Home   Chapter Home   Jobs   Conferences   Fellowships   Books


Salivary glands

Epithelial / myoepithelial tumors

Intraductal carcinoma

Reviewer: Adriana Handra-Luca, M.D. (see Reviewers page)
Revised: 27 January 2013, last major update September 2012
Copyright: (c) 2003-2013, PathologyOutlines.com, Inc.


● 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 dyct carcinoma; ambiguity exists regarding non-invasive 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


● Total parotidectomy (if parotid location) or wide excision to prevent recurrence / progression

Case reports

● 44 year old woman with mass in buccal mucosa arising from minor salivary glands (Am J Surg Pathol 2004;28:266)
● 59 year old woman with tumor arising in intraparotid lymph node (Head Neck Pathol 2011;5:321)

Gross description

● May be multifocal, cystic

Micro 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

Micro images

Intraductal tumors resembling breast DCIS

Arising in intraparotid lymph node

Cytology description

● Overlapping, cytoplasmic vacuoles, inconspicuous atypia (Diagn Cytopathol 2011;39:218)

Positive stains

Epithelial cells: high molecular weight cytokeratin, EMA, AE1-AE3, CK7, CK19, BRST2, AR; S100 (50%)
Myoepithelial cells: p63 (nuclear stain), muscle specific actin, CK14, calponin, AR, BRST2

Negative stains

● ER, PR, p53, HER2, CK20

Differential diagnosis

Acinic cell carcinoma-papillary cystic variant
● Cribriform adenocarcinoma: arises in tongue
Metastases when intranodal
Salivary duct carcinoma: males, invasive, CK19+
Warthin tumor

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

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).