Malignant Mixed Tumour. A Salivary Gland Tumour Showing Both Carcinomatous and Sarcomatous Features

Overview

Journal Virchows Arch A Pathol Anat Histopathol

Specialty Anatomy & Histology

Date 1986 Jan 1

PMID 2422810

Citations 4

Authors

H Hellquist

L Michaels

Affiliations

Soon will be listed here.

Abstract

Two malignant mixed tumours, in which both carcinomatous and sarcomatous features were present, are described. They arose in the palate in patients who had undergone surgery and irradiation for a pleomorphic adenoma at the same site 30 and 36 years previously. The histological differential diagnoses of recurrent benign pleomorphic adenoma, pleomorphic adenoma resembling mesenchymal tumour, and carcinoma in (ex) pleomorphic adenoma are discussed. On the basis of their positive reaction for keratin with specific monoclonal antibodies it is suggested that the myoepithelial cells are of epithelial origin. Immunohistochemical studies together with the histological appearance of the neoplasms indicate that the carcinomatous as well as the sarcomatous elements were derived from modified myoepithelial tumour cells. Irradiation may have been responsible for inducing a true malignant mixed tumour as distinct from the more common malignancy which may arise in pleomorphic adenoma, this being a simple carcinoma.

Citing Articles

Clinical behavior of recurrent pleomorphic adenoma in the palate: a systematic review.

Lopes-Santos G, Marques N, Tjioe K, Oliveira D Acta Cir Bras. 2024; 39:e390824.

PMID: 38422328 PMC: 10911496. DOI: 10.1590/acb390824.

Metastasizing pleomorphic adenoma presenting as an asymptomatic kidney tumor twenty-nine years after parotidectomy - urological viewpoint and overview of the literature to date.

Ebbing J, Blind C, Stein H, Miller K, Loddenkemper C Rare Tumors. 2010; 1(2):e54.

PMID: 21139933 PMC: 2994456. DOI: 10.4081/rt.2009.e54.

Intracapsular (in situ) carcinoma ex pleomorphic adenoma with unusual clinical and histological features.

Logasundaram R, Amarawickrama H, Premachandra D, Hellquist H Eur Arch Otorhinolaryngol. 2008; 265(12):1563-6.

PMID: 18288478 DOI: 10.1007/s00405-008-0615-y.

Carcinoma ex-pleomorphic adenoma of the breast. Report of three cases suggesting a relationship to metaplastic carcinoma of matrix-producing type.

Hayes M, Lesack D, Girardet C, Del Vecchio M, Eusebi V Virchows Arch. 2004; 446(2):142-9.

PMID: 15583933 DOI: 10.1007/s00428-004-1137-7.

References

Caselitz J, Loning T, Staquet M, Seifert G, Thivolet J . Immunocytochemical demonstration of filamentous structures in the parotid gland. Occurrence of keratin and actin in normal and tumoral parotid gland with special respect to the myoepithelial cells. J Cancer Res Clin Oncol. 1981; 100(1):59-68. DOI: 10.1007/BF00405902. View

Moberger J, ENEROTH C . Malignant mixed tumors of the major salivary glands. Special reference to the histologic structure in metastases. Cancer. 1968; 21(6):1198-211. DOI: 10.1002/1097-0142(196806)21:6<1198::aid-cncr2820210623>3.0.co;2-q. View

Erlandson R, Higgins P . Histogenesis of benign pleomorphic adenoma (mixed tumor) of the major salivary glands. An ultrastructural and immunohistochemical study. Am J Surg Pathol. 1984; 8(11):803-20. DOI: 10.1097/00000478-198411000-00001. View

Mepham B, Frater W, Mitchell B . The use of proteolytic enzymes to improve immunoglobulin staining by the PAP technique. Histochem J. 1979; 11(3):345-57. DOI: 10.1007/BF01005033. View

Merino M, Livolsi V . Pleomorphic adenomas of the parotid gland resembling mesenchymal tumors. Oral Surg Oral Med Oral Pathol. 1977; 44(3):405-10. DOI: 10.1016/0030-4220(77)90410-8. View

FOOTE Jr F, FRAZELL E . Tumors of the major salivary glands. Cancer. 1953; 6(6):1065-133. DOI: 10.1002/1097-0142(195311)6:6<1065::aid-cncr2820060602>3.0.co;2-0. View

Radnor C . Myoepithelial cell differentiation in rat mammary glands. J Anat. 1972; 111(Pt 3):381-98. PMC: 1271129. View

Nakazato Y, Ishizeki J, Takahashi K, Yamaguchi H, Kamei T, Mori T . Localization of S-100 protein and glial fibrillary acidic protein-related antigen in pleomorphic adenoma of the salivary glands. Lab Invest. 1982; 46(6):621-6. View

Yamaguchi H . [Studies on the immunohistochemical localization of S-100 and glial fibrillary acidic proteins in the rat nervous system and in human brain tumors (author's transl)]. No To Shinkei. 1980; 32(10):1055-64. View

10.

Dardick I, van Nostrand A, Phillips M . Histogenesis of salivary gland pleomorphic adenoma (mixed tumor) with an evaluation of the role of the myoepithelial cell. Hum Pathol. 1982; 13(1):62-75. DOI: 10.1016/s0046-8177(82)80140-8. View

11.

Cutler L, CHAUDHRY A . Differentiation of the myoepithelial cells of the rat submandibular gland in vivo and in vitro: an ultrastructural study. J Morphol. 1973; 140(3):343-54. DOI: 10.1002/jmor.1051400307. View

12.

Dardick I, van Nostrand A, Jeans M, Rippstein P, Edwards V . Pleomorphic adenoma, I: Ultrastructural organization of "epithelial" regions. Hum Pathol. 1983; 14(9):780-97. DOI: 10.1016/s0046-8177(83)80301-3. View

13.

SPIRO R, Huvos A, Strong E . Malignant mixed tumor of salivary origin: a clinicopathologic study of 146 cases. Cancer. 1977; 39(2):388-96. DOI: 10.1002/1097-0142(197702)39:2<388::aid-cncr2820390204>3.0.co;2-d. View

14.

Holthofer H, Miettinen A, Paasivuo R, Lehto V, Linder E, ALFTHAN O . Cellular origin and differentiation of renal carcinomas. A fluorescence microscopic study with kidney-specific antibodies, antiintermediate filament antibodies, and lectins. Lab Invest. 1983; 49(3):317-26. View

15.

Livolsi V, Perzin K . Malignant mixed tumors arising in salivary glands. I. Carcinomas arising in benign mixed tumors: a clinicopathologic study. Cancer. 1977; 39(5):2209-30. DOI: 10.1002/1097-0142(197705)39:5<2209::aid-cncr2820390540>3.0.co;2-8. View

16.

Takeuchi J, Sobue M, Yoshida M, Esaki T, Kato Y . Pleomorphic adenoma of the salivary gland. With special reference to histochemical and electron microscopic studies and biochemical analysis of glycosaminoglycans in vivo and in vitro. Cancer. 1975; 36(5):1771-89. DOI: 10.1002/1097-0142(197511)36:5<1771::aid-cncr2820360532>3.0.co;2-z. View

17.

Moore B . A soluble protein characteristic of the nervous system. Biochem Biophys Res Commun. 1965; 19(6):739-44. DOI: 10.1016/0006-291x(65)90320-7. View

18.

Youngs G, Scheuer P . Histologically benign mixed parotid tumour with hepatic metastasis. J Pathol. 1973; 109(2):171-2. DOI: 10.1002/path.1711090211. View

19.

ENEROTH C . HISTOLOGICAL AND CLINICAL ASPECTS OF PAROTID TUMOURS. Acta Otolaryngol Suppl. 1964; 188:SUPPL 191:1-99. View

20.

Regezi J, Lloyd R, Zarbo R, McClatchey K . Minor salivary gland tumors. A histologic and immunohistochemical study. Cancer. 1985; 55(1):108-15. DOI: 10.1002/1097-0142(19850101)55:1<108::aid-cncr2820550118>3.0.co;2-2. View