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Open Access Case Report

An invasive adenocarcinoma of the accessory parotid gland: a rare example developing from a low-grade cribriform cystadenocarcinoma?

Shin-ichi Nakatsuka1*, Hiroshi Harada2, Hiroshi Fujiyama3, Koji Takeda3, Koji Kitamura4, Hayato Kimura1, Teruaki Nagano1, Mahito Ito4 and Yuji Asada3

Author Affiliations

1 Department of Pathology, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511, Japan

2 Department of Pathology and Research, Sakai Municipal Hospital, 1-1-1 Minami-Yasui-cho, Sakai-ku, Sakai, Osaka 590-0064, Japan

3 Department of Plastic Reconstructive Surgery, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511, Japan

4 Department of Otorhinolaryngology, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511, Japan

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Diagnostic Pathology 2011, 6:122  doi:10.1186/1746-1596-6-122

Published: 7 December 2011

Abstract

Low-grade cribriform cystadenocarcinoma (LGCCA) is a rare tumor of the salivary gland that exhibits clinically indolent behavior. In this paper, we present a case of invasive adenocarcinoma of the accessory parotid gland in a young male that exhibited histology suggestive of an association of LGCCA. A 27-year-old man presented with a subcutaneous tumor in his left cheek. The tumor was separated from the parotid gland and located on the masseter muscle. The tumor was resected, and the postoperative histological diagnosis was adenocarcinoma, not otherwise specified (ANOS). The tumor exhibited papillary-cystic and cribriform proliferation of the duct epithelium and obvious stromal infiltration. Some tumor nests were rimmed by myoepithelium positive for smooth muscle actin, p63, and cytokeratin 14, indicating the presence of intraductal components of the tumor. Tumor cells exhibited mild nuclear atypia, and some of them presented an apocrine-like appearance and had cytoplasmic PAS-positive/diastase-resistant granules and hemosiderin. Other cells had foamy cytoplasm with microvacuoles. Immunohistochemistry revealed that the almost all of the tumor cells were strongly positive for S-100. These histological findings suggest the possibility that ANOS might arise secondarily from LGCCA. This is an interesting case regarding the association between ANOS and LGCCA in oncogenesis.

Virtual Slides

The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1226764594634693 webcite.

Keywords:
accessory parotid gland; low-grade cribriform cystadenocarcinoma; adenocarcinoma; not otherwise specified; salivary duct carcinoma; S-100