Salivary glands
Epithelial / myoepithelial tumors
Intraductal carcinoma

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

Revised: 14 March 2018, last major update September 2012

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PubMed Search: Intraductal carcinoma salivary glands

Cite this page: Handra-Luca, A. Intraductal carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/salivaryglandsintraductalsalivary.html. Accessed December 11th, 2018.
Definition / general
  • Rare (< 20 cases reported), in situ form of salivary duct carcinoma, entity is controversial
  • First described in 1983 by Chen (J Laryngol Otol 1983;97:189)
  • Also called low grade cribriform cystadenocarcinoma, low grade salivary duct carcinoma; ambiguity exists regarding noninvasive ex pleomorphic adenoma
  • May represent preinvasive phase of some salivary duct carcinomas
Clinical features
  • Mean age 62 years, range 32 - 91 years, usually female
  • Usually affects major salivary glands (parotid), intraparotid lymph nodes (Head Neck Pathol 2011;5:321), palate
  • Excellent prognosis - no metastases or mortality reported
  • May recur with incomplete excision as intraductal or invasive tumor
  • Recommended to sample extensively and stain for myoepithelial cells with p63 and actin to rule out invasion
Treatment
  • Total parotidectomy (if parotid location) or wide excision to prevent recurrence / progression
Case reports
Gross description
  • May be multifocal, cystic
Microscopic (histologic) description
  • Unencapsulated but circumscribed intraductal neoplasm in micropapillary, cribriform, solid, comedo or clinging patterns, with preservation of myoepithelial cells surrounding intraductal tumor
  • Resembles breast DCIS with pure intraductal proliferation of tumor cells
  • May have apocrine-like vacuoles (Am J Surg Pathol 2006;30:1014), focal necrosis, sclerotic stroma, lipofuschin
  • Variable atypia, variable mitotic figures, no invasion
Microscopic (histologic) images

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Arising in intraparotid lymph node

Cytology description
Positive stains
Negative stains
Differential diagnosis