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Background: Polymorphous adenocarcinoma (PAC) represents the second most widespread neoplasm of the minor salivary glands. These tumors rarely develop a histological progression from low-grade to high-grade malignancy, named "high-grade transformation" (HGT). Only nine cases are described in literature.
Case Description: Here, we describe the case of a 76-year-old male patient with a PAC recurrence of the oral floor displaying HGT, and we explore the tumor cytomorphological features, genomic profiling, and the patient's clinical management. The tumor mass was characterized by poorly atypical cellular elements with vesicular nuclei and comedonecrosis foci. The growth pattern was predominantly solid, tubular, and cribriform. The lesion did not show microsatellite instability or targeted molecular alterations. The case was successfully treated with radical surgery followed by radiotherapy.
Conclusion: We report for the first time the recurrence of a PAC with HGT arising in the oral floor after 20 years from the primary lesion. These preliminary data and the literature analysis enhance the knowledge of this extremely rare disease.
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http://dx.doi.org/10.3389/fonc.2023.1245043 | DOI Listing |
J Oral Pathol Med
September 2025
Postgraduate Program in Dentistry and Health, School of Dentistry, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
Purpose: Polymorphous adenocarcinoma of the salivary gland is characterized by cellular uniformity associated with a variety of morphological growth patterns, a fact that makes its diagnosis challenging. Therefore, the identification of genetic alterations and signaling pathways emerges as a tool for elucidation of the pathogenesis of this tumor and accurate differential diagnosis. The aim of this study was to assess mutations in the PRKD1 gene and in protein components of the HH pathway (SHH, IHH, SMO, and GLI-1) in cases of polymorphous adenocarcinoma of the salivary gland.
View Article and Find Full Text PDFHead Neck
August 2025
Section of Otorhinolaryngology-Head and Neck Surgery, Department of Neuroscience, University of Padua, Padua, Italy.
Background: Endoscopic surgical approaches for nasopharyngeal malignancies, including recurrent nasopharyngeal carcinoma (rNPC) and nasopharyngeal salivary gland tumors (NSGT), have seen significant development over the last decades. Our groups have expanded the classification of nasopharyngeal endoscopic resections (NER) from type 1 to 3 to incorporate internal carotid artery (ICA)-including ablations. The aim of this work is to describe the surgical technique, indications, and preliminary oncological outcomes of NER extended to ICA, proposing it as type 4 NER.
View Article and Find Full Text PDFMed Pharm Rep
July 2025
Department of Dental Medicine, Faculty of Medicine and Pharmacy, University of Oradea, Oradea, Romania.
Background: Polymorphous adenocarcinoma (PAC) is a type of salivary gland tumor that is rare and diverse in morphology. It is typically found in the minor salivary glands, with the palate being the most common location. However, this tumor is often misunderstood, underdiagnosed, and controversial in nomenclature.
View Article and Find Full Text PDFCureus
July 2025
Oral and Maxillofacial Surgery, Leeds General Infirmary, Leeds, GBR.
Multiple salivary gland tumours can occur in both major and minor salivary glands. Its histology can be greatly varied and include pleomorphic adenoma, canalicular adenoma, mucoepidermoid carcinoma, or polymorphous adenocarcinoma, amongst other pathologies. A 76-year-old lady was referred on a two-week-wait pathway to our oral and maxillofacial surgery department complaining of a one-year history of painless lumps in her upper lip, which were gradually increasing in size.
View Article and Find Full Text PDFReports (MDPI)
May 2025
Department of Oral Medicine/Pathology 1, School of Dentistry, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
: Polymorphous adenocarcinoma of the oral cavity is predominantly located in the palate. It is characterized by a slow rate of growth and thus may be misdiagnosed as a benign tumor. Its histology is intricate with other salivary malignancies, thus necessitating specific immunohistochemical stains.
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