Top

Published in:

01-12-2020 | Case Reports

Adenoid Cystic Carcinoma with Transformation to High Grade Carcinomatous and Sarcomatoid Components: A Rare Case Report with Review of Literature

Authors: Anupurva Dutta, Pattatheyil Arun, Indu Arun

Published in: Head and Neck Pathology | Issue 4/2020

Abstract

Adenoid cystic carcinoma (AdCC) comprises of less than 1% of all head and neck cancers and less than 10% of all salivary gland neoplasms. Dedifferentiation/high-grade transformation (HGT) in AdCC is a rare but well known phenomenon which is associated with aggressive clinical behaviour and poor prognosis. We herein report the clinical, cytologic, histologic and immunohistochemical findings of a left submandibular gland AdCC with transformation to high grade carcinomatous and probable dedifferentiation to sarcomatoid component, occurring in a 64 year old male patient. To the author’s best knowledge, this is the first case report of such dual transformation occurring in adenoid cystic carcinoma.

Petersson F. High-grade transformation (“dedifferentiation”)—malignant progression of salivary gland neoplasms, including carcinoma ex pleomorphic adenoma. Pathol Case Rev. 2015;20(1):27–37.CrossRef

Dahlin DC, Beabout JW. Dedifferentiation of low-grade chondrosarcomas. Cancer. 1971;28(2):461–6.PubMedCrossRef

Cheuk W, Chan JK, Ngan RK. Dedifferentiation in adenoid cystic carcinoma of salivary gland: an uncommon complication associated with an accelerated clinical course. Am J Surg Pathol. 1999;23(4):465–72.PubMedCrossRef

Seethala RR, Hunt JL, Baloch ZW, LiVolsi VA, Leon BE. Adenoid cystic carcinoma with high-grade transformation. Am J Surg Pathol. 2007;31(11):1683–94.PubMedCrossRef

Panarelli JF, Zoumalan CI, Mukkamala K, Maher EA, Iacob C, Della Rocca DA. Dedifferentiated adenoid cystic carcinoma of the lacrimal gland. Ophthalmic Plast Reconstr Surg. 2011;27(5):e119–e12121.PubMedCrossRef

Tando S, Nagao T, Kayano K, Fushiki S, Itoh K. High-grade transformation/dedifferentiation of an adenoid cystic carcinoma of the minor salivary gland to myoepithelial carcinoma. Pathol Int. 2018;68(2):133–8.PubMedCrossRef

Sung M-W, Kim KH, Kim J-W, Min Y-G, Seong W-J, Roh J-L, et al. Clinicopathologic predictors and impact of distant metastasis from adenoid cystic carcinoma of the head and neck. Arch Otolaryngol Neck Surg. 2003;129(11):1193.CrossRef

AK El-Naggar, JKC Chan, JR Grandis, Takashi TPJS. WHO classification of head and neck tumours, 4 ed - WHO. IARC, Lyon. 2017.p. 164–5.

Szanto PA, Luna MA, Tortoledo ME, White RA. Histologic grading of adenoid cystic carcinoma of the salivary glands. Cancer. 1984;54(6):1062–9.PubMedCrossRef

10.

Costa AF, Altemani A, Vékony H, Bloemena E, Fresno F, Suárez C, et al. Genetic profile of adenoid cystic carcinomas (ACC) with high-grade transformation versus solid type. Cell Oncol. 2011;34(4):369–79.CrossRef

11.

Hellquist H, Skálová A, Barnes L, Cardesa A, Thompson LDR, Triantafyllou A, et al. Cervical lymph node metastasis in high-grade transformation of head and neck adenoid cystic carcinoma: a collective international review. Adv Ther. 2016;33(3):357–68.PubMedPubMedCentralCrossRef

12.

Preet K, Ae M, Ae VA, Pandey R. High grade transformation in adenoid cystic carcinoma of the parotid: report of a case with cytologic, histologic and immunohistochemical study. Head Neck Pathol. 2009;3(4):310–4.CrossRef

13.

Ly CK, Cheng HM, Vermeulen T. High grade transformation in a case of adenoid cystic carcinoma associated with Epstein-Barr virus expression. Pathology. 2013;45(7):693–5.PubMedCrossRef

14.

Bhardwaj M, Gupta P. Dedifferentiated adenoid cystic carcinoma ex pleomorphic adenoma of the parotid. J Cancer Res Ther. 2018;14(3):706.PubMedCrossRef

15.

Seifert G, Donath K. Hybrid tumours of salivary glands. Definition and classification of five rare cases. Eur J Cancer B Oral Oncol. 1996;32B(4):251–9.PubMedCrossRef

16.

Nagao T, Gaffey TA, Serizawa H, Sugano I, Ishida Y, Yamazaki K, et al. Dedifferentiated adenoid cystic carcinoma: a clinicopathologic study of 6 cases. Mod Pathol. 2003;16(12):1265–72.PubMedCrossRef

17.

Sato K, Ueda Y, Sakurai A, Ishikawa Y, Kaji S, Nojima T, et al. Adenoid cystic carcinoma of the maxillary sinus with gradual histologic transformation to high-grade adenocarcinoma: a comparative report with dedifferentiated carcinoma. Virchows Arch. 2006;448(2):204–8.PubMedCrossRef

18.

Terasaki M, Tokutomi T, Maruiwa H, Sugita Y, Harada H, Shigemori M. High-grade adenoid cystic carcinoma originating from the lacrimal gland. Brain Tumor Pathol. 2000;17(3):159–63.PubMedCrossRef

19.

Argyris PP, Pambuccian SE, Cayci Z, Singh C, Tosios KI, Koutlas IG. Lacrimal gland adenoid cystic carcinoma with high-grade transformation to myoepithelial carcinoma: report of a case and review of literature. Head Neck Pathol. 2013;7(1):85–92.PubMedCrossRef

20.

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(1):55–66.PubMedCrossRef

21.

Pfeffer MR, Talmi Y, Catane R, Symon Z, Yosepovitch A, Levitt M. A phase II study of Imatinib for advanced adenoid cystic carcinoma of head and neck salivary glands. Oral Oncol. 2007;43(1):33–6.PubMedCrossRef

22.

Persson M, Andrén Y, Mark J, Horlings HM, Persson F, Stenman G. Recurrent fusion of MYB and NFIB transcription factor genes in carcinomas of the breast and head and neck. Proc Natl Acad Sci USA. 2009;106(44):18740–4.PubMedCrossRef

23.

Griffith CC, Schmitt AC, Little JL, Magliocca KR. New developments in salivary gland pathology: clinically useful ancillary testing and new potentially targetable molecular alterations. Arch Pathol Lab Med. 2017;141(3):381–95.PubMedCrossRef

24.

Skálová A, Stenman G, Simpson RHW, Hellquist H, Slouka D, Svoboda T, et al. The role of molecular testing in the differential diagnosis of salivary gland carcinomas. Am J Surg Pathol. 2018;42(2):e11–e27.PubMedCrossRef

25.

Wysocki PT, Izumchenko E, Meir J, Ha PK, Sidransky D, Brait M. Adenoid cystic carcinoma: emerging role of translocations and gene fusions. Oncotarget. 2016;7(40):66239–54.PubMedPubMedCentralCrossRef

26.

Stoeck A, Lejnine S, Truong A, Pan L, Wang H, Zang C, et al. Discovery of biomarkers predictive of GSI response in triple-negative breast cancer and adenoid cystic carcinoma. Cancer Discov. 2014;4(10):1154–67.PubMedPubMedCentralCrossRef

27.

Moles MAG, Avila IR, Archilla AR. Dedifferentiation occurring in adenoid cystic carcinoma of the tongue. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol. 1999;88(2):177–80.CrossRef

28.

Chau Y, Hongyo T, Aozasa K, Chan JK. Dedifferentiation of adenoid cystic carcinoma: report of a case implicating p53 gene mutation. Hum Pathol. 2001;32(12):1403–7.PubMedCrossRef

29.

Ide F, Mishima K, Saito I. Small foci of high-grade carcinoma cells in adenoid cystic carcinoma represent an incipient phase of dedifferentiation. Histopathology. 2003;43(6):604–6.PubMedCrossRef

30.

Brackrock S, Krüll A, Röser K, Schwarz R, Riethdorf L, Alberti W. Neutron therapy, prognostic factors and dedifferentiation of adenoid cystic carcinomas (ACC) of salivary glands. Anticancer Res. 2019;25(2B):1321–6.

31.

Handra-Luca A, Planchard D, Fouret P. Docetaxel-cisplatin-radiotherapy in adenoid cystic carcinoma with high-grade transformation. Oral Oncol. 2009;45(11):e208–e209209.PubMedCrossRef

32.

Bonfitto VL, Demasi AP, Costa AF, Bonfitto JF, Araujo VC, Altemani A. High-grade transformation of adenoid cystic carcinomas: a study of the expression of GLUT1 glucose transporter and of mitochondrial antigen. J Clin Pathol. 2010;63(7):615–9.PubMedCrossRef

33.

Boland JM, McPhail ED, García JJ, Lewis JE, Schembri-Wismayer DJ. Detection of human papilloma virus and p16 expression in high-grade adenoid cystic carcinoma of the head and neck. Mod Pathol. 2012;25(4):529–36.PubMedCrossRef

34.

Bavle R, D′Mello S, Makarla S, Hosthor S. Dedifferentiation in adenoid cystic carcinoma. J Oral Maxillofac Pathol. 2013;17(3):474.PubMedPubMedCentralCrossRef

35.

Sayar H, Sarıoğlu S, Bakariş S, Yıldırım İ, Öztarakçı H. High-grade transformation of adenoid cystic carcinoma delineated with a fibrous rim: a case report. Balkan Med J. 2013;30:333–6.PubMedPubMedCentralCrossRef

36.

Kusafuka K, Miki T, Nakajima T. Salivary adenoid cystic carcinoma with an early phase of high-grade transformation: case report with an immunohistochemical analysis. Diagn Pathol. 2013;8(1):113.PubMedPubMedCentralCrossRef

37.

Noda Y, Hori Y, Kishino M, Satou S, Ogawa Y, Harada H, et al. A case of dedifferentiated adenoid cystic carcinoma in submandibular gland: morphological and immunohistochemical features. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(3):e140.CrossRef

Title: Adenoid Cystic Carcinoma with Transformation to High Grade Carcinomatous and Sarcomatoid Components: A Rare Case Report with Review of Literature
Authors: Anupurva Dutta
Pattatheyil Arun
Indu Arun
Publication date: 01-12-2020
Publisher: Springer US
Published in: Head and Neck Pathology / Issue 4/2020
Electronic ISSN: 1936-0568
DOI: https://doi.org/10.1007/s12105-019-01120-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Adenoid Cystic Carcinoma with Transformation to High Grade Carcinomatous and Sarcomatoid Components: A Rare Case Report with Review of Literature

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 4/2020

Identification of Rare and Common HPV Genotypes in Sinonasal Papillomas

Benign Alveolar Ridge Keratosis: Clinical and Histopathologic Analysis of 167 Cases

Pediatric Warthin-like Mucoepidermoid Carcinoma: Report of Two Cases with One Persistent/Recurrent as Conventional Mucoepidermoid Carcinoma

Biphenotypic Branchioma: A Better Name Than Ectopic Hamartomatous Thymoma for a Neoplasm with HRAS Mutation

Nasal Chondromesenchymal Hamartoma

Laryngeal Contact Ulcer