Abstract:
:High-grade transformation (HGT)/dedifferentiation is an unusual phenomenon in salivary gland carcinomas. Here we report a case of adenoid cystic carcinoma (ACC) with HGT/dedifferentiation to myoepithelial carcinoma, occurring in the epipharynx of a 42-year-old woman. The surgically resected tumor was a pedunculated mass, 31 × 25 mm in size, which had two histologically distinct carcinomatous areas, including a high-grade sarcomatoid area composed of pleomorphic spindle cells and an area consisting of low-grade typical ACC. These two components gradually changed from the low-grade to the high-grade component. MIB-1 index in the low-grade and high-grade component was 15% and 50%, respectively. An immunohistochemical profile of the high-grade component showed immunoreactivity for α-SMA, p63, calponin and focal S100, as well as for several cytokeratin markers, which were compatible with the features of myoepithelial carcinoma. In contrast, the immunohistochemical profile of the low-grade component coincided with that of typical ACC. This HGT/dedifferentiation to myoepithelial carcinoma is extremely rare. The pathogenesis of HGT/dedifferentiation in salivary gland carcinomas still remains largely unknown, regardless of the presence or absence of myoepithelial differentiation. Further studies are required due to the more aggressive biological behavior and poorer prognosis associated with ACC with HGT/dedifferentiation, compared with conventional ACC.
journal_name
Pathol Intjournal_title
Pathology internationalauthors
Tando S,Nagao T,Kayano K,Fushiki S,Itoh Kdoi
10.1111/pin.12624subject
Has Abstractpub_date
2018-02-01 00:00:00pages
133-138issue
2eissn
1320-5463issn
1440-1827journal_volume
68pub_type
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