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Salivary glands

Epithelial / myoepithelial tumors

Cystadenocarcinoma

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 23 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.

General
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● First described in 1968 by Bookbinder (J Am Osteopath Assoc 1968;67:672)
● Invasive tumor with cystic growth pattern, usually conspicuous papillary component

Clinical features
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● Mean age 59 years, range 20-86 years
● Male gender predominance
● Often major salivary glands, but also lips, buccal mucosa, palate, tongue, retromolar area, floor of mouth, ectopic salivary glands
● Usually indolent behavior, but occasionally recurs locally or metastasizes to lymph nodes (Ear Nose Throat J 2011;90:E6)

Treatment
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● Surgery, radiotherapy for high grade tumors

Gross description
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● Cystic masses, 0.4 to 6 cm

Micro description
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● Invasive, cystic growth pattern, 75% with conspicuous papillary component
● Well or poorly differentiated, composed of small cuboidal cells, large cuboidal cells, tall columnar cells or mixture (Am J Surg Pathol 1996;20:1440)
● Cyst rupture with hemorrhage and granulation tissue is common
● Does not involve the native duct system
● Variants include mucinous (aggressive, Auris Nasus Larynx 2005;32:301, Acta Cytol 2001;45:605), oncocytic (children), papillary (low grade, often in minor salivary glands, Int J Surg Pathol 2008;16:341, Auris Nasus Larynx 2007;34:259)

Micro images
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Various images

 
Papillary cystadenocarcinoma

Cytology description
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● Ball-like, cohesive, overlapping cells, vacuolated cytoplasm (Diagn Cytopathol 2010;38:377)

Cytology images
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Papillary cystadenocarcinoma

Positive stains
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● NSE, S100, MAM6, MAM3, lyzozyme, lactoferrin, alpha-antichemotripsin

Molecular description
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● Usually no HER2 amplification (Pathology 2011;43:459)

End of Salivary glands > Epithelial / myoepithelial tumors > Cystadenocarcinoma

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