Salivary glands - Adenosquamous carcinoma

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Salivary glands

Epithelial / myoepithelial tumors

Adenosquamous carcinoma

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 24 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● Rare, aggressive, high grade tumor with squamous and glandular components (Mod Pathol 2002;15:298)
● In minor (but not major) salivary glands and ducts
● >90% males, mean age 58 years (range 32-99 years)
● Symptoms: pain
● 5 year survival: 25%
● Metastases to lymph nodes; locoregional and distant recurrence in 70-80% even with primaries < 1 cm

Sites
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● Tongue, floor of mouth, nasal cavity, larynx, upper lip, palate, upper and lower alveoli

Treatment
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● Surgical resection with neck dissection, radiotherapy

Gross description
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● 2 mm to 1 cm erythroplakic ulcer or indurated submucosal nodule

Micro description
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● Variable histology
● Adenocarcinoma, squamous cell carcinoma and mixtures resembling mucoepidermoid carcinoma
● Adjacent tumors may cause multifocal carcinoma in situ involving salivary gland ducts, upward extension of intraductal carcinoma to involve mucosal epithelium, glassy squamous cells (Eur Arch Otorhinolaryngol 2003;260:509)
● Commonly perineurial invasion and widespread invasion of submucosa

Micro images
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Adenosquamous carcinoma (figure A) and other tumors with basal cell features

Positive stains
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● Mucicarmine, PAS with diastase, Alcian blue (pH 2.5 and 1.0), cytokeratin (Acta Pathol Jpn 1988;38:445), c-kit

Negative stains
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● Negative for vimentin, MYB (Am J Surg Pathol 2011;35:92)

Molecular / cytogenetics description
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● No KRAS or HRAS mutation (Arch Pathol Lab Med 2000;124:836)

Differential diagnosis
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● Basal cell adenocarcinoma: CIS in the overlying mucosa; no glandular component
● Mucoepidermoid carcinoma: has intermediate cells
● Squamous cell carcinoma: including adenoid, basaloid and pseudoglandular variants

End of Salivary glands > Epithelial / myoepithelial tumors > Adenosquamous carcinoma

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