» Articles » PMID: 20596994

An Update on Grading of Salivary Gland Carcinomas

Overview
Specialties Oncology
Pathology
Date 2010 Jul 3
PMID 20596994
Citations 98
Authors
Affiliations
Soon will be listed here.
Abstract

Histologic grade is a significant predictor of outcome in salivary gland carcinomas. However, the sheer variety of tumor type and the rarity of these tumors pose challenges to devising highly predictive grading schemes. As our knowledge base has evolved, it is clear that carcinoma ex pleomorphic adenoma is not automatically a high grade tumor as is traditionally suggested. These tumors should be further qualified as to type/grade of carcinoma and extent, since intracapsular and minimally invasive carcinomas ex pleomorphic adenoma behave favorably. The two carcinoma types for which grading schemes are common include adenoid cystic carcinoma and mucoepidermoid carcinoma. Adenoid cystic carcinomas are graded based solely on pattern with solid components portending a worse prognosis. Occasionally, adenoid cystic carcinomas may undergo transformation to pleomorphic high grade carcinomas. This feature confers a high propensity for lymph node metastasis and should thus be reported to alert the clinical team. Mucoepidermoid carcinomas are graded in a three tier fashion based on a constellation of features including cystic component, border, mitoses, anaplasia, and perineural invasion among others. All grading schemes are somewhat cumbersome, intimidating and occasionally ambiguous, but evidence suggests that using a scheme consistently shows greater reproducibility than using an intuitive approach. The intermediate grade category demonstrates the most variability between grading systems and thus the most controversy in management. In the AFIP system intermediate grade tumors cluster with high grade tumors, while in the Brandwein system, they cluster with low grade tumors.

Citing Articles

Stroma-and Tumor-Associated Predictive Features in Salivary Gland Adenoid Cystic Carcinoma of the Head and Neck.

Rytkonen A, Laine H, Makitie A, Haglund C, Hagstrom J, Almangush A J Oral Pathol Med. 2024; 54(1):22-30.

PMID: 39523633 PMC: 11730399. DOI: 10.1111/jop.13589.


[Clinical and molecular epidemiology of malignant salivary gland tumors].

Jansen L, Nachtsheim L, Mayer M, Arolt C, Quaas A, Klussmann J Laryngorhinootologie. 2024; 104(2):87-93.

PMID: 39419038 PMC: 11790319. DOI: 10.1055/a-2373-5741.


A Retrospective Analysis of Salivary Gland Tumor Cases: Histological Variations and Clinical Outcomes.

Dolma K, Issac A, Gupta R, Kumari Achanta S, Channe P, Venkata Ramanand O J Pharm Bioallied Sci. 2024; 16(Suppl 3):S2443-S2445.

PMID: 39346366 PMC: 11426729. DOI: 10.4103/jpbs.jpbs_296_24.


Establishment and characterization of cMYB-expressing human salivary adenoid cystic carcinoma cell lines (UM-HACC-14, UM-HACC-6) and matching patient-derived xenograft model (UM-PDX-HACC-14).

Warner K, Herzog A, Sahara S, Nor F, Castilho R, Demirci H Oral Surg Oral Med Oral Pathol Oral Radiol. 2024; 138(4):516-531.

PMID: 38971694 PMC: 11827064. DOI: 10.1016/j.oooo.2024.06.005.


Current Developments in Diagnosis of Salivary Gland Tumors: From Structure to Artificial Intelligence.

Faur A, Buzas R, Lazarescu A, Ghenciu L Life (Basel). 2024; 14(6).

PMID: 38929710 PMC: 11204840. DOI: 10.3390/life14060727.


References
1.
Goode R, Auclair P, ELLIS G . Mucoepidermoid carcinoma of the major salivary glands: clinical and histopathologic analysis of 234 cases with evaluation of grading criteria. Cancer. 1998; 82(7):1217-24. DOI: 10.1002/(sici)1097-0142(19980401)82:7<1217::aid-cncr2>3.0.co;2-c. View

2.
Weinreb I, Seethala R, Perez-Ordonez B, Chetty R, Hoschar A, Hunt J . Oncocytic mucoepidermoid carcinoma: clinicopathologic description in a series of 12 cases. Am J Surg Pathol. 2008; 33(3):409-16. DOI: 10.1097/PAS.0b013e318184b36d. View

3.
Fordice J, Kershaw C, El-Naggar A, Goepfert H . Adenoid cystic carcinoma of the head and neck: predictors of morbidity and mortality. Arch Otolaryngol Head Neck Surg. 1999; 125(2):149-52. DOI: 10.1001/archotol.125.2.149. View

4.
Aro K, Leivo I, Makitie A . Management and outcome of patients with mucoepidermoid carcinoma of major salivary gland origin: a single institution's 30-year experience. Laryngoscope. 2007; 118(2):258-62. DOI: 10.1097/MLG.0b013e31815a6b0b. View

5.
Nance M, Seethala R, Wang Y, Chiosea S, Myers E, Johnson J . Treatment and survival outcomes based on histologic grading in patients with head and neck mucoepidermoid carcinoma. Cancer. 2008; 113(8):2082-9. PMC: 2746751. DOI: 10.1002/cncr.23825. View