title: Salivary gland lesions: recent advances and evolving concepts.
abstract: Recently, there have been significant developments in our understanding of salivary gland pathology, and new entities, such as mammary analogue secretory carcinoma, have been described. Attempts are being made to identify effective therapeutic agents for salivary duct carcinomas by using molecular diagnostic techniques. Concepts such as high-grade transformation have been described, which not only influence macroscopic and microscopic evaluation of a specimen but, given the high incidence of metastases and morbidity, also carry significant treatment implications. Specific chromosomal translocations, which can be detected by fluorescent in situ hybridization, can augment diagnostic accuracy and carry prognostic implications. The landscape of benign salivary gland lesions is changing with better understanding of chronic sclerosing sialadenitis related to IgG4. This multiorgan inflammatory condition may primarily present as a salivary gland lesion and clinically and radiologically mimic a salivary gland malignancy. Histology and immunohistochemistry play a critical role in its accurate diagnosis. The purpose of this article is to review these changes, with an emphasis on their effect on patient management. Given their diagnostic, prognostic, and therapeutic implications, it is critical that surgeons, oncologists, pathologists, and those involved in caring for patients with salivary gland tumors are aware of these changes while considering management options.
authors.affiliation: Department of Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050, Australia; Central Clinical School, University of Sydney, NSW 2006, Australia. Electronic address: Rutagupta@gmail.com.
authors.forename: Ruta
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Sydney Head and Neck Cancer Institute, The Chris O'Brien Lifehouse, Missenden Road, Camperdown NSW 2050, Australia; Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050, Australia.
authors.forename: Deepak
authors.initials: D
authors.lastname: Balasubramanian
authors.affiliation: Central Clinical School, University of Sydney, NSW 2006, Australia; Sydney Head and Neck Cancer Institute, The Chris O'Brien Lifehouse, Missenden Road, Camperdown NSW 2050, Australia; Department of Head and Neck Surgery, Royal Prince Alfred Hospital, Missenden Road, Camperdown NSW 2050, Australia.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D019468:Disease Management; D006801:Humans; D007150:Immunohistochemistry; D011379:Prognosis; D012468:Salivary Gland Neoplasms / Q000473:pathology* / Q000628:therapy*
chemical_list: D014408:Biomarkers, Tumor