Difference between revisions of "Carcinoma ex pleomorphic adenoma"

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| Rads      =
| Rads      =
| Endoscopy  =
| Endoscopy  =
| Prognosis  = typically poor
| Prognosis  = dependent on stage, typically poor
| Other      =
| Other      =
| ClinDDx    =
| ClinDDx    =
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Epidemiology:
Epidemiology:
*Rare.
*Rare.
*Usually a poor prognosis.<ref name=pmid21744105/>
*Prognosis dependent on stage:
**Good for early lesions - like PA.<ref name=pmid23821206/>
**Poor for advanced lesions.<ref name=pmid21744105/>


==Gross==
==Gross==
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*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311945/figure/Fig1/ Ca ex PA - showing ca and PA areas (nih.gov)].<ref name=pmid21744105/>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311945/figure/Fig1/ Ca ex PA - showing ca and PA areas (nih.gov)].<ref name=pmid21744105/>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311945/figure/Fig2/ Ca ex PA - showing capsule invasion (nih.gov)].
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3311945/figure/Fig2/ Ca ex PA - showing capsule invasion (nih.gov)].
==IHC==
Features - ca ex PA vs PA:<ref name=pmid23821206>{{Cite journal  | last1 = Di Palma | first1 = S. | title = Carcinoma ex pleomorphic adenoma, with particular emphasis on early lesions. | journal = Head Neck Pathol | volume = 7 Suppl 1 | issue =  | pages = S68-76 | month = Jul | year = 2013 | doi = 10.1007/s12105-013-0454-z | PMID = 23821206 }}</ref>
*Ki-67 elevated.
*HER2 +ve
*p53 +ve.


==See also==
==See also==

Revision as of 17:35, 23 November 2013

Carcinoma ex pleomorphic adenoma
Diagnosis in short
LM DDx salivary duct carcinoma, mucoepidermoid carcinoma, adenoid cystic carcinoma, pleomorphic adenoma
Gross firm
Site salivary gland - usu. parotid gland
Signs usu. parotid mass, firm
Prevalence uncommon
Prognosis dependent on stage, typically poor

Carcinoma ex pleomorphic adenoma, abbreviated ca ex PA, is a rare malignant salivary gland tumour that arise from a pleomorphic adenoma.

General

Definition:

Diagnosis (either 1 or 2):

  1. History of a pleomorphic adenoma at the same site.
  2. Features of a pleomorphic adenoma and a carcinoma.

Epidemiology:

  • Rare.
  • Prognosis dependent on stage:
    • Good for early lesions - like PA.[2]
    • Poor for advanced lesions.[1]

Gross

  • Usually mass lesion - partoid gland.[1]

Microscopic

Features:

  • Cells with cytologic features of malignancy - key feature.
  • Architecture (any of the following):
    • Glands.
    • Nests.
    • Single cells (may be subtle).

Architectural patterns:

Note:

  • Often adenocarcinoma-like.
  • Myoepithelial cells may be clear cells.

DDx:

Subclassification

Extent of invasion:[3]

  1. Non-invasive AKA intracapsular AKA in situ.
  2. Minimally invasive <=1.5 mm beyond the capsule.
  3. Widely invasive >1.5 mm beyond the capsule.

Images

IHC

Features - ca ex PA vs PA:[2]

  • Ki-67 elevated.
  • HER2 +ve
  • p53 +ve.

See also

References

  1. ↑ 1.0 1.1 1.2 1.3 Antony, J.; Gopalan, V.; Smith, RA.; Lam, AK. (Mar 2012). "Carcinoma ex pleomorphic adenoma: a comprehensive review of clinical, pathological and molecular data.". Head Neck Pathol 6 (1): 1-9. doi:10.1007/s12105-011-0281-z. PMID 21744105.
  2. ↑ 2.0 2.1 Di Palma, S. (Jul 2013). "Carcinoma ex pleomorphic adenoma, with particular emphasis on early lesions.". Head Neck Pathol 7 Suppl 1: S68-76. doi:10.1007/s12105-013-0454-z. PMID 23821206.
  3. ↑ URL: http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf. Accessed on: 2 April 2012.
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