title: Salivary adenocarcinoma, not otherwise specified: a collection of orphans.
abstract: BACKGROUND
  Salivary adenocarcinoma, not otherwise specified, refers to gland-forming malignancies that do not satisfy the diagnostic requirements of other "named" malignancies.
  
  
  OBJECTIVE
  To review the features of 11 patients with salivary adenocarcinoma, not otherwise specified. To also compare the diagnostic frequencies of 2 databases, one from the Mount Sinai Medical Center (New York, NY), the other from the Shanghai Ninth People's Hospital (Shanghai, People's Republic of China).
  
  
  METHODS
  Pathology files were searched to establish a database of salivary tumors. All available hematoxylin-eosin- stained slides from the resection specimens diagnosed as either adenocarcinoma, not otherwise specified, or with vague or unusual diagnoses (eg, probable carcinoma-ex-pleomorphic adenoma) were pulled from our files and reexamined. Dates of death were confirmed with the Social Security Death Index.
  
  
  RESULTS
  We identified 11 patients with salivary adenocarcinoma, not otherwise specified, ranging in age from 49 to 80 years (median, 67 years), with a male preponderance. The parotid gland was the most common site of tumor origin. Ten of these tumors were high grade, and 1 was intermediate grade. Two patients were diagnosed at stage II, while the remaining patients were diagnosed at stage III or IV. Histologically, all tumors were invasive, with variable glandular differentiation and diverse architectural patterns. The diverse cytologic tumor cell types included cuboidal, columnar, epithelioid, polygonal, oncocytoid, clear, melanoma-like, mucinous, sebaceous, and plasmacytoid. Four patients died after 4 to 27 months (mean, 15 months), 1 patient is alive with disease at 12 months, 1 patient is disease-free at 14 years, and 3 patients remain disease-free after short follow-ups (10, 12, and 12 months). One patient had surgery just recently, and the remaining patient had no follow-up.
  
  
  CONCLUSIONS
  Salivary adenocarcinoma, not otherwise specified, is an aggressive, high-grade malignancy, with a predisposition for the parotid gland. It is characterized by cytologic and architectural diversity and an invasive growth pattern.
authors.affiliation: Department of Oral Pathology, School of Stomatology and Affiliated Shanghai Ninth People's Hospital, Shanghai Second Medical University, Shanghai, People's Republic of China.
authors.forename: Jiang
authors.initials: J
authors.lastname: Li
authors.forename: Beverly Yiyao
authors.initials: BY
authors.lastname: Wang
authors.forename: Magalie
authors.initials: M
authors.lastname: Nelson
authors.forename: Lei
authors.initials: L
authors.lastname: Li
authors.forename: Yuhua
authors.initials: Y
authors.lastname: Hu
authors.forename: Mark L
authors.initials: ML
authors.lastname: Urken
authors.forename: Margaret
authors.initials: M
authors.lastname: Brandwein-Gensler
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000473:pathology*; D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000145:classification; D012468:Salivary Gland Neoplasms / Q000145:classification / Q000473:pathology*