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Carcinoma ex pleomorphic adenoma: A clinicopathologic review
Author(s) -
Olsen Kerry D.,
Lewis Jean E.
Publication year - 2001
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.1100
Subject(s) - carcinoma ex pleomorphic adenoma , medicine , pleomorphic adenoma , malignancy , salivary duct carcinoma , carcinoma , metastasis , adenocarcinoma , pathology , salivary gland , radiation therapy , stage (stratigraphy) , medical record , cancer , biology , paleontology
Background Carcinoma ex pleomorphic adenoma (CXPA) is an aggressive, poorly understood salivary gland malignancy. Misdiagnosis is common, because the residual mixed tumor component may be small, and various carcinoma subtypes are possible. Methods We retrospectively reviewed the medical records of 73 patients with major salivary gland CXPA treated at our institution from 1960 to 1994. Of the 73 patients, 66 had primary tumors and 7 had recurrent tumors; 47 were men, and 26 were women; the mean age was 61 years. Results Adenocarcinoma (31 cases) and salivary duct carcinoma (24 cases) were the most common malignant subtypes. All patients were treated surgically, and 32 also had radiation therapy. Of 66 patients with primary tumors, 23% had local recurrence. Metastasis (either initial or delayed) occurred regionally in 56% and distantly in 44%. Thirty‐six patients (55%) died of the disease. At 3 years, overall survival was 39% and at 5 years, 30%. Conclusions Important prognostic factors include tumor size, grade, and clinical and pathologic stage. Patients with minimally invasive tumors (<5 mm) should do well with appropriate surgical treatment. © 2001 John Wiley & Sons, Inc. Head Neck 23: 705–712, 2001.