, Surgery and Dentistry, University of Salerno, Salerno, Italy ,Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Luca de Campora
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Domenico Tassone
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Francesca Atturo
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Roberta Colangeli
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
| | - Gerardo Petruzzi
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Matteo Fermi
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy ,Department of Specialist, Diagnostic and Experimental Medicine, Alma Mater Studiorum University, Bologna, Italy
| | - Giulia Molinari
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Andi Abeshi
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Giulia Cintoli
- Department of Otolaryngology-Head and Neck Surgery, University of Foggia, Foggia, Italy
| | - Alfredo Lo Manto
- Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Giulia Togo
- Maxillofacial Surgery Unit, Department of Neurosciences, Reproductive and Odontostomatological Sciences, University Federico II, Naples, Italy
| | | | | | | | | | - Giovanni Salzano
- Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | - Erik Esposito
- Otolaryngology Department, ASL Napoli 3 Sud, Torre del Greco, Naples, Italy
| | - Aurelio D’Ecclesia
- IRCCS “Casa Sollievo Della Sofferenza” San Giovanni Rotondo, Foggia, Italy
| | - Marco Radici
- Unit of Otolaryngology, S. Giovanni Calibita-Fatebenefratelli General Hospital, Rome, Italy
| | - Maurizio Iemma
- Otolaryngology Department, San Giovanni di Dio e Ruggi D’Aragona University Hospital, Salerno, Italy
| | - Maurizio Giovanni Vigili
- Department of General Surgery-Head and Neck Consultant, Istituto Dermopatico Dell’Immacolata IDI-IRCCS, Rome, Italy
| | | | - Luciano Magaldi
- Department of Otolaryngology-Head and Neck Surgery, University of Foggia, Foggia, Italy
| | - Michele Cassano
- Department of Otolaryngology-Head and Neck Surgery, University of Foggia, Foggia, Italy
| | - Iacopo Dallan
- Department of Otorhinolaryngology, Azienda Ospedaliera Universitaria, Pisa, Italy
| | - Raul Pellini
- Department Otolaryngology Head and Neck Surgery, IRCCS Regina Elena National Cancer Institute, Istituti Fisioterapici Ospitalieri (IFO), Rome, Italy
| | - Livio Presutti
- Department of Otorhinolaryngology-Head and Neck Surgery, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Franco Ionna
- Otolaryngology and Maxillo-Facial Surgery Unit, Istituto Nazionale Tumori-IRCCS Fondazione G. Pascale, Naples, Italy
| | - Enrico de Campora
- Associazione Ospedaliera Italia Centromeridionale Otorinolaringoiatrica (AOICO), Rome, Italy
| | - Angelo Camaioni
- Department Otolaryngology Head and Neck Surgery, San Giovanni-Addolorata Hospital, Rome, Italy
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van Weert S, Valstar M, Lissenberg-Witte B, Bloemena E, Smit L, van der Wal J, Vergeer M, Smeele L, Leemans CR. Prognostic factors in acinic cell carcinoma of the head and neck: The Amsterdam experience. Oral Oncol 2021; 125:105698. [PMID: 34973520 DOI: 10.1016/j.oraloncology.2021.105698] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/18/2021] [Accepted: 12/22/2021] [Indexed: 01/03/2023]
Abstract
INTRODUCTION The aim was to analyse prognosticators in acinic cell carcinoma (AciCC) in two head and neck referral centers in Amsterdam, the Netherlands. MATERIALS AND METHODS Eighty- nine cases of AciCC treated between 1979 and 2016 were retrospectively reviewed. Five, - 10 -and 20- year estimates of survival were executed as well as univariate analysis of prognosticators. RESULTS The majority of AciCC were T1-T2; 89%. Two percent had nodal disease (2%). The most affected organ was the parotid gland (84%) with a female preponderance (67%). Mean age was 52 years with most cases diagnosed in the fourth to sixth decade. The majority of patients received adjuvant radiotherapy. Elective neck dissection (END) in the N0 neck showed no metastases. High grade transformation (HGT) was found in 21% of cases. Median follow up was 101.9 months. Median time to recurrence was 26 months. Nine patients developed distant metastases (DM) of whom 6 had HGT-AciCC. Median survival with DM was 7 months. Five,- ten -and twenty- year estimates were 84%, 81% and 81% for recurrence free survival respectively. Negative clinical features were advanced stage disease and tumour size > 2.6 cm. Negative histological features were a high mitotic rate, HGT, close and involved surgical margins and necrosis. CONCLUSION AciCC- HGT excluded- of the head and neck has an excellent prognosis and shows acceptable long term results. END can be considered as part of the standard treatment due to the relative high incidence of HGT- AciCC and low accuracy of cytology.
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Sivasubramaniam P, Tiegs-Heiden CA, Geiersbach KB, Hagen CE, Sturgis CD, Thangaiah JJ, Hartley CP. Mammary analogue secretory carcinoma: A challenging case arising in a young man with radiation exposure. Ann Diagn Pathol 2021; 57:151862. [PMID: 34953444 DOI: 10.1016/j.anndiagpath.2021.151862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 11/11/2021] [Indexed: 11/19/2022]
Abstract
Mammary Analogue Secretory Carcinoma (MASC) is a recently described salivary gland tumor frequently sampled via fine-needle aspiration. The cytologic features of MASC are not entirely distinctive and can simulate acinic cell carcinoma, but the tumor harbors an ETV6 gene rearrangement resulting in an ETV6-NTRK3 fusion gene. We present a case of MASC arising in a 31 year old man with a history of multiple radio-embolization procedures.
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Affiliation(s)
| | | | | | - Catherine E Hagen
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Charles D Sturgis
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
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Ding A, Zuo J, Lv H, Zhou L, Ding S, Yu Q, Xiong P. Imaging identification of primary mammary analogue secretory carcinoma and acinic cell carcinoma in major salivary glands. Oral Dis 2021; 28:1861-1870. [PMID: 34773340 DOI: 10.1111/odi.14080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 10/12/2021] [Accepted: 10/29/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVE The present study aimed to characterize and differentiate the ultrasonography (US) and computed tomography (CT) features of mammary analogue secretory carcinoma (MASC) and acinic cell carcinoma (AciCC). METHODS AND PATIENTS A total of 83 patients with clinically proven MASC and AciCC were analyzed. The following characteristics were assessed on US, CT, and magnetic resonance imaging: lesion size, shape, margin, echogenicity, echotexture, cystic components, posterior echo, vascularity, density, degree of enhancement, enhancement pattern, signal intensity (SI) on T1- and T2-weighted images (WI), hemorrhages, and lymph node enlargement. RESULTS Similarities were observed between the imaging performance of MASC and AciCC. Differences between the two characteristics of shape on US and cystic components on CT were statistically significant. The proportion of MASC to regular shape on US (p = 0.006) and cystic components on CT (p = 0.027) was significantly higher than that of AciCC. Regular shape on US had the highest sensitivity in the identification of MASC and AciCC, while regular shape on US + cystic component on CT had the highest specificity. CONCLUSIONS The shape on US and cystic components on CT are key characteristics for distinguishing MASC and AciCC.
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Affiliation(s)
- AngAng Ding
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Jiaxin Zuo
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Huan Lv
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Lu Zhou
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Shiwen Ding
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Qian Yu
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
| | - Ping Xiong
- Department of Ultrasound, Shanghai Ninth People's Hospital, Shanghai JiaoTong University School of Medicine, Shanghai, China
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Franchi A, Skalova A. Undifferentiated and dedifferentiated head and neck carcinomas. Semin Diagn Pathol 2021; 38:127-136. [PMID: 34583858 DOI: 10.1053/j.semdp.2021.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 09/14/2021] [Accepted: 09/14/2021] [Indexed: 11/11/2022]
Abstract
Undifferentiated carcinomas arising at salivary gland and head and neck mucosal sites may originate either de novo or through a process of dedifferentiation of a differentiated carcinoma. While in the latter group the diagnosis is largely dependent on the identification of the differentiated component or recognition of a specific genotype, the classification of undifferentiated carcinomas that lack a differentiated component is mainly based on the identification of specific genetic drivers, like for example the NUTM1 fusions in NUT carcinoma. A further category is represented by virus associated carcinomas (mainly HPV and EBV), that frequently displays an undifferentiated morphology. Overall, these tumors often represent a diagnostic challenge, especially in small biopsies. This review summarizes and discuss the diagnostic approach to the main head and neck carcinoma types that frequently or occasionally display an undifferentiated appearance, with a focus on salivary gland, oropharyngeal, nasopharyngeal and sinonasal subsites.
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Affiliation(s)
- Alessandro Franchi
- Section of Pathology, Department of Traslational Research and of New Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
| | - Alena Skalova
- Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic
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Wade L, Kitching P, De Winton E. Ectopic ACTH Secretion Secondary to Metastatic Acinic Cell Carcinoma of the Parotid Gland: A Case Report and Review of Current Evidence for Systemic Therapy. J Investig Med High Impact Case Rep 2021; 8:2324709620918080. [PMID: 32410474 PMCID: PMC7232044 DOI: 10.1177/2324709620918080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Acinic cell carcinoma is a rare, typically indolent, neoplasm that arises in the
salivary glands. Metastatic disease is uncommon, occurring in around 10% of
cases. We report the case of a 46-year-old male in whom the first sign of
disseminated disease was increased skin pigmentation due to paraneoplastic
Cushing’s syndrome. He underwent 3 cycles of chemotherapy with carboplatin and
paclitaxel with no symptomatic improvement and a mixed response on imaging.
There is no evidence that systemic therapy prolongs survival in metastatic
acinic cell carcinoma, and we lack a consensus as to which treatment options are
most beneficial. A summary of published evidence regarding choice of palliative
chemotherapy regimens and response is discussed in relation to the case.
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Affiliation(s)
- Louise Wade
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Paul Kitching
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
| | - Emma De Winton
- Royal United Hospitals Bath NHS Foundation Trust, Bath, UK
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Pang Y, Sun L, Liu H, Ma J. Differential diagnosis and treatment of salivary secretory carcinoma and acinic cell carcinoma. Oral Oncol 2021; 119:105370. [PMID: 34157553 DOI: 10.1016/j.oraloncology.2021.105370] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 05/10/2021] [Accepted: 05/25/2021] [Indexed: 02/08/2023]
Abstract
Secretory carcinoma (SC) and acinic cell carcinoma (AciCC) are two rare tumors originating in the salivary gland of the head and neck. Before the World Health Organization (WHO) classified SC as a new entity in 2017, the majority of SC cases were incorrectly diagnosed as AciCC. Indeed, they are similar in biological behaviors, clinical manifestations and histomorphological features. Especially, SC and zymogen granule-poor AciCC are difficult to differentiate, which brings a tough challenge in clinical diagnosis. This article provides an updated understanding of the differential diagnosis in SC and AciCC from two main perspectives: histopathology and molecular genetics. The targeted therapies for both tumors are also mentioned. It aims to give some hints in clinical diagnosis and treatment, in hopes that patients with adequate diagnosis could obtain the opportunityformore effective treatment.
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Affiliation(s)
- Yu Pang
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China; State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan Province 610041, PR China.
| | - Lingqi Sun
- Department of Neurology, Air Force Hospital of Western Theater Command, Chengdu, Sichuan Province 610041, PR China
| | - Huijia Liu
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China
| | - Ji Ma
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, Sichuan Province 610041, PR China.
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Khozestani NK, Garajei A, Mahdavi N, Abdolrahmani A. Primary acinic cell carcinoma of mandible, report of a case and literature review. Int J Surg Case Rep 2021; 84:106065. [PMID: 34153699 DOI: 10.1016/j.ijscr.2021.106065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 05/01/2021] [Accepted: 05/21/2021] [Indexed: 11/22/2022] Open
Abstract
Introduction and importance Acinic cell carcinoma (ACC) is a rare low-grade salivary gland malignancy that accounts for approximately 17% of all salivary gland malignancies. The most common site affected by ACC is the parotid gland followed by the submandibular glands, minor salivary glands, and sublingual glands. Also, it could hardly be observed in unusual sites such as the jaw bones. Case presentation This case is an example of a central acinic cell carcinoma in a 73-year-old man who came up with a painless gradual swelling for 15 months. Based on clinico-radio-pathologic findings, the diagnosis of a solid variant Intraosseous Acinic Cell Carcinoma was established. Subsequently, the patient underwent hemimandibulectomy and modified radical neck dissection, followed by postoperative radiotherapy. Within a six-month follow-up period, no evidence of residual tumor was found. Clinical discussion Central salivary gland carcinoma is a rare entity and intraosseous ACC is more scarcely observed. Based on our findings, a total of 17 cases of primary intraosseous ACC have been reported so far. Etiology and clinical presentations of this tumor are still vague due to its rarity. Conclusion Dentists and oral surgeons must be aware of such a rare malignant lesion when encountering a radiolucent lesion within the jaws. The early diagnosis and a complete surgical excision to achieve tumor-free surgical margins and a long-term follow-up could result in significantly improved survival rates. ACCs are a type of uncommon salivary gland tumors and the intra-osseous counterparts are extremely rare. Due to clinical and radiologic similarities to benign tumors, histopathologic and IHC findings should also be considered. Primary surgical design should be wide enough and en bloc resection should be suggested.
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Skalova A, Leivo I, Hellquist H, Agaimy A, Simpson RHW, Stenman G, Vander Poorten V, Bishop JA, Franchi A, Hernandez-Prera JC, Slouka D, Willems SM, Olsen KD, Ferlito A. High-grade Transformation/Dedifferentiation in Salivary Gland Carcinomas: Occurrence Across Subtypes and Clinical Significance. Adv Anat Pathol 2021; 28:107-18. [PMID: 33825717 DOI: 10.1097/PAP.0000000000000298] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
High-grade transformation (HGT) or dedifferentiation has been described in a variety of salivary gland carcinomas, including acinic cell carcinoma, secretory carcinoma, adenoid cystic carcinoma, epithelial-myoepithelial carcinoma, polymorphous adenocarcinoma, low-grade mucoepidermoid carcinoma, and hyalinizing clear cell carcinoma. High-grade (HG) transformed tumors are composed of a conventional low-grade component characterized by specific microscopic and immunohistochemical features for the given entity, intermingled with or juxtaposed to areas of HG morphology. This is usually either poorly differentiated adenocarcinoma, carcinoma not otherwise specified, or undifferentiated carcinoma, in which the original line of differentiation is lost. The HG component is composed of solid nests of anaplastic cells with large vesicular pleomorphic nuclei, prominent nucleoli, and abundant cytoplasm. Frequent mitoses and extensive necrosis may be present. The Ki-67 labeling index is consistently higher in the HG component. The molecular genetic mechanisms responsible for HGT of salivary gland carcinomas are largely unknown, though p53 inactivation and human epidermal growth factor receptor 2 overexpression and/or gene amplification have been demonstrated in the HG component in a few examples, the frequency varies for each histologic type. Salivary gland carcinomas with HGT are more aggressive than conventional carcinomas, with a higher local recurrence rate and a poorer prognosis. They have a high propensity for cervical lymph node metastasis suggesting a need for a wider resection and neck dissection. HGT of salivary gland carcinoma can occur either at initial presentation or less commonly at the time of recurrence, sometimes following postoperative radiotherapy. The potential for HGT in almost any type of salivary gland carcinoma warrants a thorough sampling of all salivary gland malignancies to prevent oversight of a HG component.
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de Angelis CM, de Lima-Souza RA, Scarini JF, Egal ESA, do Amaral-Silva GK, de Oliveira Gondak R, de Almeida OP, Chone CT, Kowalski LP, Altemani A, Mariano FV. Immunohistochemical Expression of Fatty Acid Synthase (FASN) is Correlated to Tumor Aggressiveness and Cellular Differentiation in Salivary Gland Carcinomas. Head Neck Pathol 2021; 15:1119-26. [PMID: 33843033 DOI: 10.1007/s12105-021-01319-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/23/2021] [Indexed: 10/21/2022]
Abstract
Fatty acid synthase (FASN) expression is closely related to cancer progression, in particular, tumor aggressiveness and poor prognosis. This study aimed to analyse the expression of FASN in carcinomas of the salivary glands and correlate it with Ki-67 expression. We analysed by immunohistochemistry the expression of FASN and Ki-67 on tissue sections from 7 cases of adenocarcinoma, not otherwise specified (AdNOS), 6 cases of polymorphous adenocarcinoma (PAC), 16 cases of acinic cell carcinoma (AcCC), 19 cases of adenoid cystic carcinoma (AdCC), 15 cases of epithelial-myoepithelial carcinoma (EMC); 10 cases of secretory carcinoma (SC), 13 cases of mucoepidermoid carcinoma (MEC), 10 cases of salivary duct carcinoma (SDC) and 7 cases of myoepithelial carcinoma (MC). These carcinomas were classified into aggressive and indolent regarding their biological behaviour. Additionally, MEC and AdCC were also classified according to the histological grade. High expression of FASN was found in SDC (100%), SC (100%), AcCC (68.7%) and AdNOS (57.2%). No association was found between FASN and Ki-67 expression. Aggressive carcinomas showed a higher rate of Ki-67 proliferation (p < 0.001) and greater expression of FASN when compared to indolent carcinomas (p < 0.05). With regards to carcinomas categorized as indolent, FASN expression was much higher in the lesions that presented cell differentiation (SC and AcCC). Also, FASN expression was significantly higher in high-grade AdCC and MEC when compared to low-grade tumors (p < 0.05). We concluded that FASN expression was correlated to tumor aggressiveness and cellular differentiation in salivary gland carcinomas.
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Nakajima R, Patel SG, Katabi N, Flukes S, Mauguen A, Ganly I, Schöder H. Diagnostic and Prognostic Utility of 18F-FDG PET/CT in Recurrent Salivary Gland Cancers. AJR Am J Roentgenol 2021; 216:1344-56. [PMID: 33826358 DOI: 10.2214/AJR.20.23259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE. The role of 18F-FDG PET/CT in the evaluation of recurrent salivary gland tumors remains poorly defined. We investigated the diagnostic and prognostic utility of PET in this setting. MATERIALS AND METHODS. A total of 146 patients with recurrent salivary gland cancer were treated at our institution between January 2002 and December 2015. Patients who underwent FDG PET/CT and conventional imaging (CT or MRI) within 3 months of recurrence (n = 78) were included in this retrospective analysis. On FDG PET/CT, we measured the SUVmax, total body metabolic tumor volume of all lesions, and total lesion glycolysis of all lesions to determine the intensity and extent of FDG-avid disease. We assessed the correlation of FDG PET/CT findings with clinicopathologic features, progression-free survival, and overall survival. RESULTS. FDG PET/CT was positive for recurrence in 74 of 78 patients (94.9%) and falsely negative in four patients (5.1%). In comparison with conventional imaging, FDG PET/CT performed for restaging detected additional recurrent lesions in 14 patients (17.9%). The median SUVmax was 7.4, the median total body metabolic tumor volume was 30.1 cm3, and median total lesion glycolysis was 97.3 g/mL × cm3. Sixty-six patients had progressive disease, and 54 died. Univariate and multivariate Cox hazards analysis identified pathologic risk group (p = .04), total body metabolic tumor volume (p < .001), and total lesion glycolysis (p < .001) as independent prognostic factors for progression-free survival and identified age (p = .05), total body metabolic tumor volume (p < .001), and total lesion glycolysis (p < .001) as independent prognostic factors for overall survival. CONCLUSION. In patients with recurrent salivary gland cancer, FDG PET/CT is useful as a single test for defining the extent of disease and providing prognostic information, which may help in selecting appropriate treatment strategies.
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Abstract
Salivary gland neoplasms are an uncommon and widely heterogeneous group of tumors. In recent years, there has been considerable progress in efforts to reveal the molecular landscape of these tumors, although it is still limited and appears to be only the tip of the iceberg. Genomic aberrations, especially specific chromosomal rearrangements including CRTC1-MAML2 and CRTC3-MAML2 in mucoepidermoid carcinoma, MYB-NFIB and MYBL1-NFIB fusions in adenoid cystic carcinoma, PLAG1 and HMGA2 alterations in pleomorphic adenoma and carcinoma ex pleomorphic adenoma, ETV6-NTRK3 and ETV6-RET in secretory carcinoma, EWSR1-ATF1 and EWSR1-CREM in clear cell carcinoma, provide new insights into the molecular pathogenesis of various salivary gland neoplasms and help to better classify them. These genetic aberrations primarily serve as diagnostic tools in salivary gland tumor diagnosis; however, some also have promise as prognostic or predictive biomarkers. This review summarizes the latest developments in molecular pathology of salivary gland tumors with a focus on distinctive molecular characteristics.
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Abstract
Lymphoepithelial carcinoma of salivary glands (LECSG) is an uncommon neoplasm. This article summarizes the findings of 438 cases in a review of the literature. Concurrent lymphoepithelial lesions may suggest a primary tumor. The tumor shows a nonkeratinizing carcinoma intimately associated with a rich lymphohistiocytic infiltrate, destroying adjacent salivary gland tissue. Irrespective of race or ethnicity, the tumors usually express Epstein-Barr virus, with Epstein-Barr virus encoded small RNA (EBER) and/or latent membrane protein-1 (LMP-1), although a subset does not. There is an overall good prognosis of about 80% at 5 years.
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Kirschnick LB, Silveira FM, Schuch LF, Fonseca FP, Martins MAT, Lopes MA, Santos-Silva AR, Carrard VC, Dos Santos JN, Vargas PA, Wagner VP, Martins MD. Clinicopathological analysis of oral and maxillofacial acinic cell carcinoma: A systematic review. J Oral Pathol Med 2021; 50:741-749. [PMID: 33455041 DOI: 10.1111/jop.13159] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 01/13/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The aim of the present systematic review was to analyze the available data regarding acinic cell carcinoma of the oral and maxillofacial region. METHODS A search strategy was performed using PubMed, Web of Science, Scopus, and Embase electronic databases. RESULTS Available data revealed a slight female preference (54.73%) and a mean age at diagnosis of 47.51 ± 19.85 years. The parotid glands (67.72%) were most frequently affected, and most cases were asymptomatic (69.54%). A microcystic histopathological pattern was reported in 21.56% of the cases, and the Periodic acid-Schiff was the staining method most frequently used, after the hematoxylin and eosin staining, in the tumors analyzed. The lesions were mainly treated by surgical removal (72.32%). Recurrence was reported in 81 cases (27.83%) and metastasis in 100 (42.91%). Statistical data analysis revealed that tumors located in major salivary glands and exhibiting high-grade histology were associated with local recurrence (P = .01). In addition, the patients older than 57 years, lesions with bone involvement, the high-grade tumors and the cases with a history of recurrence and metastasis were associated with a lower overall survival (P < .05). CONCLUSION By assembling all eligible cases in the literature, the present systematic review determined the most common clinicopathological profile of acinic cell carcinoma and the most relevant prognostic factors in a distinctly representative sample. The survey demonstrated the importance of considering the histopathological grading in order to better define the treatment for each case.
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Affiliation(s)
- Laura Borges Kirschnick
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Felipe Martins Silveira
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Lauren Frenzel Schuch
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Felipe Paiva Fonseca
- Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
| | | | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Vinicius Coelho Carrard
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Jean Nunes Dos Santos
- Department of Pathology, Postgraduate Program in Dentistry and Health, School of Dentistry, Universidade Federal da Bahia, Salvador, BA, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil
| | - Vivian Petersen Wagner
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil.,Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Oral Diagnosis Department, Piracicaba Dental School, Universidade Estadual de Campinas, Piracicaba, SP, Brazil.,Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Abstract
Objective To present a case of adrenocorticotropic hormone (ACTH) hypersecretion caused by a metastatic acinic cell carcinoma (AcCC) of the parotid. Only 6 cases have been reported prior to October 2019. We believe that this condition is under-reported and hope that improved recognition will improve its reporting. Methods Diagnosis in this case was done using surgical pathology of the primary tumor, involving lymph nodes, and a metastatic lesion. Following an initial misdiagnosis, a final diagnosis of AcCC was made using immunohistochemical staining. ACTH hypersecretion was diagnosed by testing for random ACTH, cortisol, and 24-hour urine aldosterone and cortisol levels. Results A 57-year-old man presented with hypokalemia, lower-extremity edema, and left-side rib pain 7 months following excision of a 4-cm left-parotid tumor. Immunostaining positive for DOG-1, CK7, pan-cytokeratin (including CAM5.2), and SOX10 led to the diagnosis of AcCC. ACTH hypersecretion was diagnosed based on a random ACTH level of 307 pg/mL (normal morning value, 7.2-63 pg/mL), a cortisol level of 33 μg/dL (normal morning value, 4.3-19.8 μg/dL; normal PM value, 3.1-15.0 μg/dL), a 24-hour urine aldosterone level of <0.7 U (normal, 2.0-20 U), and a 24-hour urine cortisol level of 4564 U (normal, 3.5-45 U). The patient’s ACTH hypersecretion and hypokalemia were treated with potassium replacement, amiloride, and ketoconazole. His metastatic recurrence was treated with radiotherapy, chemotherapy, and immunotherapy. The patient died after being diagnosed with sepsis secondary to multifocal postobstructive pneumonia 4 months after the diagnosis of his metastatic recurrence. Conclusion Ectopic ACTH production caused by metastatic AcCC is a rare phenomenon but has been increasingly described over the last 15 years. We believe that this condition likely has a greater prevalence than what is reported and that improved recognition will lead to improved outcomes.
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Affiliation(s)
- Jacob M Burch
- Sparrow Hospital, Michigan State Internal Medicine Residency, Swartz Creek, Michigan
| | - James S Choi
- Sparrow Hospital, Michigan State Internal Medicine Residency, Swartz Creek, Michigan
| | - Osama Mosalem
- Sparrow Hospital, Michigan State Internal Medicine Residency, Swartz Creek, Michigan
| | - Lawrenshey Charles
- Sparrow Hospital, Michigan State Internal Medicine Residency, Swartz Creek, Michigan
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Starek I, Salzman R, Skalova A. Heterotopic acinic cell carcinoma and its clinical implications. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub 2020; 165:13-18. [PMID: 33177745 DOI: 10.5507/bp.2020.047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Accepted: 10/05/2020] [Indexed: 11/23/2022] Open
Abstract
This is a review of the clinical and histopathological published data on very rare heterotopic acinic cell carcinomas (AcCCs) with suggested optimal management. Extrasalivary AcCCs originate primarily in parotid lymph nodes. They present at low clinical stage, show mostly low-grade histopathology and are circumscribed with a complete nodal capsule. Extracapsular dissection was advocated as adequate therapy. In rare cases with positive surgical margins, a completion parotidectomy or adjuvant radiotherapy should follow. Heterotopic high-grade AcCCs are rare, necessitating radical surgery including neck dissection and adjuvant radiotherapy. The short term prognosis is excellent, long term outcomes are not known. Longer term follow-up is essential.
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Affiliation(s)
- Ivo Starek
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Richard Salzman
- Department of Otorhinolaryngology and Head and Neck Surgery, University Hospital Olomouc and Faculty of Medicine and Dentistry, Palacky University Olomouc, Czech Republic
| | - Alena Skalova
- Department of Pathology, Faculty of Medicine in Plzen, Charles University Prague, Czech Republic
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Lee DY, Brayer KJ, Mitani Y, Burns EA, Rao PH, Bell D, Williams MD, Ferrarotto R, Pytynia KB, El-Naggar AK, Ness SA. Oncogenic Orphan Nuclear Receptor NR4A3 Interacts and Cooperates with MYB in Acinic Cell Carcinoma. Cancers (Basel) 2020; 12:E2433. [PMID: 32867110 PMCID: PMC7565926 DOI: 10.3390/cancers12092433] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 08/24/2020] [Indexed: 12/23/2022] Open
Abstract
Acinic cell carcinoma (AcCC) is a morphologically distinctive salivary gland malignancy often associated with chromosome rearrangements leading to overexpression of the NR4A3 transcription factor. However, little is known about how NR4A3 contributes to AcCC biology. Detailed RNA-sequencing of 21 archived AcCC samples revealed fusion reads arising from recurrent t(4;9), t(9;12), t(8;9) or t(2;4) chromosomal translocations, which positioned highly active enhancers adjacent to the promoter of the NR4A3 gene or the closely related NR4A2 gene, resulting in their aberrant overexpression. Transcriptome analyses revealed several distinct subgroups of AcCC tumors, including a subgroup that overexpressed both NR4A3 and MSANTD3. A poor survival subset of the tumors with high-grade transformation expressed NR4A3 and POMC as well as MYB, an oncogene that is the major driver in a different type of salivary gland tumor, adenoid cystic carcinoma. The combination of NR4A3 and MYB showed cooperativity in regulating a distinct set of genes. In addition, the ligand binding domain of NR4A3 directly bound the Myb DNA binding domain. Transformation assays indicated that, while overexpressed NR4A3 was sufficient to generate transformed colonies, the combination of NR4A3 plus Myb was more potent, leading to anchorage-independent growth and increased cellular invasiveness. The results confirm that NR4A3 and NR4A2 are the main driver genes of AcCC and suggest that concurrent overexpression of NR4A3 and MYB defines a subset of AcCC patients with high-grade transformation that display exceptionally poor outcome.
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Affiliation(s)
- David Y. Lee
- Department of Internal Medicine, Division of Hematology/Oncology, Section of Radiation Oncology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA; (D.Y.L.); (E.A.B.)
| | - Kathryn J. Brayer
- Department of Internal Medicine, Division of Molecular Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA;
| | - Yoshitsugu Mitani
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (Y.M.); (D.B.); (M.D.W.)
| | - Eric A. Burns
- Department of Internal Medicine, Division of Hematology/Oncology, Section of Radiation Oncology, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA; (D.Y.L.); (E.A.B.)
| | - Pulivarthi H. Rao
- Department of Pediatrics, Texas Children’s Cancer and Hematology Center, Texas Children’s Hospital, Baylor College of Medicine, Houston, TX 77030, USA;
| | - Diana Bell
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (Y.M.); (D.B.); (M.D.W.)
| | - Michelle D. Williams
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (Y.M.); (D.B.); (M.D.W.)
| | - Renata Ferrarotto
- Department of Thoracic and Head and Neck Medical Oncology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Kristen B. Pytynia
- Department of Head and Neck Surgery, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Adel K. El-Naggar
- Department of Pathology, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA; (Y.M.); (D.B.); (M.D.W.)
| | - Scott A. Ness
- Department of Internal Medicine, Division of Molecular Medicine, University of New Mexico School of Medicine, Albuquerque, NM 87131, USA;
- Comprehensive Cancer Center, University of New Mexico, Albuquerque, NM 87131, USA
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Moon P, Tusty M, Divi V, Megwalu UC. Significance of Nodal Metastasis in Parotid Gland Acinar Cell Carcinoma. Laryngoscope 2020; 131:E1125-E1129. [PMID: 32770798 DOI: 10.1002/lary.28966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 06/24/2020] [Accepted: 06/30/2020] [Indexed: 11/08/2022]
Abstract
OBJECTIVES To evaluate the rate of lymph node metastasis in parotid gland acinar cell carcinoma, to identified factors associated with increased risk of metastasis, and to evaluate the effect of nodal metastasis on survival. METHODS This is a retrospective cohort study utilizing data from a large population-based cancer database. Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) 18 database. The study cohort included patients with parotid gland acinar cell carcinoma diagnosed between 2000 and 2015. RESULTS The overall rate of lymph node metastasis was 6.8%. T3/T4 (OR 6.17, 95% CI, 3.03 to 13.16) disease along with High Grade (OR 15.95) disease were associated with increased risk of nodal metastasis. Non-white, non-Black race was associated with decreased risk. Age and sex were not associated with nodal metastasis. Nodal metastasis was associated with worse OS (HR 6.27, 95% CI, 3.85 to 10.20) and DSS (HR 6.96, 95% CI, 3.81 to 12.73) after adjusting for covariates. CONCLUSION Parotid gland acinar cell carcinoma carries a low risk of nodal metastasis. Both advanced T stage and high grade are associated with increased risk of nodal metastasis. Nodal metastasis is associated with decreased overall survival. LEVEL OF EVIDENCE 3 Laryngoscope, 131:E1125-E1129, 2021.
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Affiliation(s)
- Peter Moon
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Palo Alto, CA, U.S.A
| | - Mahbuba Tusty
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Palo Alto, CA, U.S.A
| | - Vasu Divi
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Palo Alto, CA, U.S.A
| | - Uchechukwu C Megwalu
- Department of Otolaryngology and Head and Neck Surgery, School of Medicine, Stanford University, Palo Alto, CA, U.S.A
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40
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Park YM, Kang MS, Kim DH, Koh YW, Kim SH, Lim JY, Choi EC. Surgical extent and role of adjuvant radiotherapy of surgically resectable, low-grade parotid cancer. Oral Oncol 2020; 107:104780. [PMID: 32442895 DOI: 10.1016/j.oraloncology.2020.104780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 04/18/2020] [Accepted: 05/05/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Due to the rarity of low-grade parotid gland cancer and the diversity of histologic subtype, its optimal treatment modalities and prognostic factors have not been established yet. In this study, we aimed to identify the prognostic factors and adequate treatment modalities for patients with low-grade parotid gland cancer. METHODS We retrospectively analyzed clinico-pathologic data from 287 patients with low-grade parotid gland cancer from 1999 to 2018. RESULTS Recurrence-free survival, disease-specific survival, and overall survival rates at 10 years were 80.6%, 93.9%, and 84.4%, respectively. Among all patients, 56.1% received surgery alone, and the remaining 43.9% received surgery with adjuvant radiotherapy. Resection margin status and TNM stage were significant unfavorable prognostic factors. In patients with T1-2 tumor, surgical extent (total vs. less-than-total) did not show any significant effect on disease recurrence and patients' survival, and the disease was controlled well if a negative surgical margin was obtained after surgery, even with microscopic clear margin of<1 mm. In patients with adverse pathologic features (positive margin, lymphovascular invasion, perineural invasion, extracapsular nodal spread, T3-4, and N1-3), adjuvant radiotherapy significantly decreased loco-regional recurrence. CONCLUSIONS Oncological outcomes were good in patients with low-grade parotid gland cancer with surgery and radiotherapy. In patients with T1-2 low-grade parotid gland cancer, surgery alone showed good local control rate regardless of the extent of surgery, if a negative surgical margin was obtained after surgery. Adjuvant radiotherapy played a significant role in controlling loco-regional recurrence in patients with adverse pathologic features.
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Affiliation(s)
- Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Da Hee Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Gangnam Severance Hospital, Seoul, Republic of Korea.
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Park YM, Yoon SO, Kim JH, Kang MS, Kim DH, Koh YW, Kim SH, Lim JY, Choi EC. Comprehensive Analysis of Clinicopathologic Factors Predictive of an Unfavorable Prognosis in Patients With Acinic Cell Carcinoma of the Parotid Gland. Clin Exp Otorhinolaryngol 2020; 14:108-115. [PMID: 32392906 PMCID: PMC7904441 DOI: 10.21053/ceo.2019.01550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 12/18/2019] [Indexed: 11/22/2022] Open
Abstract
Objectives. In subset of patients, acinic cell carcinoma (AcCC) exhibits aggressive features such as recurrence, distant metastasis, and mortality. This study aimed to investigate clinicopathologic factors influencing patients’ prognosis and to identify adverse features predictive of an unfavorable prognosis. Methods. Between January 2000 and December 2016, 59 patients with AcCC were enrolled in this study. Results. The patients’ 5-year overall survival rate was 93.3%, and their 5-year recurrence-free survival rate was 80.5%. During the study period, recurrence occurred in 10 patients. The mean time to recurrence after surgery was 26 months (range, 5–60 months). During the study period, three patients died from the disease. Univariate analysis showed that sex, surgical extent, extranodal extension, T classification, and TNM stage were significantly associated with disease recurrence. Multivariate analysis showed that, among the clinicopathologic factors included in the analysis, only TNM stage displayed a statistically significant correlation with disease recurrence. Conclusion. Surgical treatment alone yielded good results for AcCC, and additional treatment did not affect the recurrence-free survival rate or the overall survival rate, even when the resection margin was less than 1 mm. Other pathologic factors did not show prognostic significance for disease recurrence or death.
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Affiliation(s)
- Young Min Park
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Sun Och Yoon
- Department of Pathology, Yonsei University College of Medicine, Seoul, Korea
| | - Joo Hyun Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Min Seok Kang
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Da Hee Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Yoon Woo Koh
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Se-Heon Kim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Eun Chang Choi
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
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42
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Cavaliere M, De Luca P, Scarpa A, Savignano L, Cassandro C, Cassandro E, Iemma M. Acinic cell carcinoma of the parotid gland: from pathogenesis to management: a literature review. Eur Arch Otorhinolaryngol 2020; 277:2673-9. [PMID: 32367151 DOI: 10.1007/s00405-020-05998-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 04/18/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE Acinic cell carcinoma (ACCs) is uncommon malignant epithelial neoplasm of the salivary glands; the most common presentation is a well-defined painless solid mass. Diagnosis of ACCs is frequently complicated, due to its similarity with benign tumors. METHODS A review of the literature available on ACCs was carried out. Studies were sourced from PubMed with searching of relevant headings and sub-headings and cross-referencing. RESULTS There are no clear characteristics of ACCs found on CT, MRI and ultrasound imaging. The management of the ACC, a rare malignancy of the parotid gland, is often difficult and controversial. Radical surgery is the best treatment option. The role of radiotherapy remains controversial: the precise indications and oncologic effects of adjuvant radiotherapy in ACC of the parotid gland are not well known. There is insufficient literature regarding the chemotherapy for metastatic ACC. CONCLUSION Knowledge about ACC, a rare malignancy of parotid gland, has changed over the past few decades. More clinical randomized works would be needed, both to assess the real effectiveness of radio and chemotherapy and to have an unanimous consensus about their indications.
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43
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Na K, Hernandez-Prera JC, Lim JY, Woo HY, Yoon SO. Characterization of novel genetic alterations in salivary gland secretory carcinoma. Mod Pathol 2020; 33:541-550. [PMID: 31822803 PMCID: PMC7113190 DOI: 10.1038/s41379-019-0427-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 11/11/2019] [Accepted: 11/11/2019] [Indexed: 12/13/2022]
Abstract
Secretory carcinoma is a salivary gland tumor with a characteristic chromosomal translocation that results in an ETV6-NTRK3 fusion gene. Secretory carcinoma shows relatively frequent rates of lymph-node metastasis and tumor recurrence and has a characteristic histology. Except for the ETV6 translocation, genomic alterations in secretory carcinoma have not been reported. In the present study, we characterized the novel recurrent genetic mutations of secretory carcinoma. On the basis of histology, immunohistochemistry, and ETV6 gene break-apart fluorescence in situ hybridization assays, 22 tumors were classified as secretory carcinomas (19 ETV6 translocation-positive and 3 ETV6 translocation-negative secretory carcinomas) and their clinicopathologic characteristics were reviewed. Targeted deep sequencing analyses were performed on 20 secretory carcinomas (17 ETV6 translocation-positive and 3 ETV6 translocation-negative secretory carcinomas) to investigate their genetic alterations. The A16V (C→T) mutation in PRSS1, which encodes a cationic trypsinogen and has a mutation associated with hereditary pancreatitis and pancreatic adenocarcinoma, was observed in 40% (8/20) (7/17 of ETV6 translocation-positive and 1/3 of ETV6 translocation-negative secretory carcinomas). Pathogenic variants of MLH1, MUTYH, and STK11 were also identified. Variants of uncertain significance included mutations in KMT5A. These novel characteristic genetic alterations may advance current understandings of secretory carcinoma tumorigenesis and progression, leading to improved diagnoses and treatment strategies.
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Affiliation(s)
- Kiyong Na
- Department of Pathology, Yonsei University College of Medicine, Yonsei University Health System, Severance Hospital, Seoul, South Korea
- Department of Pathology, College of Medicine, Kyung Hee University, Seoul, South Korea
| | - Juan C Hernandez-Prera
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Jae-Yol Lim
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Yonsei University Health System, Seoul, South Korea
| | - Ha Young Woo
- Department of Pathology, Yonsei University College of Medicine, Yonsei University Health System, Severance Hospital, Seoul, South Korea
| | - Sun Och Yoon
- Department of Pathology, Yonsei University College of Medicine, Yonsei University Health System, Severance Hospital, Seoul, South Korea.
- Department of Anatomic Pathology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
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44
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Ali SA, Kovatch KJ, Yousif J, Gupta S, Rosko AJ, Spector ME. Predictors of distant metastasis in acinic cell carcinoma of the parotid gland. World J Clin Oncol 2020; 11:11-19. [PMID: 31976306 PMCID: PMC6935691 DOI: 10.5306/wjco.v11.i1.11] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Revised: 10/14/2019] [Accepted: 11/06/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND AiCC is a primarily indolent disease process. Our aim with this study is to determine characteristics consistent with rapidly progressive AiCC of the parotid gland.
AIM To report on patients with metastatic lung disease from AiCC and potential correlative factors.
METHODS Single-institution retrospective review of patients treated at the University of Michigan between 2000 and 2017. Univariate analyses were performed.
RESULTS A total of 55 patients were identified. There were 6 patients (10.9%) with primary AiCC of the parotid gland who developed lung metastases. The mean age at diagnosis for patients with lung metastases was 57.8 years of age, in comparison to 40.2 years for those without metastases (P = 0.064). All 6 of the patients with lung metastases demonstrated gross perineural invasion intraoperatively, in comparison to none of those in the non-lung metastases cohort. Worse disease-free and overall survival were significantly associated with gross perineural invasion, high-grade differentiation, and T4 classification (P < 0.001).
CONCLUSION AiCC of the parotid gland is viewed as a low-grade neoplasm with good curative outcomes and low likelihood of metastasis. With metastasis, however, it does exhibit a tendency to spread to the lungs. These patients thereby comprise a unique and understudied patient population. In this retrospective study, factors that have been shown to be statistically significant in association with worse disease-free survival and overall survival include presence of gross facial nerve invasion, higher T-classification, and high-grade disease.
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Affiliation(s)
- Syed Ahmed Ali
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI 48104, United States
| | - Kevin J Kovatch
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI 48104, United States
| | - Jonah Yousif
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI 48104, United States
| | - Sonali Gupta
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI 48104, United States
| | - Andrew J Rosko
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI 48104, United States
| | - Matthew E Spector
- Department of Otolaryngology - Head and Neck Surgery, Michigan Medicine, Ann Arbor, MI 48104, United States
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Abstract
Submucosal glands (SMGs) present throughout human esophagus with clusters at either the upper third or lower third of the organ. SMGs tend to atrophy with age, and neoplasms arising in these glands are rare. In order to bring convenience to diagnosis, we summarize the histopathologic characteristics of all esophageal submucosal gland tumors (SGTs). Due to the morphological similarity, the nomenclature of salivary tumors is adopted for SGTs. However, there is great confusion about the definition and histogenesis of these tumors, especially the malignant subtypes. In the literature, esophageal mucoepidermoid carcinoma and adenoid cystic carcinoma usually adjoin the surface squamous epithelium and coexist with intraepithelial neoplasia or invasive squamous cell carcinoma (SCC). In addition, the typical gene alterations of salivary tumors have not been reported in these SGTs. Therefore, we propose to apply stringent diagnostic criteria to esophageal SGTs so as to exclude mimickers that are SCCs with various degree of SMG differentiation.
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46
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Lassche G, van Boxtel W, Ligtenberg MJL, van Engen-van Grunsven ACH, van Herpen CML. Advances and challenges in precision medicine in salivary gland cancer. Cancer Treat Rev 2019; 80:101906. [PMID: 31644971 DOI: 10.1016/j.ctrv.2019.101906] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/11/2019] [Accepted: 10/07/2019] [Indexed: 12/13/2022]
Abstract
Salivary gland cancer (SGC) is a rare malignancy consisting of 22 subtypes with different genetic, histological and clinical characteristics. This rarity and heterogeneity makes systemic treatment of recurrent or metastatic (R/M) disease challenging. Use of chemotherapy is scarcely studied and chemotherapy at best has moderate effects. New therapeutic strategies are therefore warranted, but advances made in SGC are lagging behind on advances made in more common cancers. By unraveling tumor characteristics of SGC, such as genetic alterations and protein expression profiles, therapeutic strategies tailored to the patient's tumor can be rationalized. This genomic profiling and mapping of immunohistochemical expression profiles is essential in the search for a suitable treatment approach. Thereby, it alleviates the paucity in systemic treatment options and can significantly alter the prognosis of patients with R/M SGC. This review aims to give a comprehensive overview of known genetic alterations and expression profiles amenable for targeted therapy in every histological subtype of SGC. We discuss the remaining knowledge gaps and the implications of these targets for future studies and personalized treatments, thereby aiding clinicians faced with this rare and heterogeneous type of cancer.
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47
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Koutlas IG, Dolan M, Lingen MW, Argyris PP. Plasmacytoid cells in salivary pleomorphic adenoma: an alternative interpretation of their immunohistochemical characteristics highlights function and capability for epithelial-mesenchymal transition. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:515-529. [PMID: 31400990 DOI: 10.1016/j.oooo.2019.01.081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/02/2019] [Accepted: 01/29/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Plasmacytoid cells (PLCs) in salivary pleomorphic adenoma (SPA) are regarded as modified neoplastic myoepithelia and define plasmacytoid myoepithelioma (pMYO). However, histochemically, immunohistochemically and ultrastructurally, PLCs fail to demonstrate frank myogenous properties. Epithelial-mesenchymal transition (EMT) may explain the phenotypes in SPA. Our aim was to evaluate (1) PLCs with accepted or purported myoepithelial and EMT-related markers; and (2) pMYOs for PLAG1 aberrations by using fluorescence in situ hybridization. STUDY DESIGN Eight SPAs with or without PLC-predominance and 3 pMYOs were immunohistochemically studied. RESULTS PLCs in SPA and pMYO exhibited strong, scattered to diffuse positivity for K7, rare K14 positivity and were mostly negative for α-smooth muscle actin, h-caldesmon, and p63/p40. S100 staining was strong and diffuse, whereas calponin was variable. DOG1 was negative. PLCs in pMYO and PLC-rich SPA exhibited selective or diffuse WT1 and D2-40 immunoreactivity. EMT markers SNAIL/SLUG exhibited strong and variable immunoreactivity in PLCs in contrast to weak or absent E-cadherin expression. SOX10 was diffusely and strongly positive. PLAG1 rearrangement was present in 1 pMYO. CONCLUSIONS PLCs mostly fail to express myoepithelial markers; PLCs are neoplastic cells adapting to microenvironmental changes and capable of EMT; and tumors composed solely of PLCs are apparently SPAs depleted of a ductal component.
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Affiliation(s)
- Ioannis G Koutlas
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN, USA.
| | - Michelle Dolan
- Department of Laboratory Medicine and Pathology, University of Minnesota Medical School, University of Minnesota, Minneapolis, MN, USA
| | - Mark W Lingen
- Department of Pathology, University of Chicago, Chicago, IL, USA
| | - Prokopios P Argyris
- Division of Oral and Maxillofacial Pathology, School of Dentistry, University of Minnesota, Minneapolis, MN, USA; Department of Biochemistry, Molecular Biology and Biophysics, College of Biological Sciences, University of Minnesota, Minneapolis, MN, USA
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48
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Mantsopoulos K, Mueller S, Goncalves M, Koch M, Iro H. Completion surgery after extracapsular dissection of low-grade parotid gland malignant tumors. Head Neck 2019; 41:3383-3388. [PMID: 31273890 DOI: 10.1002/hed.25863] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 04/09/2019] [Accepted: 06/18/2019] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND The aim of the study was to compare the oncological and functional outcome between extracapsular dissection and completion surgery on the one hand and sole extracapsular dissection on the other hand in small low-grade malignant parotid tumors. METHODS The records of all patients treated for T1-T2 low-grade malignant tumors of the parotid gland primarily by means of extracapsular dissection between 2006 and 2015 were studied retrospectively. RESULTS Forty patients with T1-T2 low-grade parotid malignancies were detected. Our study showed outstanding oncological outcomes in both patient groups, the facial nerve function being significantly better after sole extracapsular dissection in the direct postoperative phase, with no differences between the groups in the long term. CONCLUSIONS Our study showed very encouraging preliminary results following primary extracapsular dissection as the sole surgical therapy for carefully selected low-stage, low-grade, inferiorly located lesions in patients with high compliance.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Sarina Mueller
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Miguel Goncalves
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Michael Koch
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany
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49
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Abstract
Background Distant metastasis (DM) is a common treatment failure pattern in acinic cell carcinoma (AciCC) of the major salivary glands; therefore, the main goal of this study was to analyse the predictors of DM in parotid AciCC. Methods Consecutive patients with surgically treated parotid AciCC who were followed for at least 5 years were retrospectively reviewed. Data regarding age, sex, TNM stage, pathologic characteristics, surgical treatment, and follow-up examinations were collected and analysed. The primary end-point was DM control (DMC); the DMC survival was calculated from the date of surgery to the date of event or the latest follow-up examination and analysed by the Kaplan-Meier method. Independent prognostic factors were evaluated by the Cox proportional hazards method. Results A total of 144 patients were included. Positive intraparotid nodes (IPNs) were noted in 34 (31.8%) patients. High-grade transformation was noted in 12 (8.3%) patients. A total of 83 (57.6%) patients underwent neck dissection, and neck node metastasis was proven in 37 (44.6%, 37/83) patients. The 10-year DMC rate was 86%. The Cox model analysis confirmed IPN metastasis (1.854 [1.061–4.144], p = 0.011) and high-grade transformation (4.219 [1.948–15.553], p < 0.001) as independent predictive factors of the DMC survival. Conclusion IPN metastasis and high-grade transformation are independent prognostic factors of the DMC survival.
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Affiliation(s)
- Qigen Fang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, People's Republic of China.
| | - Junfu Wu
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, People's Republic of China
| | - Wei Du
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, People's Republic of China
| | - Xu Zhang
- Department of Head Neck and Thyroid, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, People's Republic of China
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50
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Haller F, Bieg M, Will R, Körner C, Weichenhan D, Bott A, Ishaque N, Lutsik P, Moskalev EA, Mueller SK, Bähr M, Woerner A, Kaiser B, Scherl C, Haderlein M, Kleinheinz K, Fietkau R, Iro H, Eils R, Hartmann A, Plass C, Wiemann S, Agaimy A. Enhancer hijacking activates oncogenic transcription factor NR4A3 in acinic cell carcinomas of the salivary glands. Nat Commun 2019; 10:368. [PMID: 30664630 PMCID: PMC6341107 DOI: 10.1038/s41467-018-08069-x] [Citation(s) in RCA: 105] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2018] [Accepted: 12/12/2018] [Indexed: 02/06/2023] Open
Abstract
The molecular pathogenesis of salivary gland acinic cell carcinoma (AciCC) is poorly understood. The secretory Ca-binding phosphoprotein (SCPP) gene cluster at 4q13 encodes structurally related phosphoproteins of which some are specifically expressed at high levels in the salivary glands and constitute major components of saliva. Here we report on recurrent rearrangements [t(4;9)(q13;q31)] in AciCC that translocate active enhancer regions from the SCPP gene cluster to the region upstream of Nuclear Receptor Subfamily 4 Group A Member 3 (NR4A3) at 9q31. We show that NR4A3 is specifically upregulated in AciCCs, and that active chromatin regions and gene expression signatures in AciCCs are highly correlated with the NR4A3 transcription factor binding motif. Overexpression of NR4A3 in mouse salivary gland cells increases expression of known NR4A3 target genes and has a stimulatory functional effect on cell proliferation. We conclude that NR4A3 is upregulated through enhancer hijacking and has important oncogenic functions in AciCC.
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MESH Headings
- Acinar Cells/metabolism
- Acinar Cells/pathology
- Animals
- Carcinoma, Acinar Cell/genetics
- Carcinoma, Acinar Cell/metabolism
- Carcinoma, Acinar Cell/pathology
- Cell Proliferation
- Chromatin/chemistry
- Chromatin/metabolism
- Chromosomes, Human, Pair 4/chemistry
- Chromosomes, Human, Pair 4/metabolism
- Chromosomes, Human, Pair 9/chemistry
- Chromosomes, Human, Pair 9/metabolism
- Cohort Studies
- DNA-Binding Proteins/genetics
- DNA-Binding Proteins/metabolism
- Enhancer Elements, Genetic
- Epigenesis, Genetic
- Female
- Gene Expression Regulation, Neoplastic
- Genetic Loci
- Humans
- Male
- Mice
- Multigene Family
- Primary Cell Culture
- Receptors, Steroid/genetics
- Receptors, Steroid/metabolism
- Receptors, Thyroid Hormone/genetics
- Receptors, Thyroid Hormone/metabolism
- Salivary Gland Neoplasms/genetics
- Salivary Gland Neoplasms/metabolism
- Salivary Gland Neoplasms/pathology
- Salivary Glands/metabolism
- Salivary Glands/pathology
- Salivary Proteins and Peptides/genetics
- Salivary Proteins and Peptides/metabolism
- Translocation, Genetic
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Affiliation(s)
- Florian Haller
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054, Erlangen, Germany.
| | - Matthias Bieg
- Center for Digital Health, Berlin Institute of Health and Charité - Universitätsmedizin Berlin, Kapelle-Ufer 2, 10117, Berlin, Germany
- Heidelberg Center for Personalized Oncology (DKFZ-HIPO), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Rainer Will
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany
| | - Cindy Körner
- Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany
| | - Dieter Weichenhan
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Alexander Bott
- Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany
| | - Naveed Ishaque
- Center for Digital Health, Berlin Institute of Health and Charité - Universitätsmedizin Berlin, Kapelle-Ufer 2, 10117, Berlin, Germany
- Heidelberg Center for Personalized Oncology (DKFZ-HIPO), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Pavlo Lutsik
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Evgeny A Moskalev
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054, Erlangen, Germany
| | - Sarina K Mueller
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany
| | - Marion Bähr
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Angelika Woerner
- Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany
| | - Birgit Kaiser
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany
| | - Claudia Scherl
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany
| | - Marlen Haderlein
- Department of Radiation Therapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Universitätsstrasse 27, 91054, Erlangen, Germany
| | - Kortine Kleinheinz
- Division of Theoretical Bioinformatics (B080), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Rainer Fietkau
- Department of Radiation Therapy, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Universitätsstrasse 27, 91054, Erlangen, Germany
| | - Heinrich Iro
- Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Waldstrasse 1, 91054, Erlangen, Germany
| | - Roland Eils
- Center for Digital Health, Berlin Institute of Health and Charité - Universitätsmedizin Berlin, Kapelle-Ufer 2, 10117, Berlin, Germany
- Heidelberg Center for Personalized Oncology (DKFZ-HIPO), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
- Health Data Science Unit, University Hospital Heidelberg, Im Neuenheimer Feld 267, 69120 Heidelberg, Germany
- Translational Lung Research Center Heidelberg, German Center for Lung Research, University of Heidelberg, Im Neuenheimer Feld 156, 69120 Heidelberg, Germany
| | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054, Erlangen, Germany
| | - Christoph Plass
- Division of Cancer Epigenomics, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany
| | - Stefan Wiemann
- Genomics and Proteomics Core Facility, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany.
- Division of Molecular Genome Analysis, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 580, 69120, Heidelberg, Germany.
| | - Abbas Agaimy
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Krankenhausstr. 8-10, 91054, Erlangen, Germany
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