Metastases to the parotid glands: An institutional experience.
Milan system
fine needle aspiration cytology
metastatic lesions
salivary glands
salivary malignancies
Journal
Cytopathology : official journal of the British Society for Clinical Cytology
ISSN: 1365-2303
Titre abrégé: Cytopathology
Pays: England
ID NLM: 9010345
Informations de publication
Date de publication:
16 May 2024
16 May 2024
Historique:
revised:
20
04
2024
received:
22
02
2024
accepted:
26
04
2024
medline:
16
5
2024
pubmed:
16
5
2024
entrez:
16
5
2024
Statut:
aheadofprint
Résumé
Metastatic lesions to the salivary gland are rare and mostly affect the parotids. Metastases represent 8% of all malignant lesions of the parotid gland. Around 80% originate from squamous cell carcinomas (SCC) of the head and neck region. Fine needle aspiration (FNA) plays a crucial role in distinguishing primary salivary gland lesions from metastases. Herein we describe our series of metastases to the parotid glands. We analysed 630 parotid gland FNAs over a decade including conventional and liquid-based cytology specimens. Ancillary techniques such as immunocytochemistry (ICC) were conducted on cell blocks. Eighty (12.4%) cases were malignant lesions, of which 53 (63.75%) were metastases including 24% melanoma, 22.6% SCC, 19% renal carcinomas, 7.5% breast carcinomas, 11.3% lung, 9% intestinal and 1.8% testicular, malignant solitary fibrous tumour and Merkel cell carcinoma. The 53 cases, classified according to the Milan system for salivary cytopathology, belonged to 5 Suspicious for malignancy (SFM) and 48 malignant (M) categories. Forty had a known history of primary malignancy (75.4%), while 13 were suspicious to be a metastatic localisation (24.5%), distributed as 5SFM (2SCC and 3Melanoma) and 8 M. A combination of clinical history, cytomorphology and ICC identified 100% of them. Fine needle aspiration plays a central role in the diagnostic workup of patients with metastatic lesions to their parotid glands, thereby defining the correct management. Diagnostic accuracy may be enhanced by applying ICC. Although melanoma and SCC are the most common histological types, several other malignancies may also metastasize to the parotid glands and should be kept into consideration.
Sections du résumé
BACKGROUND
BACKGROUND
Metastatic lesions to the salivary gland are rare and mostly affect the parotids. Metastases represent 8% of all malignant lesions of the parotid gland. Around 80% originate from squamous cell carcinomas (SCC) of the head and neck region. Fine needle aspiration (FNA) plays a crucial role in distinguishing primary salivary gland lesions from metastases. Herein we describe our series of metastases to the parotid glands.
MATERIALS AND METHODS
METHODS
We analysed 630 parotid gland FNAs over a decade including conventional and liquid-based cytology specimens. Ancillary techniques such as immunocytochemistry (ICC) were conducted on cell blocks.
RESULTS
RESULTS
Eighty (12.4%) cases were malignant lesions, of which 53 (63.75%) were metastases including 24% melanoma, 22.6% SCC, 19% renal carcinomas, 7.5% breast carcinomas, 11.3% lung, 9% intestinal and 1.8% testicular, malignant solitary fibrous tumour and Merkel cell carcinoma. The 53 cases, classified according to the Milan system for salivary cytopathology, belonged to 5 Suspicious for malignancy (SFM) and 48 malignant (M) categories. Forty had a known history of primary malignancy (75.4%), while 13 were suspicious to be a metastatic localisation (24.5%), distributed as 5SFM (2SCC and 3Melanoma) and 8 M. A combination of clinical history, cytomorphology and ICC identified 100% of them.
CONCLUSIONS
CONCLUSIONS
Fine needle aspiration plays a central role in the diagnostic workup of patients with metastatic lesions to their parotid glands, thereby defining the correct management. Diagnostic accuracy may be enhanced by applying ICC. Although melanoma and SCC are the most common histological types, several other malignancies may also metastasize to the parotid glands and should be kept into consideration.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Author(s). Cytopathology published by John Wiley & Sons Ltd.
Références
Lussier C, Klijanienko J, Vielh P. Fine‐needle aspiration of metastatic nonlymphomatous tumors to the major salivary glands: a clinicopathologic study of 40 cases cytologically diagnosed and histologically correlated. Cancer. 2000;90:350‐356.
Zhang C, Cohen JM, Cangiarella JF, Waisman J, McKenna BJ. Chhieng DC fine‐needle aspiration of secondary neoplasms involving the salivary glands. A report of 36 cases. Am J Clin Pathol. 2000;113:21‐28.
Laforga JB, Gasent JM. Mammary invasive duct carcinoma metastatic to parotid gland: report of a case diagnosed by fine‐needle aspiration. Diagn Cytopathol. 2009;37:154‐158.
Salama AR, Jham BC, Papadimitriou JC, Scheper MA. Metastatic neuroendocrine carcinomas to the head and neck: report of 4 cases and review of the literature. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:242‐247.
Udager AM, Rungta SA. Metastatic renal cell carcinoma, clear cell type, of the parotid gland: a case report, review of literature, and proposed algorithmic approach to salivary gland clear cell neoplasms in fine‐needle aspiration biopsies. Diagn Cytopathol. 2014;42:974‐983.
Andreadis D, Nomikos A, Barbatis C. Metastatic renal clear cell carcinoma in the parotid gland: a study of immunohistochemical profile and cell adhesion molecules (CAMs) expression in 2 cases. Pathol Oncol Res. 2007;13:161‐165.
Chhieng DC, Cangiarella JF, Waisman J, Cohen JM. Fine‐needle aspiration cytology of desmoplastic malignant melanoma metastatic to the parotid gland: case report and review of the literature. Diagn Cytopathol. 2000;22:97‐100.
Elshenawy Y, Youngberg G, Al‐Abbadi MA. Unusual clinical presentation of cutaneous malignant melanoma metastatic to the parotid gland; initially discovered by fine needle aspiration: case report and review of literature. Diagn Cytopathol. 2011;39:373‐376.
Seifert G, Hennings K, Caselitz J. Metastatic tumors to the parotid and submandibular glands‐analysis and differential diagnosis of 108 cases. Pathol Res Pract. 1986;181(6):684‐692.
Contucci AM, Corina L, Sergi B, Fadda G, Paludetti G. Correlation between fine needle aspiration biopsy and histologic findings in parotid masses. Personal experience. Acta Otorhinolaryngol Ital. 2003;23:314‐318.
Pusztaszeri MP, Faquin WC. Update in salivary gland cytopathology: recent molecular advances and diagnostic applications. Semin Diagn Pathol. 2015;32:264‐274.
Wang H, Hoda R, Faquin WC, et al. FNA biopsy of secondary nonlymphomatous malignancies in salivary glands: a multi‐institutional study of 184 cases. Cnacer Cytopathol. 2017;25:91‐103.
Horáková M, Porre S, Tommola S, Baněčková M, Skálová A, Kholová I. FNA diagnostics of secondary malignancies in the salivary gland: Bi‐institutional experience of 36 cases. Diagn Cytopathol 2021 Feb;49(2):241–251
Frable MA, Frable WJ. Fine‐needle aspiration biopsy of salivary glands. Laryngoscope. 1991;101:245‐249.
Song SJ, Shafique K, Wong LQ, LiVolsi VA, Montone KT, Baloch Z. The utility of the Milan system as a risk stratification tool for salivary gland fine needle aspiration cytology specimens. Cytopathology. 2019;30(1):91‐98.
Rohilla M, Singh P, Rajwanshi A, Gupta N, Srinivasan R, Dey P, Vashishta RK. Three‐year cytohistological correlation of salivary gland FNA cytology at a tertiary center with the application of the Milan system for risk stratification. Cancer Cytopathol 2017 Oct;125(10):767–775.
Faquin W, Rossi ED, eds. The Milan System for Reporting Salivary Gland Cytopathology. 1st ed. Springer; 2018.
Rossi ED, Faquin WC. The Milan system for reporting salivary gland cytopathology (MSRSGC): an international effort toward improved patient care‐when the roots might be inspired by Leonardo da Vinci. Cancer Cytopathol. 2018;126(9):756‐766.
Pusztaszeri M, Rossi ED, Baloch ZW, Faquin WC. Salivary gland fine needle aspiration and introduction of the Milan reporting system. Adv Anat Pathol. 2019;26(2):84‐92.
Barbarite E, Puram SV, Derakhshan A, Rossi ED, Faquin WC, Varvares MA. A call for universal acceptance of the Milan system for reporting salivary gland cytopathology. Laryngoscope. 2020;130(1):80‐85.
Rossi ED, Martini M, Straccia P, et al. Is thyroid gland only a "land" for primary malignancies? Role of morphology and immunocytochemistry. Diagn Cytopathol. 2015;43(5):374‐380.
Fadda G, Rossi ED, Mule’ A, Miraglia A, Vecchio FM, Capelli A. Diagnostic efficacy of immunocytochemistry on fine needle aspiration biopsies processed by thin layer cytology. Acta Cytol. 2006;50:129‐135.
Fadda G, Rossi ED. Liquid based cytology in fine‐needle aspiration biopsies of the thyroid gland. Acta Cytol. 2011;55:389‐400.
Moriniere S, Perie S, Lacau St Guily J. Primary and non‐primary parotid malignancies: comparison of treatment modalities and outcomes. Eur Arch Otorrinolaringol. 2007;264:1231‐1237.
Zhu S, Schuerch C, Hunt J. Review and updates of immunohistochemistry in selected salivary gland and head and neck tumors. Arch Pathol Lab Med. 2015;139:55‐66.
Franzen A, Buchali A, Lieder A. The rising incidence of parotid metastases: our experience from four decades of parotid gland surgery. Acta Otorhinolaryngol Ital. 2017;37(4):264‐269.
Jo VY, Hornick JL, Qian X. Utility of brachyury in distinction of chordoma from cytomorphologic mimics in fine‐needle aspiration and core needle biopsy. Diagn Cytopathol. 2014;42:647‐652.
Pastore A, Ciorba A, Soliani M, et al. Secondary malignant tumors of the parotid gland: not a secondary problem. J BUON. 2017;22(2):513‐518.
Malata CM, Camilleri IG, McLean NR, Piggott TA, Soames JV. Metastatic tumours of the parotid gland. Br J Oral Maxillofac Surg. 1998;36(3):190‐195.
Sweeny L, Zimmerman T, Carroll WR, Schmalbach CE, Day KE, Rosenthal EL. Head and neck cutaneous squamous cell carcinoma requiring parotidectomy: prognostic indicators and treatment selection. Otolaryngology. 2014;150:610‐617.
Willis BC, Johnson G, Wang J, Cohen C. SOX10: a useful marker for identifying metastatic melanoma in sentinel lymph nodes. Appl Immunohistochem Mol Morphol. 2015;23(2):109‐112.
Ohtomo R, Mori T, Shibata S, et al. SOX10 is a novel marker of acinus and intercalated duct differentiation in salivary gland tumors: a clue to the histogenesis for tumor diagnosis. Mod Pathol. 2013;26(8):1041‐1045.
Hsieh MS, Lee YH, Chang YL. SOX10‐positive salivary gland tumors: a growing list, including mammary analogue secretory carcinoma of the salivary gland, sialoblastoma, low‐grade salivary duct carcinoma, basal cell adenoma/adenocarcinoma, and a subgroup of mucoepidermoid carcinoma. Hum Pathol. 2016;56:134‐142.
Pusztaszeri M, Reis‐Filho JS, Schmitt FCL, Edelweiss M. Chapter 8: Ancillary studies for salivary gland cytology. In: Faquin W, ed. Rossi ED the Milan System for Reporting Salivary Gland Cytopathology. Springer; 2018:1139‐1155.
El‐Naggar AK, Grandis JR, Takata T, Slootweg PJ. Chapter 7: Tumours of salivary glands. WHO Classification of Head and Neck Tumours. 4th ed. IARC; 2017:159‐202.
Agarwal M, Agarwal L, Saxena R. Primary squamous cell carcinoma of submandibular salivary gland: a case report. J Clin Diagn Res. 2017;11(7):XD01‐XD02.