Coexpression of intermediate-sized filaments in sialadenoma papilliferum and other salivary gland neoplasms

Sialadenoma papilliferum: clinicopathologic, Immunohistochemical, molecular analyses of new five cases and review of the literature

Background

Sialadenoma papilliferum (SP) is an extremely rare benign neoplasm of salivary glands. To explore and define the clinicopathological features of SP, we retrospectively analyzed 89 cases previously reported and five new cases.

Methods

The clinical features, histopathology, immunohistochemistry and molecular analysis of our cases were further performed and the related literatures were reviewed and analyzed.

Results

Combining 89 cases from the literature with our cases, the hard palate was the most common locations for SP. However, two of our cases were rarely located in the esophageal mucosa. Among all cases, the male gender was more affected, with the average age and median age of 61.8 and 62 years, respectively. Conventional histomorphologically, SP was characterized by complex papillary structures with a biphasic growth pattern of exophytic squamous component and endophytic glandular component. The glandular structures were lined by a double layer of epithelium composed of flattened or cuboidal basal cells and a cuboidal or columnar luminal cells formed papillary infoldings into the ductal lumina. Immunohistochemically, the luminal epithelial configurations showed strong expression of CK7 along the luminal cell membrane, while the basal myoepithelia displayed strong nuclear p63 expression. In both the glandular and squamous tumour components showed BRAF V600E-positive immunostaining and BRAF V600E mutation.

Conclusion

For the first time, we have comprehensively aggregated and analyzed 90 cases sialadenoma papilliferum from almost all previous publications, and further explored the clinicopathological features of SP; concordantly, this study demonstrated that SP shows a papillomatous growth pattern with exophytic and endophytic proliferation of ductal epithelium composed of double-layered cells harboring BRAF V600E mutation. Additionly, adequate treatment for SP is surgical excision, with a favorable prognosis in patients.

Sialadenoma Papilliferum: Analysis of Seven New Cases and Review of the Literature

Sialadenoma papilliferum (SP) is a rare benign salivary gland neoplasm that comprises from 0.4 to 1.2% of all salivary gland tumors. The tumor is so named because of its microscopic resemblance to the syringocystadenoma papilliferum, an uncommon benign tumor of sweat gland origin. The purpose of this paper is to report the clinical and microscopic features of seven new cases of SP and combine them with cases previously reported in the English language literature to further define this unusual lesion. Combining our cases with acceptable cases from the literature, the palate (especially the hard palate) was the most common site, with 80% of the cases occurring in this location. Other locations in decreasing order were buccal mucosa, upper lip, retromolar pad, and parotid gland. Age at diagnosis ranged from 18 to 87 years with a peak in the 6th decade and an average age of 56.4 years. Microscopically, the lesions demonstrated a papillary surface morphology, and the papillary projections varied from long and pointed to short and blunted. The supporting connective tissue contained a variable number of convoluted ductal structures, which often fused with the overlying surface epithelium. The ductal structures exhibited papillary infoldings and were lined by a double layer of epithelium consisting of basal cell layer and a luminal layer of cuboidal-to-columnar ductal cells. Immunohistochemical reactivity with p63 and p40 indicated that the basal cell layer was comprised predominantly of neoplastic myoepithelial cells. The luminal cells were immunoreactive with epithelial membrane antigen characteristic of ductal cell differentiation. Conservative surgical treatment was accomplished in most cases and appears to be adequate treatment as only two recurrences were documented. Several case reports of purported malignant transformation in SP have been reported in the literature, but in our opinion, there is insufficient evidence in the publications to unequivocally determine whether any of the malignancies truly originated within a pre-existing SP.

Sialadenoma papilliferum: clinical misdiagnosis with a histological decree

Sialadenoma papilliferum is a rare salivary gland tumor clinically resembling papilloma originating probably from the excretory duct. It is characterized by a biphasic growth pattern of exophytic squamous component and endophytic glandular component. We report a rare case of sialadenoma papilliferum in the floor of the mouth with epithelial dysplasia with pertinent review of literature. The present case highlights the importance of keeping sialadenoma papilliferum as a differential diagnosis of exophytic papilliferous oral lesions and the need to explore the etiology and malignant potential of the tumor.

Mucoepidermoid carcinoma arising in a background of sialadenoma papilliferum: a case report

Sialadenoma papilliferum is a rare tumor, primarily of minor salivary gland origin, first described by Abrams and Finck (Cancer 24:1057-63, 1969). It is both an exophytic and endophytic papillary lesion histologically resembling syringocystadenoma papilliferum of sweat gland. The tumor is considered benign although rare recurrent cases have been reported. Three cases of malignant transformation of sialadenoma papilliferum have been described in the literature. We report a high grade mucoepidermoid carcinoma arising in a background of sialadenoma papilliferum, at the base of the tongue, an unusual location for minor salivary gland neoplasms. Eleven months after excision and nodal dissection, there is no evidence of recurrence or metastasis.

Sialadenoma papilliferum in a young patient: a case report and review of the literature

Sialadenoma papilliferum is a rare exophytic tumor of salivary gland origin, accounting for less than 1% of minor salivary gland tumors. It usually occurs in males older than 50 years as a painless papillary intraoral lesion. An 18-year-old male patient presented with an exophytic intraoral lesion present for approximately 12 years. The tumor was excised with a clinical diagnosis of infected hemangioma. However, histopathological diagnosis was consistent with sialadenoma papilliferum. The patient was followed up at regular intervals and no evidence of recurrence was noted. Our patient, aged 18 years, with tumor lasting for 12 years becomes the youngest case of intraoral sialadenoma papilliferum yet reported. This case highlights the importance of keeping sialadenoma papilliferum as a differential diagnosis of an intraoral exophytic proliferative lesion even in a young patient.

[Rare sialadenoma papilliferum in the hard palate: case report and survey of the literature]

Sialadenoma papilliferum is a rare tumour of the salivary glands that usually occurs in the oral cavity. Following the course of the salivary glands of the oral mucosa, the hard and soft palate are the most common locations of this tumor. In the international literature, only a few case reports about this entity can be found. We present a 63-year-old patient with a sialadenoma papilliferum accidentally found during diagnostic procedures for progredient dysphagia. Suffering from infrabifurcal cancer of the oesophagus, the patient had undergone partial oesophagectomy 1 year before. Histological verification was performed with a tumor biopsy at the border of hard and soft palate, on the right side. This case is compared with 39 further cases reported in the literature. The therapy of choice is resection of the tumor. Because of the high frequency of recurrence, in sano resection should be planned.

Malignant transformation of sialadenoma papilliferum of the palate: a case report

We report a case of a 79-year-old woman with an unusual salivary gland tumor that developed at the junction between the soft and hard palates. The tumor consisted of sialadenoma papilliferum (SP) with areas of an epithelial-myoepithelial carcinoma (EMC) component and a high-grade carcinoma component. There were also transitional regions among the SP, the EMC and the high-grade carcinoma components. The high-grade carcinoma component, which was similar to invasive micropapillary carcinoma of the breast, infiltrated into the right parapharyngeal space and metastasized to the lungs and cervical vertebrae. The high-grade carcinoma cells were positively immunostained for p53 protein. SP has been considered to be a benign tumor with exceptionally good prognosis, and, to the best of our knowledge, there has never been a confirmed case of malignant SP. This is the first report of SP with a definite malignant component.

Sialadenoma papilliferum: immunohistochemical study

Sialadenoma papilliferum (SP) is a rare benign tumour of salivary gland origin, which has been included among the ductal papillomas in the latest classification of tumours by the World Health Organisation. Two SP from the minor salivary gland of the palate of middle age patients were presented and studied by immunohistochemical. Our results showed presence of cytokeratins (CKs) 13, 14, 7, 8, 19 and absence of vimentin and smooth muscle actin. This immunoprofile is similar to the excretory duct of salivary gland.

Sialadenoma papilliferum of the hard palate: report of 2 cases and immunohistochemical evaluation

This study reports on the clinical and histologic features of 2 previously unreported cases of sialadenoma papilliferum. Immunohistochemical analysis of one of the cases demonstrated that the ductal cell component shows both epithelial and myoepithelial differentiation.

Sialadenoma papilliferum: an immunohistochemical study of five cases

Sialadenoma papilliferum (SP) is a rare, benign, salivary gland tumor which most commonly arises in the palate. It has a typical biphasic gross and microscopic appearance which distinguishes this tumor from other papillary-like tumors of the oral cavity. This study reports the clinico-pathologic features of 5 new cases and analyzes the morphologic and immunophenotypic features of their cell components. Adluminal epithelial cells of duct-like structures appeared immunoreactive to cytokeratin 19 and to S-100 protein antibodies; two subsets of basally-located cells were identified by means of immunohistochemistry. One cell subset expressed cytokeratin 14, S-100 protein, GFAP, vimentin and smooth muscle actin immunoreactivity; this antigenic profile is consistent with myoepithelial differentiation. The second subset of basal cells expressed cytokeratins 13 and 14 reactivity but it was negative to all other antibodies. Anti-CD 1a and anti-S-100 protein antibodies revealed distinct cells with dendritic processes which resembled Langerhans cells. The extralobular location of SP, the continuity between neoplastic duct-like structures and the surface epithelium along with the presence, within the excretory ducts adjacent to the tumour, of lesions which possibly precede the development of SP give further strength to the hypothesis of an origin from the excretory ducts of this tumor. Langerhans cells seem to be present in sialadenoma papilliferum but their role in this tumor is still unclear.

Recurrent sialadenoma papilliferum of the buccal mucosa

Sialadenoma papilliferum is a rare, benign, exophytic tumour of the salivary glands. The prognosis is exceptionally good. Since the lesion was first described, 30 cases have been reported in the English literature, and only one of these is known to have recurred. A case of sialadenoma papilliferum occurring in the buccal mucosa with recurrence three years after local excision, is presented. The literature is briefly discussed.

The rare sialadenoma papilliferum. Report of a case and review of the literature

Sialadenoma papilliferum is a rare benign tumor of salivary gland origin. A case is described of a 46-year-old man with an exophytic lesion at the junction of the hard and soft palate. The literature is briefly discussed.