Salivary glands - Giant cell tumor of salivary glands

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Salivary glands

Epithelial / myoepithelial tumors

Giant cell tumor of salivary glands

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 26 January 2013, last major update September 2012
Copyright: (c) 2003-2013, Pathol2gyOutlines.com, Inc.

General
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● Very rare salivary gland tumor of evenly distributed osteoclastic giant cells in background of mononuclear cells
● First reported in 1984 by Eusebi (Am J Clin Pathol 1984;81:666); <20 cases reported to date

Clinical features
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● Mean age 62 years, range 28-92 years; 80% male
● 87% of salivary gland tumors occur in parotid gland; 13% in submandibular gland
● Giant cell component may be neoplastic
● Uncertain histogenesis, may be a carcinoma
● 50% associated with carcinoma (usually salivary duct carcinoma or carcinoma ex pleomorphic adenoma / malignant mixed tumor/ carcinosarcoma, Ann Diagn Pathol 2009;13:114)
● 13% die of disease; 48% 5 year survival - more aggressive than giant cell tumor of bone, less aggressive than undifferentiated carcinoma
● Presents as rapidly enlarging mass, often with lymph node metastases

Treatment
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● Resection of tumor and lymph nodes, radiotherapy

Gross description
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● No peripheral mineralized bone shell

Micro images
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57 year old man with parotid tumor

Micro description
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● Evenly distributed osteoclastic giant cells in background of mononuclear cells
● Nuclei differ between mononuclear cells and osteoclastic giant cells, unlike giant cell tumor of bone (Am J Surg Pathol 2004;28:953)
● Osteoid or mature bone present; either pure or associated with at least focal carcinoma

Micro images
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57 year old man with parotid tumor

Cytology description
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● Numerous osteoclast-like multinucleated giant cells and many malignant mononuclear cells (Acta Cytol 2006;50:80)

Cytology images
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57 year old man with parotid tumor

Positive stains
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● Mononuclear cells: EMA, CEA, androgen receptor, p53, histiocytic markers
● Osteoclast giant cells: CD68, vimentin
● Carcinoma cells: CK7, CK8, EMA, androgen receptor, HER2, GCDFP15, histiocyte markers

Electron microscopy description
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● Giant cells are similar to bone osteoclasts
● Mononuclear cells have numerous microvilli and some cell junctions but few lysosomes

Molecular / cytogenetics description
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● 17p13LOH (carcinoma and GCT components), 10q23 LOH (carcinoma)

End of Salivary glands > Epithelial / myoepithelial tumors > Giant cell tumor of salivary glands

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