title: An invasive adenocarcinoma of the accessory parotid gland: a rare example developing from a low-grade cribriform cystadenocarcinoma?
abstract: Low-grade cribriform cystadenocarcinoma (LGCCA) is a rare tumor of the salivary gland that exhibits clinically indolent behavior. In this paper, we present a case of invasive adenocarcinoma of the accessory parotid gland in a young male that exhibited histology suggestive of an association of LGCCA. A 27-year-old man presented with a subcutaneous tumor in his left cheek. The tumor was separated from the parotid gland and located on the masseter muscle. The tumor was resected, and the postoperative histological diagnosis was adenocarcinoma, not otherwise specified (ANOS). The tumor exhibited papillary-cystic and cribriform proliferation of the duct epithelium and obvious stromal infiltration. Some tumor nests were rimmed by myoepithelium positive for smooth muscle actin, p63, and cytokeratin 14, indicating the presence of intraductal components of the tumor. Tumor cells exhibited mild nuclear atypia, and some of them presented an apocrine-like appearance and had cytoplasmic PAS-positive/diastase-resistant granules and hemosiderin. Other cells had foamy cytoplasm with microvacuoles. Immunohistochemistry revealed that the almost all of the tumor cells were strongly positive for S-100. These histological findings suggest the possibility that ANOS might arise secondarily from LGCCA. This is an interesting case regarding the association between ANOS and LGCCA in oncogenesis.
  The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/1226764594634693.
authors.affiliation: Department of Pathology, Kansai Rosai Hospital, 3-1-69 Inabaso, Amagasaki, Hyogo 660-8511, Japan. nakatsuka@kanrou.net
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Nakatsuka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Harada
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiyama
authors.forename: Koji
authors.initials: K
authors.lastname: Takeda
authors.forename: Koji
authors.initials: K
authors.lastname: Kitamura
authors.forename: Hayato
authors.initials: H
authors.lastname: Kimura
authors.forename: Teruaki
authors.initials: T
authors.lastname: Nagano
authors.forename: Mahito
authors.initials: M
authors.lastname: Ito
authors.forename: Yuji
authors.initials: Y
authors.lastname: Asada
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000473:pathology*; D000328:Adult; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D010307:Parotid Neoplasms / Q000378:metabolism / Q000473:pathology*