Malignant transformation of Warthin's tumor into squamous cell carcinoma: A case report.
Oncology letters
Malignant transformation of Warthin's tumor into squamous cell carcinoma is rare. The present study reported on a case of a 67-year-old male patient diagnosed with this condition. Microscopically, the tumor was mainly composed of squamous cell carcinoma and lymphoid stroma. Furthermore, the squamous cell carcinoma cells were arranged in a solid flake-like, papillary and cystic shape. Local bleeding was observed in the mass and a large number of lymphoid stroma-associated centers were observed between the cancer cells. The expression of cytokeratin (CK)5/6, P40, CK7, CK18, CK8 and MutS protein homolog 2 was detected by immunohistochemistry, in addition to Epstein-Barr encoding region hybridization (-), Ki-67 (epithelial 25% +) and p53 (wild-type). The diagnosis of malignant transformation of Warthin's tumor into squamous cell carcinoma depends on the histopathology. The microscopic diagnosis is based on the dynamic process of scaling, atypical hyperplasia and cancerization of the eosinophilic columnar epithelium. Of note, it is also necessary to differentiate it from cervical malignant tumors such as lymphoepithelial carcinoma. The main clinical treatment is surgical resection with negative margins.
10.3892/ol.2022.13322
Concurrent presence of secretory carcinoma and Warthin's tumor in ipsilateral parotid gland.
Kaleem Arshad,Patel Neel,Alzahrani Shadi,Hatoum Hisham,Tursun Ramzey
Oral oncology
BACKGROUND:The presence of synchronous benign and malignant salivary gland neoplasms is very rare. The authors present a previously unreported combination of Secretory Carcinoma (SC) and Warthin's Tumor (WT) within the same parotid gland. METHODS:The patient presented with increasingly painful enlargement of the left parotid gland. CT scan with contrast revealed a heterogeneous solid/cystic mass in the superficial lobe. Fine needle aspiration cytology favored pleomorphic adenoma (PA) and patient underwent superficial parotidectomy without complication. RESULTS:Final pathology revealed concomitant presence of SC and WT. Stains were positive for S100 and mammaglobin, and FISH revealed the presence of t(12;15) (p13;q25) translocation, resulting in the ETV6-NTRK3 fusion gene. CONCLUSION:It is important for surgeons and pathologists to note the potential for co-existing benign and malignant pathology within the same salivary gland, as this can have an impact on management and prognosis for patients.
10.1016/j.oraloncology.2020.104691
Distinguishing Parotid Polymorphic Adenoma and Warthin Tumor Based on the CT Radiomics Nomogram: A Multicenter Study.
Academic radiology
RATIONALE AND OBJECTIVES:To develop, validate, and test a comprehensive radiomics prediction model to distinguish parotid polymorphic adenomas (PAs) and warthin tumors (WTs) using clinical data and enhanced computed tomography (CT) from a multicenter cohort. MATERIALS AND METHODS:A total of 267 patients with PAs (n =172) or WTs (n = 95) from two hospitals were randomly divided into training (n =188) and validation (n =79) datasets. Radiomics features were extracted from the enhanced CT (arterial phase) followed by dimensionality reduction. Clinical and CT features were combined to establish a prediction model. A radiomics nomogram was constructed by combining RadScore and clinical factors. Moreover, an independent dataset of 31 patients from a third hospital was employed to test the model. Thus, the performance of the nomogram, radiomics signature, and clinical models was evaluated on the training, validation, and the independent testing datasets. Receiver operating characteristic (ROC) curves were used to compare the performance, and decision curve analysis (DCA) was used to evaluate the clinical effectiveness of the model. RESULTS:A total of 15 radiomics features were selected from CT data as the imaging markers to generate RadScores, and demographics or clinical data like age, sex, and smoking factors combined with RadScores were used to distinguish PAs and WTs based on multivariate logistic regression analyses. The results showed that radiomics nomograms combining clinical factors and RadScores provided satisfactory predictive values for distinguishing PAs from WTs, with areas under ROC curves (AUC) of 0.979, 0.922, and 0.903 for the training, validation, and the independent testing datasets, respectively. Decision curve analysis revealed that the radiomics nomogram outperformed the clinical factor models in terms of accuracy and effectiveness. CONCLUSION:CT-based radiomics nomograms combining RadScores and clinical factors can be used to identify PAs and WTs, which may help tumor management by clinicians.
10.1016/j.acra.2022.06.017
Cytopathology and diagnostics of Warthin's tumour.
Sučić Mirna,Ljubić Nives,Perković Leila,Ivanović Dunja,Pažanin Leo,Sučić Radovanović Tena,Župnić-Krmek Dubravka,Knežević Fabijan
Cytopathology : official journal of the British Society for Clinical Cytology
Warthin's tumour (WT) is a benign epithelial salivary tumour, one type of salivary adenoma. Histologically, WT is structured of two components, epithelial tissue that often lines cystic formations and lymphoid tissue in the tumour stroma. FNA is a reliable diagnostic approach in the diagnosis of salivary gland lesions allowing a highly accurate categorization of benign tumour-like lesions, benign tumours and malignant tumours. In the proposed Milan reporting system of salivary gland lesions, WT is categorized in the IVA group of benign neoplasms. Accurate cytological diagnosis is straightforward when three characteristic components are present: oncocytes, either isolated or associated in clusters, lymphocytes and lymphoid cells and often an inflammatory/necrotic-like substance. Also, specific features of scintigraphy and radiological imaging contribute to the diagnosis of WT. WT is categorized according to Seifert G. et al in 4 types, depending on the proportions of the epithelial component and lymphoid stroma. Differential cytopathological and pathohistological diagnosis include other salivary gland lesions with lymphoid, oncocytic epithelial and cystic components. In some cases, such as the metaplastic WT variant, there are additional cytopathological and histological diagnostic difficulties. Moreover, bilateral, multicentric or multiple and infrequently seen extra-salivary localizations of WT are associated with further cytopathological diagnostic difficulties. Also, a rare possibility of malignant transformation of the epithelial or lymphoid component of WT as well as possible association with other primary tumours remains a challenge in accurate cytopathological and histological diagnosis of WT.
10.1111/cyt.12830
Newly described salivary gland tumors.
Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc
This review concentrates on three salivary gland tumors that have been accepted in the recent literature as new neoplastic entities: mammary analog secretory carcinoma (MASC), sclerosing polycystic adenoma (SPA) and cribriform adenocarcinoma of tongue and other minor salivary glands (CAMSGs). MASC is a distinctive low-grade malignant salivary cancer that harbors a characteristic chromosomal translocation, t(12;15) (p13;q25) resulting in an ETV6-NTRK3 fusion. SPA is a rare lesion often mistaken histologically for low-grade salivary carcinoma. Previously thought to be a reactive fibroinflammatory process, but recent evidence of clonality, recurrences in up 30%, and dysplastic foci suggest it may be truly neoplastic. CAMSG is a distinct tumor entity that differs from polymorphous low-grade adenocarcinoma (PLGA) by location (ie, most often arising on the tongue), by prominent nuclear clearing, alterations of the PRKD gene family and clinical behavior with frequent metastases at the time of presentation of the primary tumor. Early metastatic disease seen in most cases of CAMSG associated with indolent behavior makes it a unique neoplasm among all low-grade salivary gland tumors. Salivary glands may give rise to a wide spectrum of different tumors. They are often diagnostically challenging as morphological features often overlap between different entities. Although conventional morphology in combination with immunohistochemical findings still provide the most important clues for diagnosis, recent advances in molecular pathology offer new diagnostic tools in investigating the differential diagnosis, as well as providing potentially valuable prognostic indicators. In the last two decades, several new salivary gland tumor entities have been described, namely MASC, SPA and CAMSGs.
10.1038/modpathol.2016.167
Surgical anatomy of the lingual lymph nodes: systematic literature analysis and proposition for topographic classification.
Surgical and radiologic anatomy : SRA
PURPOSE:Metastatic involvement of the lingual lymph nodes (LLNs) in oral cavity squamous cell cancer (SCC) has recently been proven to significantly reduce locoregional control and survival. Despite recent refinements in the detection of these lesions, the understanding of the LLN topographic anatomy among clinicians is limited. A proposition of a topographic division on LLN based on a comprehensive literature search and synthesis may be helpful in this condition. METHODS:A literature search and election based on contemporary PRISMA guidelines was performed for sources on LLN anatomy with special attention on their subdivision. RESULTS:Four topographic LLN subgroups were defined: median-between genioglossal and geniohyoid muscles; intermediate parahyoid-medial to the hyoglossal muscle, at the greater cornu of the hyoid bone; lateral sublingual (paraglandular) LLNs-at the sublingual salivary gland; lateral submandibular (paraglandular) LLNs -lateral to the hyoglossal muscle, at the deep surface of the submandibular salivary gland. CONCLUSION:The development and implementation of a unified anatomical topographic classification of LLN subgroups may be among the important conditions for improving the detection and treatment of LLN lesions.
10.1007/s00276-023-03078-y