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Polymorphous adenocarcinoma of the salivary glands: reappraisal and update

Journal article
Authors V. Vander Poorten
A. Triantafyllou
A. Skalova
Göran Stenman
J. A. Bishop
E. Hauben
J. L. Hunt
H. Hellquist
S. Feys
R. De Bree
A. Makitie
M. Quer
P. Strojan
O. Guntinas-Lichius
A. Rinaldo
A. Ferlito
Published in European Archives of Oto-Rhino-Laryngology
Volume 275
Issue 7
Pages 1681-1695
ISSN 0937-4477
Publication year 2018
Published at Institute of Biomedicine, Department of Pathology
Sahlgrenska Cancer Center
Pages 1681-1695
Language en
Links https://doi.org/10.1007/s00405-018-...
Keywords Polymorphous adenocarcinoma, Pathology, Salivary glands, Therapy, Prognosis, Polymorphous low-, low-grade adenocarcinoma, adenoid cystic carcinoma, needle-aspiration-cytology, lymph-node metastasis, term-follow-up, cribriform adenocarcinoma, neck-cancer, malignant-tumors, oral-cavity, case series, Otorhinolaryngology
Subject categories Pathology, Otorhinolaryngology

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.

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