Differential diagnosis of salivary acinic cell carcinoma. Pdf acinic cell carcinoma acc is a lowgrade malignant salivary neoplasm that. Salivary gland tumours are a rare, heterogeneous group of. Gata3 is a zinc finger transcription factor that regulates the normal development of many tissues and cell types. Spiro rhhuvos agstrong ew acinic cell carcinoma of salivary origin. Acinic cell carcinoma of the lung with metastasis to lymph. Salivary gland carcinomas are relatively uncommon, accounting for approximately 6% of all malignancies of the head and neck and of tenderness or nmbs 2 acinic cell tumors of minor salivary gland origin 225 fig. As a rule, the lower the number, the less the cancer has spread. Salivary gland cancer is a type of head and neck cancer that involves abnormal growth of salivary gland cells factors that increase the risk of salivary gland cancer include older age, radiation therapy to the head and neck, or exposure to cancercausing chemicals at work. Keywords acinic cell carcinoma 4 pathology 4 salivary glands 4 therapy 4. The reported 10year survival rate is approximately 70%45. The intensity of the immunostaining was strong in all tumors figures 1, 2, 3 and 4.
Novel prkd gene rearrangements and variant fusions in cribriform adenocarcinoma of salivary gland origin. Mar 23, 2018 an acinic cell carcinoma acc of salivary gland is a type of malignant epithelial tumor affecting either the major or minor salivary glands. A 64yearold man presented with an asymptomatic left lower lobe mass. The disease presents as a slow growing mass, associated with pain or tenderness in 50% of the cases. Acinic cell carcinoma was the most common histologic type 22%, followed by mucoepidermoid carcinoma 21. Acinic cell carcinoma is an uncommon lowgrade malignant tumor of the salivary glands, in which some cells resemble normal acinic cells. Salivary gland tumours or neoplasms are tumours that form in the tissues of salivary glands.
Dec 21, 2017 the earliest stage salivary gland cancers are stage 0 carcinoma in situ, and then stages range from i 1 through iv 4. Acinic cell carcinoma is a malignant tumor representing 2% of all salivary tumors. Generally, for this rare lowgrade malignant salivary. Acinic cell carcinoma with highgrade transformation of the salivary gland is an unusual variant with less than fifty cases being reported in the literature. Previous radiation exposure and familial predisposition are some of the risk factors for acc. It is observed in a wide age category of both children and adults. We describe a patient with acinic cell tumor arising in the parotid gland, with metastases to the. Salivary gland tumors msd manual professional edition.
A rare case of iliac crest metastasis from acinic cell. Dedifferentiated acinic cell carcinoma is a highly malignant, newly recognized parotid malignancy. Longterm results are related to the grade of the cancer. Dedifferentiation andor highgrade transformation hgt has been described in a variety of salivary gland carcinomas, including acinic cell carcinoma, adenoid cystic carcinoma, epithelialmyoepithelial carcinoma, polymorphous lowgrade adenocarcinoma, myoepithelial carcinoma, lowgrade mucoepidermoid carcinoma and hyalinizing clear cell carcinoma, although the phenomenon is a rare. In the head and neck region, the parotid gland is the predominant site of origin and acc is usually more frequent in women than men. Monotonous proliferation of cells with abundant finely granular, weakly eosinophilic or clear vacuolated cytoplasm, central round nuclei and prominent nucleoli, resembling acinic cells of salivary gland j clin pathol 2003. The major salivary glands consist of the parotid, submandibular, and sublingual glands.
A lesion termed as ranula is associated with the sublingual salivary gland c. Most were asymptomatic swellings, but four patients complained of tenderness or nmbs 2 acinic cell tumors of minor salivary gland origin 225 fig. Acinic cell tumors of minor salivary glands are most uncommon. Acinic cell carcinoma acc is a lowtointermediate grade neoplasm. Malignant neoplasm of salivary gland arising from acinic cells. The salivary glands are classified as major or minor.
Gata3 immunohistochemical expression in salivary gland. Acinic cell carcinoma acc is a rare, slowgrowing, lowgrade salivary gland cancer. Salivary gland tumors merck manuals professional edition. The sublingual salivary gland is the most common site of salivary gland neoplasia d. Apr 20, 20 gata3 is a zinc finger transcription factor that regulates the normal development of many tissues and cell types. All malignant salivary gland tumors 84 of 84, 100% were positive for ck7. Publications home of jama and the specialty journals of the. Photomicrograph of section of the act displayed in fig. Sox10 is a novel marker of acinus and intercalated duct differentiation in salivary gland tumors. An end should be considered in patients with acinic cell carcinoma of the parotid gland due to i a notable rate of occult neck metastases in lowgrade tumors and ii the worse dss of patients.
The minor salivary glands consist of 800 small mucussecreting glands located throughout the lining of the oral cavity. Dedifferentiation and highgrade transformation in salivary. Salivary gland cancer facts medically edited by charles patrick davis, md, phd. Acinic cell carcinoma acc is an infrequent type of malignant salivary gland tumor. Sep 01, 2005 acinic cell carcinoma is a relatively uncommon malignancy, accounting for 1 to 6% of all salivary gland tumors and 15% of all malignant tumors of the parotid gland. On the core biopsy, a diagnosis of acinic cell carcinoma was made, a rare diagnosis.
Dedifferentiated acinic cell carcinoma of the salivary gland is an uncommon variant of acinic cell carcinoma, characterized by the coexistence of both an usual lowgrade acinic cell carcinoma and a highgrade dedifferentiated component, as well as by an accelerated clinical course. Cell proliferation correlates with prognosis in acinic cell carcinomas of salivary gland origin. Dedifferentiation andor highgrade transformation hgt has been described in a variety of salivary gland carcinomas, including acinic cell carcinoma, adenoid cystic carcinoma, epithelialmyoepithelial carcinoma, polymorphous lowgrade adenocarcinoma, myoepithelial carcinoma, lowgrade mucoepidermoid carcinoma and hyalinizing clear cell carcinoma, although the phenomenon is a rare event. The earliest stage salivary gland cancers are stage 0 carcinoma in situ, and then stages range from i 1 through iv 4. Acinic cell adenocarcinoma acc is a lowgrade malignant salivary neoplasm that constitutes approximately 17% of all primary salivary gland malignancies. Approximately 16% of all accs occur in the mouth according to several small. Immunohistochemical study of 30 cases using the mib 1 antibody in formalinfixed paraffin sections. Jul 31, 2015 minor salivary gland tumours vary according on the site of origin painless masses on the palate or floor of the mouth are the most common form but laryngeal salivary gland tumours can produce airway obstruction, dysphagia, or hoarseness. Dedifferentiated acinic cell acinous carcinoma of the. Metastasis of acinic cell carcinoma of the parotid gland. Radiotherapy if a salivary gland tumour is cancerous, radiation therapy may be necessary fast neutron therapy has been used successfully to treat salivary gland tumors, 11 and has shown to be significantly more effective than photons in studies treating unresectable salivary gland tumors. Metastasis of acinic cell carcinoma of the parotid gland to the. Acinic cell carcinomas of the salivary glands are rare malignant neoplasms that account for % of all salivary gland tumors.
Salivary gland cancers are named according to which of these cell types they most look like when seen under a microscope. Although each persons cancer experience is unique, cancers with similar stages tend to. Metastasis of acinic cell carcinoma of the parotid gland to. At bronchoscopy there was a tumor in the superior segment. In the nasal cavity or paranasal sinus they cause nasal obstruction or sinusitis. Normal salivary glands are made up of many different kinds of cells, and tumors can start in any of these cell types. Salivary gland cancers malignant salivary gland tumors there are many types of salivary gland cancers. The parotid gland is the predominant site of origin. Acinic cell carcinoma acc is a lowgrade malignant salivary neoplasm. During the fna, the cytopathologist remarked that all the smears he was seeing looked just like acinar cells. Acinic cell carcinoma salivary glands radiology reference. Acinic cell carcinoma of minor salivary gland origin. While the degree of malignant behavior of individual acinic cell tumors is notably variable, all must be treated with aggression. Mcqs on diseases of salivary glands oral pathology part 1.
Search of the english language literature revealed twenty previously reported cases. Immunohistochemical expression of cytokeratins 7 and 20 in. In the head and neck region, the parotid gland is the predominant site of origin and women are. April 22, 2017 salivary duct carcinoma, salivary gland cancer, salivary gland cancer trial no comments 72m a closer look at her2 in salivary duct carcinoma sdc we have made some assumptions that since erbb2 gene amplifications occur frequently in salivary duct carcinoma sdc, they must be driving this cancer. Most acc occur in the parotid gland, representing between 2 and3% of all epithelial parotid neoplasms. Salivary gland cancer stages american cancer society. Lobectomy and lymph node staging showed involvement of interlobar n1 nodes, while higher stations were benign. Acinic cell carcinoma of minor salivary gland origin the. Acinic cell carcinoma of the parotid gland radiology. Pathology pathology may superficially resemble normal serous acinar cells of the salivary glands.
Sox10 is a novel marker of acinus and intercalated duct. Apr 22, 2017 april 22, 2017 salivary duct carcinoma, salivary gland cancer, salivary gland cancer trial no comments 72m a closer look at her2 in salivary duct carcinoma sdc we have made some assumptions that since erbb2 gene amplifications occur frequently in salivary duct carcinoma sdc, they must be driving this cancer. Nodal metastases in acinic cell carcinoma of the parotid gland. An acinic cell carcinoma acc of salivary gland is a type of malignant epithelial tumor affecting either the major or minor salivary glands. A higher number, such as stage iv, means cancer has spread more. Three cases of acinic cell carcinoma of minor salivary glands, located respectively in the larynx, base of the tongue, and right tonsil, were encountered at the section of pathology of the ent department of the university of padua between 1974 and 1978. Differential diagnosis of salivary acinic cell carcinoma and. Otolaryngologistshead and neck surgeons and surgical pathologists should be aware of the potential for acinic cell carcinomas to dedifferentiate so that adequate histologic tumor sampling can be performed. Acinic cell carcinoma is an uncommon lowgrade malignant tumor of the salivary glands, in which. Metastatic acinic cell carcinoma of the parotid gland to the. Such neoplasms arising in minor salivary gland tissue are extremely rare, but may be found in all sites containing normal or aberrant salivary. Acinic cell carcinoma with highgrade transformation of the salivary gland is an. It is characterized by a low and highgrade component juxtaposed with one another and tends to take on a more aggressive clinical course than its lowgrade counterpart, suggesting a poor clinical outcome.
There was no evidence of salivary gland or other site of origin. Late recurrence of acinic cell carcinoma of the parotid gland. Most salivary gland tumors are benign and occur in the parotid glands. Acinic cell carcinoma acc is a lowgrade malignant salivary neoplasm that constitutes approximately. Sep 28, 2017 salivary gland cancers malignant salivary gland tumors there are many types of salivary gland cancers. Given that breast and salivary gland tissues are very similar with. Highgrade transformation dedifferentiation of acinic. Publications home of jama and the specialty journals of. Generally, for this rare lowgrade malignant salivary gland neoplasm, 20% of cases may have local recurrences whereas about 10% of cases have distant metastases. Recent studies have shown that immunohistochemical nuclear staining for gata3 among tumors is highly restricted to carcinomas of breast and urothelial origin. Ultrastructural findings of acinic cell carcinomas in salivary glands, including those of minor salivary gland origin, have been reported by several authors and seem to be well established. For malignant tumors, treatment is with excision and. Acinic cell carcinoma is a relatively uncommon malignancy, accounting for 1 to 6% of all salivary gland tumors and 15% of all malignant tumors of the parotid gland.
Highgrade transformation dedifferentiation of acinic cell. For malignant tumors, treatment is with excision and radiation. A painless salivary mass is the most common sign and is evaluated by fineneedle aspiration biopsy. The definition is, however, useful because it emphasizes the. They may arise many years after the initial presentation of the original tumor. A case of acinic cell carcinoma of the right parotid gland metastasizing to the right iliac crest is presented. The relative prevalence of the neoplasm in the various salivary gland reflects the abundance of acinic cells. The acinic cell tumor of salivary gland origin, once thought to be benign, is now known to be an incidiously slow growing malignant neoplasm with lethal potential. Acinic cell carcinoma of the parotid gland radiology case.
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