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Salivary duct carcinoma and the concept of early carcinoma ex pleomorphic adenoma
Author(s) -
Griffith Christopher C,
Thompson Lester D R,
Assaad Adel,
Purgina Bibianna M,
Lai Chi,
Bauman Julie E,
Weinreb Ilan,
Seethala Raja R,
Chiosea Simion I
Publication year - 2014
Publication title -
histopathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.626
H-Index - 124
eISSN - 1365-2559
pISSN - 0309-0167
DOI - 10.1111/his.12454
Subject(s) - salivary duct carcinoma , carcinoma ex pleomorphic adenoma , medicine , carcinoma , adenoma , pleomorphic adenoma , lymph node , pathology , salivary gland
Aims The data on the histological type of carcinomatous component and the extent of extracapsular invasion for salivary carcinomas ex pleomorphic adenoma (PA) are conflicting. We aimed to determine the prognostic value of extracapsular invasion in salivary duct carcinomas (SDC) ex PA. Methods and results A total of 117 patients with SDC were identified retrospectively; 44 cases involving major salivary glands had pre‐existing PA (44 of 117, 37%). The morphological spectrum of SDC ex PA was characterized. The primary endpoint was overall survival (OS). Most SDC ex PA were widely invasive at presentation (27 of 44; 61%). Five patients with intracapsular SDC ex PA experienced no disease progression. The assessment of extracapsular invasion was precluded in eight cases (e.g. positive margins of resection). The rate of lymph node involvement was similar in cases with extracapsular invasion of ≤2 mm (two of three) and >7 mm (22 of 26). Only pT correlated with OS [116 months, 95% confidence interval (CI) 22–210 months for pT1 versus 20 months (95% CI 6–34) for pT4; P = 0.013]. Conclusions Intracapsular SDC ex PA are potentially indolent. SDC ex PA with extracapsular invasion of ≤2 mm are rare, and appear to be clinically aggressive. Several histological parameters preclude assessment of extracapsular invasion.