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Salivary glands

Epithelial / myoepithelial tumors

Squamous cell carcinoma


Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 29 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● True salivary gland primaries of squamous cell carcinoma are very rare; most squamous cell carcinomas are metastases to intraparotid lymph nodes from primaries in oral cavity, upper aerodigestive tract or skin
● Squamous cell carcinomas represent 16-54% of malignant salivary gland tumors, about 11% of malignant tumors of major salivary glands

Clinical features
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● Squamous cell carcinomas (primary or secondary) are most frequent parotid malignant tumor (30-37%), represent 4% of submandibular gland tumors
● Usually men (when considering major salivary gland tumors); also associated with AIDS
● May occur in Stensen duct
● Rapid painless growth with infiltration of surrounding structures, regardless of origin; may cause acute facial paralysis
● Aggressive behavior, with 50% 5 year survival (Arch Pathol Lab Med 2001;125:740)

Treatment
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● Radical surgery, radiation therapy

Gross description
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● Large, poorly encapsulated mass

Micro description
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● Classic features of squamous cell carcinoma
● May have perineural invasion, clear cell change
● Often component or coexisting with other tumors: carcinosarcoma, epidermoid cyst, epithelial-myoepithelial carcinoma, malignant mixed tumor, mucoepidermoid carcinoma, sarcomatoid carcinoma, salivary duct carcinoma, sebaceous lymphadenoma, Warthin tumor (Mod Pathol 2002;15:724)

Micro images
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Various images


Metastasis to parotid gland

Positive stains
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● CK7 (variable, Mod Pathol 2004;17:407), CK13, CK14, CK19; also vimentin, p53, cyclin D1, MDM2, p63 diffuse (basaloid type)

Negative stains
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● CK20, COX2, CK8, factor XIIIa, p16, CDK4, Rb, E2F1
● Loss of E-cadherin

Differential diagnosis
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Adenoid cystic carcinoma: p63+, resembles basaloid squamous cell carcinoma (Mod Pathol 2005;18:645)
High grade mucoepidermoid carcinoma: intermediate cells, mucus cells, COX2+

End of Salivary glands > Epithelial / myoepithelial tumors > Squamous cell carcinoma


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