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Maleki Z, Saoud C, Viswanathan K, Kilic I, Tommola E, Griffin DT, Heider A, Petrone G, Jo VY, Centeno BA, Saieg M, Mikou P, Fadda G, Ali SZ, Kholová I, Wojcik EM, Barkan GA, Eisele DW, Bellevicine C, Vigliar E, Wiles AB, Al-Ibraheemi A, Allison DB, Dixon GR, Chandra A, Walsh JM, Baloch ZW, Faquin WC, Krane JF, Rossi ED, Pantanowitz L, Troncone G, Callegari FM, Klijanienko J. Application of the Milan System for Reporting Salivary Gland Cytopathology in pediatric patients: An international, multi-institutional study. Cancer Cytopathol 2022; 130:370-380. [PMID: 35081269 DOI: 10.1002/cncy.22556] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pediatric salivary gland fine-needle aspiration (FNA) is uncommon with a higher frequency of inflammatory lesions and a small proportion of malignancies. This international, multi-institutional cohort evaluated the application of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) and the risk of malignancy (ROM) for each diagnostic category. METHODS Pediatric (0- to 21-year-old) salivary gland FNA specimens from 22 international institutions of 7 countries, including the United States, England, Italy, Greece, Finland, Brazil, and France, were retrospectively assigned to an MSRSGC diagnostic category as follows: nondiagnostic, nonneoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), or malignant. Cytology-histology correlation was performed where available, and the ROM was calculated for each MSRSGC diagnostic category. RESULTS The cohort of 477 aspirates was reclassified according to the MSRSGC as follows: nondiagnostic, 10.3%; nonneoplastic, 34.6%; AUS, 5.2%; benign neoplasm, 27.5%; SUMP, 7.5%; SM, 2.5%; and malignant, 12.4%. Histopathologic follow-up was available for 237 cases (49.7%). The ROMs were as follows: nondiagnostic, 5.9%; nonneoplastic, 9.1%; AUS, 35.7%; benign neoplasm, 3.3%; SUMP, 31.8%; SM, 100%; and malignant, 100%. Mucoepidermoid carcinoma was the most common malignancy (18 of 237; 7.6%), and it was followed by acinic cell carcinoma (16 of 237; 6.8%). Pleomorphic adenoma was the most common benign neoplasm (95 of 237; 40.1%). CONCLUSIONS The MSRSGC can be reliably applied to pediatric salivary gland FNA. The ROM of each MSRSGC category in pediatric salivary gland FNA is relatively similar to the ROM of each category in adult salivary gland FNA, although the reported rates for the different MSRSGC categories are variable across institutions.
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Affiliation(s)
- Zahra Maleki
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Carla Saoud
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Kartik Viswanathan
- Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia
| | - Irem Kilic
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Erkka Tommola
- Fimlab Laboratories, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Daniel T Griffin
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Amer Heider
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Gianluigi Petrone
- Department of Pathology, Catholic University of Sacred Heart University, Rome, Italy
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Mauro Saieg
- Department of Pathology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | | | - Guido Fadda
- Department of Pathology, University of Messina, Messina, Italy
| | - Syed Z Ali
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Ivana Kholová
- Fimlab Laboratories, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Eva M Wojcik
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Güliz A Barkan
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - David W Eisele
- Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Austin B Wiles
- Department of Pathology, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Derek B Allison
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Glen R Dixon
- HCA Laboratories, HCA Healthcare, London, United Kingdom
| | - Ashish Chandra
- Department of Pathology, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Jonathan M Walsh
- Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Zubair W Baloch
- Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - William C Faquin
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeffrey F Krane
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Esther Diana Rossi
- Department of Pathology, Catholic University of Sacred Heart University, Rome, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
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Testicular cancer metastasis to the soft tissue: A case report and review of the literature. Radiol Case Rep 2021; 16:1695-1699. [PMID: 34007386 PMCID: PMC8111471 DOI: 10.1016/j.radcr.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 03/30/2021] [Accepted: 04/02/2021] [Indexed: 11/30/2022] Open
Abstract
While germ cell testicular cancer is rare and only accounts for 1% of cancers in males, it is the most common solid malignancy among men between 14 and 44 years of age. Testicular cancer can be surgically excised by orchiectomy and is highly responsive to both chemotherapy and radiation therapy. Therefore, testicular tumors generally have the best cancer prognoses, especially since the majority are localized in the initial stage. However, long-term outcome depends on the potential for germ cell testicular cancer to metastasize, both proximal to the testicles and distally throughout the body. Germ cell testicular cancer metastasis to soft tissue, including the trunk, and extremities, appears to be exceedingly rare, as reflected in the extremely limited number of published cases (total of seven patients reported in literature). Vague symptomatology, delayed medical attention, and inconsistent treatment compliance may contribute to testicular soft tissue metastasis and underreporting of these tumors. Here, we report a case of metastatic non–seminomatous germ cell testicular cancer with a large necrotizing, ulcerative mass in the left Iliopsoas muscle and posterior abdominal wall.
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