Abstract
Low-grade papillary adenocarcinoma (LGPA) represents a relatively rare histological variant of polymorphous low-grade adenocarcinoma (PLGA). There has been a debate as to whether LGPA is associated with greater aggressive potential compared to PLGA; this is further obfuscated by the fact that diagnostic criteria for LGPA have not been well-defined. We believe that this is the first report of a patient with LGPA who developed metastases to the femur and scalp. We review the published evidence for classifying LGPA as distinct from PLGA. The weight of published data does support the idea that LGPA is oncologically distinct from LGPA. However, as uniform diagnostic criteria are lacking, we suggest a cut-off value of 10% or greater papillary formation as being necessary to separate LGPA from PLGA.
References
Seifert G, Sobin L, Thackray A, editors. Histological typing of salivary gland tumours. 2nd ed. New York: Springer; 1991.
Batsakis J, Pinkston G, Luna M, et al. Adenocarcinomas of the oral cavity: a clinicopathologic study of terminal duct carcinomas. J Laryngol Otol. 1983;97(9):825–35. doi:10.1017/S0022215100095062.
Freedman P, Lumerman H. Lobular carcinoma of intraoral minor salivary gland origin. Report of 12 cases. Oral Surg Oral Med Oral Pathol. 1983;56(2):157–66. doi:10.1016/0030-4220(83)90282-7.
Mills S, Garland T, Allen M. Low-grade papillary adenocarcinoma of palatal salivary gland origin. Am J Surg Pathol. 1984;8(5):367–74.
Allen M, Fitz-Hugh G, Marsh WL. Low-grade papillary adenocarcinoma of the palate. Cancer. 1974;33:153–8. doi :10.1002/1097-0142(197401)33:1<153::AID-CNCR2820330123>3.0.CO;2-A.
Slootweg P, Muller H. Low-grade adenocarcinoma of the oral cavity. A comparison between the terminal duct and the papillary type. J Craniomaxillofac Surg. 1987;15(6):359–64. doi:10.1016/S1010-5182(87)80083-5.
Evans H, Luna M. Polymorphous low-grade adenocarcinoma: a study of 40 cases with long-term follow-up and an evaluation of the importance of papillary areas. Am J Surg Pathol. 2000;24(10):1319–28. doi:10.1097/00000478-200010000-00001.
Colmenero C, Patron M, Burgueno M, et al. Polymorphous low-grade adenocarcinoma of the oral cavity: a report of 14 cases. J Oral Maxillofac Surg. 1992;50(6):595–600. doi:10.1016/0278-2391(92)90440-B.
Buchner A, Merrell P, Carpenter W. Relative frequency of intra-oral minor salivary gland tumors: a study of 380 cases from northern california and comparison to reports from other parts of the world. J Oral Pathol Med. 2007;36(4):207–14.
Waldron C, el-Mofty S, Gnepp D. Tumors of the intraoral minor salivary glands: a demographic and histologic study of 426 cases. Oral Surg Oral Med Oral Pathol. 1998;66(3):323–33. doi:10.1016/0030-4220(88)90240-X.
Yih W, Kratochvil F, Stewart J. Intraoral minor salivary gland neoplasms: review of 213 cases. J Oral Maxillofac Surg. 2005;63(6):805–10. doi:10.1016/j.joms.2005.02.021.
Castle J, Thompson L, Frommelt R, et al. Polymorphous low grade adenocarcinoma: a clinicopathologic study of 164 cases. Cancer. 1999;86(2):207–19. doi :10.1002/(SICI)1097-0142(19990715)86:2<207::AID-CNCR4>3.0.CO;2-Q.
Vincent S, Hammond H, Finkelstein M. Clinical and therapeutic features of polymorphous low-grade adenocarcinoma. Oral Surg Oral Med Oral Pathol. 1994;77(1):41–7.
Cho K, Jung J, Cho D, et al. Primary polymorphous low-grade adenocarcinoma of lung treated by sleeve bronchial resection: a case report. J Korean Med Sci. 2007;22(2):373–6.
Nagao T, Gaffey T, Kay P, et al. Polymorphous low-grade adenocarcinoma of the major salivary glands: report of three cases in an unusual location. Histopathology. 2004;44(2):164–71. doi:10.1111/j.1365-2559.2004.01799.x.
Cinamon U, Maly B, Elidan J. Polymorphous low-grade adenocarcinoma of the submandibular gland. Otolaryngol Head Neck Surg. 2000;123(3):337–8. doi:10.1067/mhn.2000.108200.
Sato T, Indo H, Takasaki T, et al. A rare case of intraosseous polymorphous low-grade adenocarcinoma (PLGA) of the maxilla. Dentomaxillofac Radiol. 2001;30(3):184–7. doi:10.1038/sj.dmfr.4600596.
Pelkey T, Mills S. Histologic transformation of polymorphous low-grade adenocarcinoma of salivary gland. Am J Clin Pathol. 1999;111(6):785–91.
Simpson R, Pereira M, Ribeiro A, et al. Polymorphous low-grade adenocarcinoma of the salivary glands with transformation to high-grade carcinoma. Histopathology. 2002;41(3):250–9. doi:10.1046/j.1365-2559.2002.01439.x.
Perez-Ordonez B, Linkov I, Huvos A. Polymorphous low-grade adenocarcinoma of minor salivary glands: a study of 17 cases with emphasis on cell differentiation. Histopathology. 1998;32(6):521–9. doi:10.1046/j.1365-2559.1998.t01-2-00410.x.
Mitchell D, Eveson J, Ord R. Polymorphous low-grade adenocarcinoma of minor salivary glands—a report of three cases. Br J Oral Maxillofac Surg. 1989;27(6):494–500. doi:10.1016/S0266-4356(89)80008-7.
Evans H, Batsakis J. Polymorphous low-grade adenocarcinoma of minor salivary glands. A study of 14 cases of a distinctive neoplasm. Cancer. 1984;53(4):935–42. doi :10.1002/1097-0142(19840215)53:4<935::AID-CNCR2820530420>3.0.CO;2-V.
Tsang Y, Tung Y, Chan J. Polymorphous low grade adenocarcinoma of the palate in a child. J Laryngol Otol. 1991;105(4):309–11.
Sung M, Kim K, Kim J, et al. Clinicopathologic predictors and impact of distant metastasis from adenoid cystic carcinoma of the head and neck. Arch Otolaryngol Head Neck Surg. 2003;129(11):1193–7. doi:10.1001/archotol.129.11.1193.
Pogodzinski M, Sabri A, Lewis J, et al. Retrospective study and review of polymorphous low-grade adenocarcinoma. Laryngoscope. 2006;116(12):2145–9. doi:10.1097/01.mlg.0000243200.35033.2b.
Aberle A, Abrams A, Bowe R, et al. Lobular (polymorphous low-grade) carcinoma of minor salivary glands. A clinicopathologic study of 20 cases. Oral Surg Oral Med Oral Pathol. 1985;60(4):387–95. doi:10.1016/0030-4220(85)90261-0.
Slootweg P. Low-grade adenocarcinoma of the oral cavity: polymorphous or papillary? J Oral Pathol Med. 1993;22(7):327–30. doi:10.1111/j.1600-0714.1993.tb01083.x.
Lee V, McCaughan B, Scolyer R. Polymorphous low-grade adenocarcinoma in the lung: a case report. Int J Surg Pathol. 2004;12(3):287–92. doi:10.1177/106689690401200313.
Tanaka F, Wada H, Inui K, et al. Pulmonary metastasis of polymorphous low-grade adenocarcinoma of the minor salivary gland. Thorac Cardiovasc Surg. 1995;43(3):178–80.
Thomas K, Cumberworth V, McEwan J. Orbital and skin metastases in a polymorphous low grade adenocarcinoma of the salivary gland. J Laryngol Otol. 1995;109(12):1222–5. doi:10.1017/S0022215100132517.
Hannen E, Bulten J, Festen J, et al. Polymorphous low grade adenocarcinoma with distant metastases and deletions on chromosome 6q23-qter and 11q23-qter: a case report. J Clin Pathol. 2000;53(12):942–5. doi:10.1136/jcp.53.12.942.
Crean S, Bryant C, Bennett J, et al. Four cases of polymorphous low-grade adenocarcinoma. Int J Oral Maxillofac Surg. 1996;25(1):40–4. doi:10.1016/S0901-5027(96)80010-5.
Le Q, Birdwell S, Terris D, et al. Postoperative irradiation of minor salivary gland malignancies of the head and neck. Radiother Oncol. 1999;52(2):165–71. doi:10.1016/S0167-8140(99)00084-5.
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Hunter, J.B., Smith, R.V. & Brandwein-Gensler, M. Low-Grade Papillary Adenocarcinoma of the Palate: The Significance of Distinguishing it from Polymorphous Low-Grade Adenocarcinoma. Head and Neck Pathol 2, 316–323 (2008). https://doi.org/10.1007/s12105-008-0082-1
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DOI: https://doi.org/10.1007/s12105-008-0082-1