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Eur Arch Otorhinolaryngol. 2018 Jul;275(7):1681-1695. doi: 10.1007/s00405-018-4985-5. Epub 2018 May 14.

Polymorphous adenocarcinoma of the salivary glands: reappraisal and update.

Author information

1
Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium. vincent.vanderpoorten@uzleuven.be.
2
Multidisciplinary Salivary Gland Society, Geneva, Switzerland. vincent.vanderpoorten@uzleuven.be.
3
School of Dentistry, University of Liverpool, Liverpool, UK.
4
Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK.
5
Multidisciplinary Salivary Gland Society, Geneva, Switzerland.
6
Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic.
7
Department of Pathology and Genetics, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden.
8
Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
9
Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
10
Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA.
11
Epigenetics and Human Disease Laboratory, CBMR, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal.
12
Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium.
13
Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands.
14
Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
15
Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden.
16
Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain.
17
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
18
Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany.
19
University of Udine School of Medicine, Udine, Italy.
20
International Head and Neck Scientific Group, Padua, Italy.

Abstract

Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG  often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.

KEYWORDS:

Cribriform adenocarcinoma of minor salivary glands; Pathology; Polymorphous adenocarcinoma; Polymorphous low-grade adenocarcinoma; Prognosis; Salivary glands; Therapy

PMID:
29761209
DOI:
10.1007/s00405-018-4985-5
[Indexed for MEDLINE]

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