Salivary glands
Primary salivary gland neoplasms
Malignant
Intraductal carcinoma
Author: Adriana Handra-Luca, M.D.
Topic Completed: 1 September 2012
Minor changes: 26 February 2021
Copyright: 2003-2021, PathologyOutlines.com, Inc.
PubMed Search: Intraductal carcinoma salivary glands
Table of Contents
Definition / general | Clinical features | Treatment | Case reports | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Differential diagnosisCite this page: Handra-Luca A. Intraductal carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/salivaryglandsintraductalsalivary.html. Accessed March 4th, 2021.
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
- 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
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
Images hosted on other servers:
Arising in intraparotid lymph node
Cytology description
- Overlapping, cytoplasmic vacuoles, inconspicuous atypia (Diagn Cytopathol 2011;39:218)
Positive stains
Differential diagnosis
- Acinic cell carcinoma - papillary cystic variant
- Cribriform adenocarcinoma: arises in tongue
- Cystadenocarcinoma
- Metastases when intranodal
- Salivary duct carcinoma: males, invasive, CK19+
- Warthin tumor
