Salivary glands
Epithelial / myoepithelial tumors
Adenocarcinoma, not otherwise specified (NOS)

Author: Adriana Handra-Luca, M.D. (see Authors page)

Revised: 13 March 2018, last major update September 2012

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PubMed Search: Adenocarcinoma[TI] not otherwise specified[TI] salivary glands[TI]

Cite this page: Handra-Luca, A. Adenocarcinoma, not otherwise specified (NOS). PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/salivaryglandsadenocarcinomaNOS.html. Accessed September 25th, 2018.
Definition / general
  • Invasive tumor, often aggressive, with glandular or ductal differentiation but no features characteristic of other specific types (Arch Pathol Lab Med 2004;128:1385)
  • Common, 5 - 10% of salivary gland tumors
  • 6 - 10% of salivary gland malignancies, 17% of parotid gland malignancies, 15% of minor salivary gland malignancies
Sites
  • Parotid gland, submandibular gland, palate, buccal mucosa
Clinical features
  • Mean age 58 years (median 67 years), range 10 - 93 years
  • Usually asymptomatic
  • Often fixed to skin or deep tissues
  • Palatal lesions often ulcerated and involve bone
  • Gender predominance debated, recent reports show male predominance
  • Cervical lymph node metastases in 23%, distant metastases in 37%
  • Diagnosis of exclusion (not metastatic, not another salivary gland carcinoma)
  • 5 year disease specific survivals is 57%
Case reports
Treatment
  • Complete surgical excision
Gross description
  • Poorly circumscribed with infiltrative borders
  • Solid tan cut surface with hemorrhage and necrosis
Microscopic (histologic) description
  • Invasive with glandular or ductal differentiation but no features characteristic of other specific types
  • Patterns include glandular spaces with cyst formation, papillary formation, solid sheets, comedonecrosis, hyalinized "shadow" nodules
  • Small clusters of cuboidal, round or ovoid cells with distinct borders and abundant cytoplasm
  • May have clear cell or oncocytic features
  • Low, intermediate or high grade based on cytomorphic features
  • In situ component in 68% (Virchows Arch 2006;449:159)
Microscopic (histologic) images

Images hosted on other servers:

Cellular tumor with glandular or duct-like structures, occasional pink cytoplasmic granules, occasional mucicarmine+ cells

Various images

Oncocytic carcinoma, H&E and p63

Positive stains
Negative stains
Molecular / cytogenetics description
  • EGFR gene amplification, increased EGFR gene copy number
  • HER2 amplification, high HER2 gene copy number
  • KRAS mutation rarely (Arch Pathol Lab Med 2000;124:836)