1/13. Intracapsular carcinoma ex pleomorphic adenoma. Report of a case with unusual metastatic behaviour.Intracapsular carcinomas ex pleomorphic adenoma are exceedingly rare salivary glands tumours, known to have a benign clinical behaviour with metastatic unrecognised potential. We report a case of a 57-year-old female patient presenting with a typical example of intracapsular carcinoma ex pleomorphic adenoma of the parotid gland and evidence of ipsilateral cervical lymph node metastases two years before. The behaviour of this unique case illustrates the disputed malignancy of carcinomas arising within encapsulated pleomorphic adenomas.- - - - - - - - - - ranking = 1keywords = behaviour (Clic here for more details about this article) |
2/13. carcinosarcoma of the parotid gland with epithelial-myoepithelial carcinoma and pleomorphic sarcoma components.We report a case of true malignant mixed tumour (carcinosarcoma) of the parotid gland with epithelial-myoepithelial carcinoma and pleomorphic sarcomatous components in a 68-year-old woman. The pleomorphic sarcomatous component behaved aggressively with lymph node and distant metastases. The biological behaviour of the individual components in a malignant mixed tumour makes it difficult to diagnose. We could find no previous report of epithelial-myoepithelial carcinoma as a component of a carcinosarcoma of the parotid.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
3/13. Accuracy of fine-needle aspiration biopsy for Warthin's tumours.BACKGROUND: Although the overall accuracy of fine-needle aspiration biopsy (FNAB) for salivary gland neoplasms has been well established, definitive results for Warthin's tumour (WT) are lacking. For most salivary gland tumours, surgery is recommended because of progressive enlargement and the risk of malignant transformation. This behaviour is unusual with WT, and surgery is usually advocated for pathologic confirmation. A highly accurate diagnosis of WT by FNAB may justify conservative management for the asymptomatic patient. However, if the reliability of this diagnostic procedure is questionable, there should be little hesitation in recommending parotidectomy. methods: A retrospective study design was used to evaluate the accuracy of FNAB for parotid WTs. All consecutive parotid FNABs and parotidectomy specimens from 1992 to 2000 were reviewed, and cases suggestive of WT were identified. The fine-needle cytology and histopathology results were then correlated. The true-positive, false-positive, and false-negative rates were tabulated to determine the sensitivity and positive predictive value (PPV) of FNAB for WT. RESULTS: A total of 41 patients were included in the study. Of these, 33 patients had FNABs suggestive or diagnostic of WT that were confirmed following parotidectomy (true positives = 33). In 4 patients, the FNAB incorrectly suggested WT, with the surgical histopathology confirming different diagnoses (false positives = 4) (3 acinic cell carcinomas and 1 pleomorphic adenoma). Four patients had surgically confirmed WTs with FNABs suggestive of other diagnoses (false negatives = 4) (1 cystic squamous cell carcinoma, 1 simple cyst, 1 "inflammatory process," and 1 "negative for malignant cells"). The sensitivity and PPV were 89.2% and 89.2%, respectively. CONCLUSION: Although the sensitivity and PPV in this study are high, the false-positive rate is clinically significant given the type of lesions missed. Three acinic cell carcinomas and one pleomorphic adenoma were misdiagnosed as WT on FNAB. One must be cautious in recommending conservative management for parotid tumours even when a WT is suggested by FNAB.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
4/13. Malignant melanoma of the parotid gland.We report a case which demonstrates pitfalls in the management of a parotid gland mass and highlights behaviour of malignant melanoma that is not widely appreciated. The danger of assuming a benign histological diagnosis of such a mass and the subsequent delay of definitive surgery is demonstrated. Metastases within the parotid gland are not uncommon, melanoma being one of the commonest sources. A search should always be made for a primary tumour in the head, neck and chest. This can be made exceptionally difficult by the uncommon phenomenon of spontaneous regression of the primary melanoma.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
5/13. Hybrid tumours of the salivary glands. A report of two cases involving the palate and a review of the literature.Hybrid tumours are very rare salivary gland lesions composed of two or more different tumoural entities in a single neoplasm that arise within a definite topographical region. In most cases adenoid cystic carcinoma has been the predominant component in these lesions. In this study we describe two patients with hybrid tumours located in the palate, one in a 49-year-old woman and one in a 71-year-old man. The first case involved adenoid cystic carcinoma and mucoepidermoid carcinoma, and the patient in the second case exhibited adenoid cystic carcinoma and epithelial-myoepithelial carcinoma. Both patients were treated with surgery and radiotherapy, and there has been no evidence of recurrence after 13 and 36 months of follow-up, respectively. The recognition of the histologic component with the higher grade of malignancy in every case of hybrid tumour of the salivary glands is a necessary step to determine the biological behaviour and, consequently, to determine the proper therapeutic approach.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
6/13. Myoepithelial carcinoma of parotid gland: a case report.Myoepithelial carcinoma or malignant myoepithelioma are considered extremely rare malignant salivary gland neoplasms. Their clinical behaviour by literature seems variable: most studies reported good prognosis for low-grade malignancy and vice versa. Nevertheless long term survival has been described in patients with high-grade tumours, while patients with low-grade have been reported to develop metastases. We report a case of myoepithelial carcinoma of the parotid gland arising in pleomorphic adenoma in a 52-year-old woman with favourable course in long term follow-up.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
7/13. Epithelioid haemangioendothelioma of the parotid salivary gland: a case report.Haemangioendothelioma is a vascular tumour characterised by the proliferation of endothelial cells with an epithelioid appearance. The behaviour of this neoplasm is intermediate between haemangioma and angiosarcoma. It may be localised in a wide range of sites, with a preference for soft and bone tissue. It is only rarely localised in the head and neck and even more rarely in the salivary glands. We describe a case of haemangioendothelioma in a 28-year-old man that originated in the retroneural region of the parotid gland, compressing the gland tissue and posteriorly infiltrating the muscular plane. A total parotidectomy surgical operation including the removal of lymph nodes in the region was performed followed by radiotherapy. An immunohistochemical investigation, carried out using the oxidase-antiperoxidase method, indicated that the neoplastic elements of the marker of the endothelial cells CD34 were positive for vimentine and for muscle-specific actin, showing a moderate proliferative action of the cellular elements with MIB-1 positivity estimated at around 6%. The peculiarity of the case we describe resides in the rarity of the haemangioendothelioma localisation in the parotid gland.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
8/13. Undifferentiated carcinoma arising from the Stensen's duct: a case report and review of the literature.Primary carcinoma arising in Stensen's duct is an extremely rare and poorly understood tumor. A 38-year-old man was referred with a malignant lesion situated in the right cheek. The patient was treated by local resection, total parotidectomy, and modified radical neck dissection. Microscopic examination revealed tumor cells of basaloid pattern with squamous differentiation in some areas. The tumor showed a very aggressive behaviour with early local recurrence and metastatic disease. The histological and radiological findings suggest the origin from the Stensen's duct. Primary carcinoma of Stensen's duct should be histologically consistent with epidermoid, mucoepidermoid, or undifferentiated carcinoma. The diagnosis of true Stensen's duct carcinoma can be performed on the basis of clinical presentation, radiological findings, and tumor histology. Criteria for determination of origin in the duct are revised and compared with this case.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
9/13. Salivary duct carcinoma in major and minor salivary glands. A clinicopathological analysis of four cases.Salivary duct carcinomas are an uncommon but distinct group of highly malignant salivary gland tumours. We report the clinical course, pathological findings and surgical treatment of this tumour in 4 patients. In one patient an intraductal tumour developed in a minor salivary gland, while in the other three patients, a major salivary gland was involved by an infiltrating salivary duct carcinoma. We point out the highly aggressive biological behaviour of the tumour when occurring in the major salivary glands, in contrast to the benign course of the intraductal carcinoma in the minor salivary gland.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
10/13. Ductal carcinoma of the parotid gland.A case of ductal carcinoma of the parotid gland is described. The medical literature contains only 13 previous reports on this kind of adenocarcinoma of the parotid gland. The tumour is characterized by its histologic resemblance to ductal carcinomas of the breast and prostate. The course of previously described cases suggests that this tumour has a highly aggressive biological behaviour.- - - - - - - - - - ranking = 0.16666666666667keywords = behaviour (Clic here for more details about this article) |
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