Basal cell adenocarcinoma arising in salivary gland metaplasia of the breast: a novel salivary gland-type tumor developing in the breast

Salivary Gland-like Tumors of the Breast

CONTEXT

The World Health Organization classification of tumors of the breast recognizes several special type carcinomas and benign lesions with features comparable to those of salivary gland tumors.

OBJECTIVE

To discuss the histologic, immunophenotypic, molecular, and clinical features of salivary gland-like carcinomas of the breast. These breast tumors are often negative for hormone receptors and human epidermal growth factor receptor 2 (HER2), that is, triple-negative, but they generally have a much better prognosis than triple-negative breast carcinomas of no special type. We compare the immunophenotypic, molecular, and clinical features of these breast tumors with their salivary gland counterparts, highlighting similarities and differences. We also discuss benign salivary gland-like breast tumors. Finally, we highlight recent developments in understanding the molecular pathogenesis of these breast tumors and novel ancillary studies that can be used to support their diagnosis.

DATA SOURCES

A literature review was conducted, and papers were selected for further analysis and discussion by the authors of this review based on their novelty, applicability, and impact in the field.

CONCLUSIONS

Breast tumors that exhibit morphologic overlap with salivary gland tumors have been recognized by pathologists for decades, but the similarities and differences in their molecular pathogenesis have not been understood until more recently. These developments have led to novel diagnostic tools and further knowledge of these rare breast lesions.

Increased immunoexpression of trefoil factors in salivary gland tumors

OBJECTIVE

Very little is known about the role of trefoil factors (TFFs) in salivary gland tumors, and TFF immunoexpression has never been investigated in such tumors. The aim of this study was to evaluate TFF immunoexpression in benign and malignant salivary gland tumors.

MATERIALS AND METHODS

Benign (n = 25) and malignant (n = 25) salivary gland tumor specimens were included in this study, using mucocele (n = 25) specimens as a control group. Immunohistochemical staining was performed to evaluate the expression of TFFs (TFF1, TFF2, and TFF3) by semiquantitative means.

RESULTS

Expression of TFF1, TFF2, and TFF3 was significantly increased in benign (p = 0.001, p = 0.005, p < 0.001, respectively) and malignant (p < 0.001, p < 0.001, p < 0.001, respectively) groups as compared with the control group. Patterns of co-expression between TFF1/TFF2, TFF2/TFF3, and TFF1/TFF3 were different among the three groups.

CONCLUSIONS

The present study provided new information showing that all TFFs were significantly increased in benign and malignant salivary gland tumors, and overexpression of TFFs could be associated with neoplastic transformation in salivary gland tissues.

CLINICAL RELEVANCE

Overexpression of TFFs may be useful as biomarkers in terms of differential diagnosis between salivary gland tumors and other oral neoplasms for which clinical manifestations are indistinguishable.

Subglottic Basal Cell Adenocarcinoma

OBJECTIVES

To discuss the presentation and management of a rare neoplasm in a previously unreported laryngeal subsite.

METHODS

Case report and literature review.

RESULTS

An 89-year-old woman presented with a subglottic mass, biopsy of which was consistent with basal cell adenocarcinoma. She was successfully treated with surgical intervention and remains disease free 29 months postoperatively.

CONCLUSIONS

Basal cell adenocarcinoma is a rare salivary gland tumor, the laryngeal variant of which is even scarcer. Herein we describe the presentation and successful surgical management of the first reported case of subglottic basal cell adenocarcinoma. We additionally provide a histologic review followed by approaches to treatment.

Basal cell adenoma of the breast

Salivary gland-like neoplasms of the breast are a known entity. A single novel case of basal cell adenoma of the breast is presented, and the presentation, treatment, and morphologic features of this case are discussed.