title: Mucinous adenocarcinoma of minor salivary glands: a high-grade malignancy prone to lymph node metastasis.
abstract: Salivary gland mucinous adenocarcinoma (MAC) is a rarely encountered and poorly understood tumor. We describe two additional cases presenting as a lip lesion of older women. The prognosis was dismal with one death and one patient with recurrent/metastatic disease. Combining these with 19 cases in the literature unveiled that intraoral MAC occurred primarily in the palate (43%) of elderly individuals (average 65 years) with slight male preponderance (59%). Tumor evolved slowly (>2 years) and most (60%) were diagnosed at an advanced stage. Local recurrences were common (33%) and cervical lymph node and distant metastases were frequent (63% and 29%, respectively). About half the patients (47%) died of tumor within 6 years. Both histologically and immunohistochemically, MAC lacked acinar, myoepithelial, and neuroendocrine phenotypes. Cytokeratins 7 and 20 and estrogen and progesterone receptors, in some combination, may assist to distinguish primary versus metastatic mucinous carcinoma. Minor salivary gland MAC belongs to a high-grade category with a significant risk of local recurrence, lymph node metastasis, and fatal outcome.
authors.affiliation: Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurumi, Tsurumi-ku, Yokohama, 230-8501, Japan. ide-f@tsurumi-u.ac.jp
authors.forename: Fumio
authors.initials: F
authors.lastname: Ide
authors.forename: Kenji
authors.initials: K
authors.lastname: Mishima
authors.forename: Akio
authors.initials: A
authors.lastname: Tanaka
authors.forename: Ichiro
authors.initials: I
authors.lastname: Saito
authors.forename: Kaoru
authors.initials: K
authors.lastname: Kusama
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D053554:Keratin-20 / Q000378:metabolism; D053552:Keratin-7 / Q000378:metabolism; D008048:Lip Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology; D008207:Lymphatic Metastasis; D011379:Prognosis; D011960:Receptors, Estrogen / Q000378:metabolism; D012008:Recurrence; D012468:Salivary Gland Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology
chemical_list: D053554:Keratin-20; D053552:Keratin-7; D011960:Receptors, Estrogen