• Korean Journal of Head & Neck Oncology
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• v.40 no.1
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• pp.37-41
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• 2024

Carcinoma ex pleomorphic adenoma is an uncommon malignant salivary gland tumor that arises from a long-standing pleomorphic adenoma. The carcinomatous component of carcinoma ex pleomorphic adenoma can possess virtually any histologic subtype of salivary gland cancer. We experienced a case of a 61-year-old patient who presented with a right parotid mass that was initially palpated 20 years ago, with a sudden increase in size in the last few months. Radiological and cytological findings from fine needle aspiration biopsy could not exclude malignancy. Total parotidectomy and selective neck dissection were performed for treatment, and carcinoma ex pleomorphic adenoma with mixed carcinoma components of salivary duct carcinoma and myoepithelial carcinoma was diagnosed. After receiving postoperative radiation of 6000 cGy over 6 weeks, there has been no recurrence up to the 18-month follow-up. We report this rare case of carcinoma ex pleomorphic adenoma with mixed malignancy subtypes, accompanied by a review of literature.

• The Journal of Internal Korean Medicine
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• v.42 no.5
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• pp.1062-1073
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• 2021

Objectives: This study examined the case of a patient with recurrent salivary duct carcinoma and hepatic metastasis. Methods: The patient was treated with Casodex/Nolvadex from January 25^th 2021 onward with doses of bicalutamide (150 mg/day) and tamoxifen (10 mg/day) every four weeks. Simultaneously, the patient was treated with Korean medicine. The tumor size was measured using computed tomography (CT). Adverse events were evaluated according to the National Cancer Institute's Common Terminology Criteria for Adverse Events (NCI-CTCAE), version 5.0. Results: Following the four-month treatment, the extent of the proximal portion of hepatic metastasis decreased, and discomfort and physical activity gradually improved. Conclusions: The results suggest that combined chemotherapy and Korean medicine may help to reduce tumor size and improve quality of life.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.33 no.2
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• pp.139-142
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• 2007

Malignant salivary gland tumor is rare neoplasm. In Korean population, retrospective study of malignant salivary gland tumor has not been performed. We analyzed 67 cases of malignant salivary gland tumors from 2001 to 2005 in Seoul National University Dental Hospital in Seoul, Korea. The mean age is 51.7 and the male to female ratio is 1:1.39. The most affected site is the palate. Histologically, the tumors were classified as adenoid cystic carcinoma(34.4%), mucoepidermoid carcinoma(31.3%), adenocarcinoma, NOS(11.9%), polymorphous low grade adenocarcinoma(3.0%), salivary duct carcionoma(6.0%), carcinoma ex pleomorphic adenoma(4.5%), myoepithelial carcinoma(4.5%), epithelial-myoepithelial carcinoma(1.5%), cyatadenocarcinoma(1.5%) and adenosquamous carcinoma(1.5%).

• The Korean Journal of Cytopathology
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• v.15 no.1
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• pp.40-44
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• 2004

To evaluate the quality of fine needle aspiration cytology diagnosis on malignant salivary gland neoplasms, cytologic findings were correlated with histologic diagnosis of 56 surgically removed malignant salivary gland tumors. Seven cases (12.5%) were insufficient, 23 cases (41.1%) were diagnosed as malignant, 17 (30.4%) cases were accurately diagnosed by histologic subtype, and 9 cases (16%) were diagnosed as benign. Five out of 9 false negative cases were misdiagnosed as pleomorphic adenomas. Except the cases with insufficient specimen, overall sensitivity was 81.6%, and the sensitivity varied according to the histologic subtype; 91% in salivary duct carcinoma, 100% in carcinoma ex pleomorphic adenoma, 50% in mucoepidermoid carcinoma, 63% in adenoid cystic carcinoma, and 50% in acinic cell carcinoma. The diagnostic accuracy differed among cytopathologists irrespective of periods after acquisition of board of pathologists. These results confirm that salivary gland neoplasm can be easily misdiagnosed in fine needle aspiration cytology and a great caution should be given in diagnosing the benign appearing salivary aspirates to avoid under-diagnosis of malignant neoplasm with low grade cytologic atypia.

• Korean Journal of Head & Neck Oncology
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• v.9 no.1
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• pp.74-87
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• 1993

Immunohistochemical studies on S-100 protein and lactoferrin were carried out to evaluate the existence and distribution pattern of S-100 protein and lactoferrin positive cells in salivary gland tumors. The specimens used were 25 cases of pleomorphic adenoma, 2 cases of monomorphic adenoma, 2 cases of mucoepidermoid tumor, 2 cases of acinic cell tumor, 3 cases of adenoid cystic carcinoma and 2 cases of adenocarcinoma occured in parotid and submandibular salivary gland. ABC kits(Dako corp. Copenhagen. Denmark) for S-100 protein and lactoferrin were used. The results obtained were summarized as follows: In the normal salivary gland. positive immunoreaction for S-100 protein was observed in myoepithelial cells of acini and intercalated ducts. Positive immunoreaction for lactoferrin was observed in serous acinic cells, epithelial cells of intercalated ducts, and excretory material in the ductal lumina. In the pleomorphic and monomorphic adenomas. most of tumor cells were positive for S-100 protein, while luminal tumor cells in gland-like or duct-like structures were rarely positive for lactoferrin. In mucoepidermoid tumor, most of squamous cells and a few of intermediate cells were positive for S-100 protein, but all of tumor cells were negative for lactoferrin. In acinic cell tumor, most of tumor cells were positive for lactoferrin, but all of tumor cells were negative for S-100 protein. In adenoid cystic carcinoma, basaloid tumor cells in trabecular structure were focally positive for S-100 protein. and in adenocarcinoma, many of tumor cells were posivive for both S-100 protein and lactoferrin. Thus, according to the embryonic stage of the development of the tumor cell origin, it was possible to classify the salivary gland tumor as followings: mucoepidermoid carcinoma which originated from the earliest stage, acinic cell tumor which originated from the end stage. Between these two extremes, there were pleomorphic adenoma, adenoid cystic carcinoma and adenocarcinoma which originated in the middle stage of the development of .the salivary glands. Based on the above results, it can be stated that S-100 protein is demonstrated in tumor cells orginated from myoepithelial cells and lactoferrin in glandular differentiated tumor cells.

• Korean Journal of Head & Neck Oncology
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• v.30 no.2
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• pp.90-94
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• 2014

Salivary duct carcinoma(SDC) is rare malignancy, accounting for approximately 1-3% of all malignant salivary gland tumors. Systemic chemotherapy has been used for stage IV SDC, but there is no consensus on the standard treatment. SDC is histologically similar to ductal carcinoma of breast and often overexpress HER2/neu, hence HER2/neu targeted therapy could be one of treatment options. A 75-year-old Arabian man was diagnosed as SDC of right parotid gland with extensive metastases. He received oral 5-FU as palliative chemotherapy, but he was intolerable to oral chemotherapy due to severe oral mucositis. Considering immunohistochemical stain of tumor tissue showing strong positive for HER2/neu, we decided to administer an anti-HER2/neu antibody, trastuzumab. Follow-up CT scans before the third dose of trastuzumab demonstrated remarkable regression of multiple metastases as well as primary tumor. This case suggests that HER2/neu targeted therapy may be a potential therapeutic option for the SDC patient with overexpression of HER2/neu.

• The Korean Journal of Cytopathology
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• v.7 no.1
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• pp.64-68
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• 1996

The report of aspiration cytologic findings of epithelial-myoepithelial carcinoma(EMC) in the salivary gland is extremely rare. We present a case of fine needle aspiration cytology(FNAC) from EMC in the right submandibular gland of a 46 years old male patient. Neck CT scan revealed a confined lesion in the submandibular gland without enlargement of the regional lymph node. FNAC from the tumor showed several three-dimensional cellular clusters with admixed normal acinar cells. They frequently formed blanching tubular structures composed of two type of cells; darker cells haying eosinophilic scanty cytoplasm with round dense nuclei and clear cells having abudant pale cytoplasm with vesicular nuclei at the periphery of clusters. The tumor cells of both types did not show pleomorphism or mitoses. The resected submandibular gland showed an ill-defined whitish firm tumor, measuring $2{\times}1.5{\times}2cm$. The histology revealed an infiltrative tumor showing characteristic two cell types in a duct-like arrangement surrounded by thin basement menbrane. An inner layer of darker cells and outer layer of clear cells were postive for cytokeratin in the former and S-100 protein in the taller on the immunohistochemical stain.

• Korean Journal of Head & Neck Oncology
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• v.17 no.2
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• pp.238-241
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• 2001

Epithelial-myoepithelial carcinoma is a rare neoplasm comprising approximately 1% of all salivary gland neoplasms. Histopathologically, the carcinomas are characterized by a dual cell population of an inner duct-forming epithelium and an outer myoepithelial cell. They are characterized by their variable clinical course and a lack of features that predict clinical outcome. The following report describes our experience with this type of tumor. We suggest that radiation therapy and long term follow-up will be necessary because this tumor have a high risk of locoregional aggressiveness.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.27 no.1
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• pp.83-86
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• 2001

Myoepithelioma is histologically composed exclusively of myoepithelial cells. Myoepithelial cells are present in the major and minor salivary glands. Salivary gland neoplasms that frequently contain myoepithelial cells are the pleomorphic adenoma, adenoid-cystic carcinoma, and epithelial myoepithelial carcinoma of intercalated duct origin. Neoplasms composed exclusively of myoepithelial cells are rare. Myoepitheliomas may be composed of spindle-shaped cells, plasmacytoid(hyaline) cells, or combination of both in varying proportions. A case is reported of plasmacytoid myoepithelioma with ultrastructural confirmation, together with reviews of the English literature.

• Tuberculosis and Respiratory Diseases
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• v.78 no.4
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• pp.428-431
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• 2015

Epithelial-myoepithelial carcinoma (EMC) of lung is a minor subset of salivary type carcinoma of lung of known low grade malignancy. Histologically, two-cell components forming duct-like structure with inner epithelial cell layer and outer myoepithelial cell layer are characteristics of EMC. In salivary gland, dedifferentiation of conventional low grade malignancy has been reported and is thought to be related with poor prognosis. However, precise histomorphology and prognostic factors of pulmonary EMC have not been clarified due to its rarity. Herein, we reported a rare case of EMC presented as endobronchial mass in a 53-year old woman, which showed predominant solid lobular growth pattern and lymph node metastases.