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Query: UMLS:C0027627 (metastases)
 103,950 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Evaluating salivary gland neoplasms is difficult because of the relatively low incidence of these lesions, their variable locations, and their multiple histologic cell types. Little has been reported on nodal metastases, whether manifest or occult, from these neoplasms. Ninety cases of salivary gland neoplasm are analyzed to provide a clearer understanding of the appropriate approach to occult salivary gland cervical metastases. Manifest regional metastases at the original presentation were absent in 72% (65/90). Few nodal metastases occurred after the primary tumor was controlled (2% [1/56]). Local recurrence (38% [34/90]) and distant metastases (25% [14/56]) were more common. Stage I and II disease was treated by surgical resection of the primary tumor alone; resection was combined with postoperative radiation therapy for stage III disease. Whenever the neck was entered for stage III disease, a conservative neck dissection was incorporated with the resection to reduce the postoperative irradiation field once the neck had been proved N, O histologically. Delayed nodal metastasis was treated by neck dissection alone.
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PMID:Management of occult metastatic disease from salivary gland neoplasms. 253 94

Plasmacytoid myoepitheliomas are rare salivary gland neoplasms that probably represent a variant of the pleomorphic adenoma. They appear to occur more frequently in the minor salivary glands of the mouth. The mean average age at time of diagnosis of intraoral lesions is 18.8 years. Cytologic pleomorphism is a frequent histologic feature, which has led to a questionable diagnosis of malignancy in five out of ten cases. Caution is advocated in the evaluation of a salivary gland neoplasm with such features, and confusion with primary squamous cell or undifferentiated carcinoma of the salivary glands should be avoided. Patients who have cytologically pleomorphic lesions should be assessed for evidence of metastases. Rapid growth, neurologic evidence of sensory or motor dysfunction, and bone invasion should be regarded as ominous clinical parameters. Therapy should be directed toward complete surgical extirpation.
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PMID:Plasmacytoid myoepithelioma of a minor salivary gland. 298 89

The clinicopathologic features of five low-grade papillary adenocarcinomas of palatal salivary gland origin are presented and seven well-documented cases from the literature are reviewed. Patients in our series ranged in age from 30 to 77 years (median 48). Symptoms were nonspecific and related to a mass present for a long duration. Histologically, these were complex cystic, papillary, focally solid tumors that were partially encapsulated. Cytologically, they were composed of bland, predominantly cuboidal cells with eosinophilic or clear cytoplasm. Four tumors were initially considered to be benign mixed tumors, but long-term follow-up indicates that these are slowly growing, malignant neoplasms. Three patients developed solitary cervical lymph node metastases from 2 to 21 years after initial presentation. One tumor underwent an anaplastic transformation to solid adenocarcinoma, and this was from the only patient in our series who died with tumor. Low-grade papillary adenocarcinoma is a clinicopathologically distinctive salivary gland neoplasm, with histologic features unlike those of other papillary salivary gland tumors.
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PMID:Low-grade papillary adenocarcinoma of palatal salivary gland origin. 673 63

We describe 11 patients with a distinctive salivary gland neoplasm. Most of the patients were adult women who presented with a painless mass. Nine tumors arose in minor salivary glands of the oral cavity (82%). Microscopically, they were characterized by the formation of trabeculae, cords, islands, and/or nests of monomorphic clear cells that were glycogen rich and mucin negative and were surrounded by hyalinized bands with foci of myxohyaline stroma. Cells with eosinophilic and granular cytoplasm were also noted. Both cell types showed minimal nuclear pleomorphism and a very low mitotic index. The neoplasms all had infiltrative borders. Immunohistochemically, the tumor cells expressed cytokeratins and epithelial membrane antigen, but not S-100 protein and smooth muscle actin. Ultrastructurally, the tumor cells contained abundant glycogen, desmosomes, peripheral tonofilaments, and prominent interdigitating microvilli without actin myofilaments or dense bodies. These immunohistochemical and ultrastructural findings provide evidence of epithelial differentiation without myoepithelial differentiation. For these tumors, we propose the name, hyalinizing clear cell carcinoma (HCCC). These are low-grade malignant neoplasms. Two patients had ipsilateral cervical lymph node metastases at presentation, but with surgical excision and either preoperative or post-operative radiotherapy in three cases, eight of 10 patients with clinical follow-up are alive and well without evidence of recurrence. The mean clinical follow-up is 3.6 years, with a range of 6 months to 11 years. One patient died as a result of surgery, another died of unrelated causes, and one patient was lost to follow-up.
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PMID:Hyalinizing clear cell carcinoma of salivary gland. 753 Apr 10

We report the clinical and pathologic features of an adenoid cystic carcinoma of the submandibular gland that metastasized to the ovaries 10 years after initial presentation. A 30-year-old woman underwent excision of a right submandibular adenoid cystic carcinoma followed by regional external beam radiation therapy. Three years later, she underwent extended hepatic resection and localized radiotherapy to the hepatic region for metastatic disease. The patient was without evidence of disease for 7 years when she developed pelvic pain and a pelvic mass was found. A solid and cystic 10-cm left ovarian mass and a single metastatic tumor nodule involving the right ovary were excised via the laparoscope. Histologically, the tumor was identical to the patient's initial salivary gland neoplasm. The neoplastic cells were CAM 5.2 positive, S100 positive, muscle-specific actin positive, and smooth muscle actin positive. Ultrastructurally, characteristic pseudocysts (pseudolumina) with abundant basal lamina and true glandular lumina lined by short microvilli were present. Other than a single anecdotal account of a parotid gland adenoid cystic carcinoma, this case represents the first documented report of an adenoid cystic carcinoma of salivary gland origin that was associated with symptomatic ovarian metastases. This case demonstrates that the ovary is a potential site for metastatic disease many years following the diagnosis and treatment for a primary neoplasm however uncommon or remote the site of origin. Since metastatic adenoid cystic carcinoma can rarely present as an ovarian mass, a clinical history of this neoplasm should be heavily weighed in the differential diagnosis of any unusual ovarian tumor with a predominant cribriform, trabecular, or tubular pattern.
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PMID:Adenoid cystic carcinoma of the submandibular gland with symptomatic ovarian metastases. 888 83

Primary epithelial neoplasms of the salivary gland in children are uncommon but are well recognized and occur principally in the major salivary glands. The purpose of this report is to document our experience with an adenocarcinoma of the buccal submucosa (one of several sites of minor salivary gland tissue) that metastasized to multiple bones as the initial sites of distant disease after a local recurrence. The clinical history, imaging studies, and microscopic sections including immunoperoxidase studies were evaluated from the primary tumor, local recurrence, and a metastatic lesion from the femur. The histopathologic features and immunohistochemical phenotype of the adenocarcinoma in the buccal submucosa supported its salivary gland origin. This case of adenocarcinoma of the intraoral buccal tissues independent of the parotid gland in a 12-year-old female is an unusual clinical presentation of a salivary gland neoplasm in childhood, and its ability to metastasize to distant skeletal sites is also remarkable in terms of a primary salivary gland carcinoma regardless of age at diagnosis.
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PMID:Adenocarcinoma of minor salivary gland origin with skeletal metastasis in a child. 896 34

Adenoid cystic carcinoma (ACC) is a generally slow-growing but highly malignant salivary gland neoplasm with remarkable capacities for local invasion and lung metastasis. The precise characteristics of ACC are not fully understood because there was no suitable animal model. We have successfully established a new human tumor line (ACCI) derived from ACC of the oral floor, which showed a cribriform pattern histologically and serially transplantable into nude mice. This tumor developed spontaneous metastasis to the neck at the second passage level, and the histological feature changed from ACC to undifferentiated carcinoma (ACCIM). ACCIM caused spontaneous metastasis to the lung at high incidence when transplanted subcutaneously in nude mice. In this study, we examined the characteristics of this interesting human ACC metastatic line. Tumor fragments were subcutaneously transplanted into nude mice and tumor growth was measured at 1-week intervals. Histological and immunohistochemical examinations were performed. As a result, the tumor growth rate of ACCIM increased as compared to that of ACCI, and the PCNA labeling index was elevated. Furthermore, ACCIM produced multiple metastases to lymph nodes and lungs 5 months after transplantation, and all mice died within 6 months. These multiple metastases were also confirmed in orthotopic transplantation to the tongue. RT-PCR analysis revealed that ACCIM expressed human beta-actin, indicating its human origin. From these findings, ACCIM transplanted into nude mice would provide a useful model for investigating the biological behaviour of ACC.
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PMID:Establishment of nude mouse transplantable model of a human adenoid cystic carcinoma of the oral floor showing metastasis to the lymph node and lung. 1714 80

Acinic cell adenocarcinoma is a malignant salivary gland neoplasm with a relatively low rate of lymphangitic spread to regional lymph nodes. Distant metastases are rare and their occurrence typically indicates an unfavorable outcome. We encountered an unusual example of acinic cell adenocarcinoma that initially presented in the lung, whereas the primary parotid carcinoma, despite extensive clinical evaluation, only became apparent 1 year after initial diagnosis. The histologic, immunohistochemical, and ultrastructural features of the tumor in the parotid gland and lung were similar. The tumor displayed an aggressive behavior resulting in death within 2 years of the initial presentation. This presentation is unique, showing that peripheral lung tumors of salivary gland type are likely to be metastatic, and careful clinical evaluation is warranted in establishing their primary site of origin.
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PMID:Occult primary parotid gland acinic cell adenocarcinoma presenting with extensive lung metastasis. 1755 Mar 29

Carcinoma ex pleomorphic adenoma is a rare salivary gland neoplasm, especially when the malignant component is only intracapsular/minimally invasive. Moreover, only few studies have assessed the behavior of carcinoma ex pleomorphic adenoma according to the histologic subtype. Forty-three cases of carcinoma ex pleomorphic adenoma were identified over a 27-year period and subjected to a detailed histopathologic analysis. There were 13 intracapsular/minimally invasive and 30 widely invasive carcinomas. There were 15 myoepithelial carcinomas, 25 salivary duct carcinomas, 2 adenocarcinomas not otherwise specified, and 1 carcinosarcoma. There was a trend toward a higher frequency of myoepithelial carcinomas in widely invasive tumors (13/30, 43%) than in intracapsular/minimally invasive (2/13, 15%) carcinoma ex pleomorphic adenoma (P = .095). Adequate follow-up was available for 38 patients. Vascular invasion and distant metastases correlated with decreased disease-free survival and disease-specific survival (P < .05), whereas the extent of invasion and the presence of a high mitotic rate or atypical mitoses correlated with decreased disease-free survival only (P < .05). There was a trend toward worse disease-free survival and disease-specific survival in patients with myoepithelial carcinoma (P = .08). Within the intracapsular/minimally invasive carcinoma ex pleomorphic adenoma group, both myoepithelial carcinoma (2/2, 100%) had metastatic disease, whereas only 1 of 11 nonmyoepithelial carcinoma relapsed (P = .038). Vascular invasion, high mitotic rate, and histologic subtype were found to correlate with recurrence in carcinoma ex pleomorphic adenoma. Patients with intracapsular/minimally invasive tumor have a more favorable outcome than patients with widely invasive neoplasm, but intracapsular/minimally invasive carcinoma ex pleomorphic adenoma can recur and cause death. The presence of myoepithelial carcinoma subtype increases the risk of recurrence in carcinoma ex pleomorphic adenoma, especially within the group of intracapsular/minimally invasive tumors.
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PMID:Prognostic factors of recurrence in salivary carcinoma ex pleomorphic adenoma, with emphasis on the carcinoma histologic subtype: a clinicopathologic study of 43 cases. 2033 16

Mucoepidermoid carcinoma (MEC), an invasive malignant neoplasm composed of mucus-secreting, epidermoid, and intermediate cells in varying proportions, is the commonest malignant salivary gland neoplasm in adults. Cutaneous metastases from the same, although not entirely common, has been previously reported but are typically confined to dermis. In this report, we present a case of MEC presenting as a cutaneous metastasis. A histologic feature unique to this case was epidermotropism, previously not noted in either metastatic or primary MEC.
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PMID:Epidermotropic metastatic mucoepidermoid carcinoma. 2048 72


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