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Introduction and Importance: Pulmonary mucoepidermoid carcinoma (PMEC) is a rare lung tumor, accounting 0.1-0.2 % of lung malignancies, commonly affecting adults under 50. PMEC arises from salivary gland tissue within the lung and can resemble other lung cancers, which challenging the diagnosis., Case Presentation: A 50-year-old woman with asthma presented with increased cough and abdominal pain. An incidental lung mass on CT was confirmed as low-grade PMEC. She underwent right lower lobectomy via video-assisted thoracoscopy (VATS), complicated by a pulmonary embolism, which was managed successfully. Follow-up imaging revealed a new nodule, later found to be benign., Case Discussion: Despite of its rarity, PMEC should be considered in patients with respiratory symptoms, especially in unsuccsisful treatments, such as asthma management. PMEC's central location can lead to misdiagnosis as non-small cell lung cancer, but immunohistochemistry and histopathology are key for accurate differentiation. VATS is the preferred surgical approach for resectable PMEC, providing benefits of reduced recovery time and complications compared to open surgery. While low-grade PMEC has a generally favorable prognosis, cases like this highlight the importance of follow-up, as recurrence or new lesions can emerge post-resection, necessitating vigilant monitoring., Conclusion: This case highlights the diagnostic and management challenges of PMEC, underscoring the importance of incidental findings, tailored surgical approaches, and proactive follow-up., Competing Interests: Declaration of competing interest All Authors have no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The development of targeted nanotherapeutics has emerged as a pivotal advancement in cancer treatment, aiming to enhance the efficacy and specificity of drug delivery while minimizing systemic toxicity. Due to their biocompatibility and modifiable surface properties, Chitosan-based nanoparticles have shown considerable promise in encapsulating and delivering therapeutic agents directly to tumor sites. This study investigates the potential of 1,5-diary pyrazole derivative (T4)-loaded chitosan (CS) nanoparticles as a novel anticancer agent, evaluating their physical characteristics, in vivo biodistribution, and therapeutic efficacy against cancerous cells. SEM morphological analysis confirmed chitosan-based nanoparticles' smooth, spherical structure, with aggregation patterns typical of high surface energy nanoparticle synthesis. UV-visible spectroscopy and XRD analysis validated the successful incorporation of T4, showing characteristic absorption peaks and indicating a reduction in crystallinity desirable for enhanced drug release. In vivo imaging demonstrated the rapid systemic distribution of T4-CS nanoparticles, essential for delivering therapeutic agents effectively. The cytotoxic potential of T4-CS nanoparticles was significantly higher against cancer cells compared to controls, confirmed by MTT and scratch assays, indicating enhanced anti-cancer activity and potential inhibition of cancer metastasis. Furthermore, histological and gene expression analyses supported the anti-tumor and pro-apoptotic capabilities of T4-CS nanoparticles, showing reduced proliferation markers and inflammatory pathways. Behavioral assessments in rats highlighted the neuroprotective effects of T4-CS nanoparticles against 7,12-dimethyl benzanthracene (DMBA) induced neurotoxicity, suggesting their utility as both anticancer and neuroprotective agents. This multifaceted evaluation underscores the versatility and therapeutic potential of T4-CS nanoparticles, warranting further investigation into their mechanistic effects and clinical applications., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Introduction: Salivary gland tumor operations are associated with complications including facial nerve dysfunction (FND) and salivary fistula. The objective of this study was to investigate the effect of extracapsular dissection (ECD) and the application of Clostridium botulinum toxin (CBT) in contrast to partial and lateral parotidectomy on complications. Methods: All salivary gland tumor operations performed within the last 6 years were retrospectively examined. Data were collected from electronic patient files from our otorhinolaryngology clinic. Total parotidectomies and submandibulectomies were not included in the analysis of CBT application. Results: In total, 418 cases were examined, including 84 (20%) malignant tumors. In total, 18 patients underwent ECD, 93 partial parotidectomy, 199 lateral parotidectomy, 76 total parotidectomy, and 32 submandibulectomy. The most common complication was transient FND (49%; n = 205; data available for 415 patients), which was measured at four days. Additional complications included salivary fistula ( n = 56), infection ( n = 49), bleeding or hematoma ( n = 21). Preoperative facial nerve paralysis ( p < 0.0001), pain ( p < 0.0001), and a history of squamous cell skin carcinoma (SCC) ( p < 0.001) were predictive of malignancy. The application of CBT did not reduce the risk of salivary fistula ( p -value: 0.0182) and was associated with a higher combined complication rate ( p -value: 0.0199). ECD was not associated with a lower likelihood for FND ( p = 0.350). Conclusions: Preoperative pain, facial paralysis, or a history of SCC are predictors of malignancy. Use of CBT was not associated with a reduced risk of salivary fistula, but rather a higher complication rate.

The histopathological diagnosis of salivary tumors is considered complex, due to their histological, phenotypic, and genotypic diversity. There are numerous tumors with morphological and/or immunohistochemical aspects that are superimposable but require very different treatment. In this context, salivary lesions containing clear cells are numerous and form part of the diagnostic challenges. We present the case of a 63-year-old woman with a tumor of the accessory salivary glands of the palate, with a predominant clear cell contingent. The aim of this paper is to report a case of a clear cell salivary tumor and to detail the difficulties of differential diagnosis, highlighting new data in the literature and the role of molecular biology., Competing Interests: Human subjects: Consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Strokov et al.)

Background: Mucinous cells can be detected sporadically or may constitute the primary tumor component in salivary gland tumors, as observed in the intraductal papillary mucinous neoplasm (IPMN). This low-grade tumor is composed of mucinous columnar cells organized into papillary cystic structures. The present study aimed to compare the mucous cells in IPMN with mucous cells present in mucoepidermoid carcinoma (MEC) and papillary cystadenoma (PC)., Methods: Immunohistochemistry analysis was carried out to compare the mucous cells in IPMN with the sporadic mucous cells in MEC (n = 4) and PC (n = 3)., Results: The results indicated that IPMN cells were positive for CK7, CK18, DOG1, and NKX3.1 and negative for CK14, SMA, and p63. The mucous cells in both MEC and PC were positive for CK7 and negative for CK18, SMA, DOG1, and NKX3.1. The positive expression of CK14 and p63 revealed the presence of basal cells both in PC, cystic areas of MEC, and normal mucous salivary glands., Conclusion: The immunohistochemical profile of IPMN closely resembles that of the mucous cells of the minor salivary glands yet differs from the mucous cells observed in MEC and PCX. This suggests that IPMN is probably derived from the transformation of secretory cells of the minor mucous salivary gland and has no rimming/basal cells. For this reason, we propose that this tumor is designated as mucous acinic cell carcinoma., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Mammary analogue secretory carcinoma (MASC) is a rare salivary gland tumor which shares its histologic, immunohistochemical, and genetic features with the secretory carcinoma (SC) of breast. In this case report, we describe a case of MASC in a young adolescent male with swelling in the right angle of mandible which is a relatively rare site to present along with its correlation of cytological, histological, and immunohistochemical features. A 16-year-old male came with the complaint of swelling in the right angle of mandible since 2 years. Contrast-enhanced computed tomography (CECT) neck revealed differential diagnosis of nerve sheath tumor, pleomorphic adenoma, and adenoid cystic neoplasm was kept, and subsequently fine-needle aspiration cytology (FNAC) was done. FNAC was done in which differential diagnosis of myoepithelial neoplasm, acinic cell carcinoma, and SC was given. Surgical excision was done followed by histopathological examination. Immunohistochemistry panel was also applied, and final diagnosis of SC was rendered. SC has distinct cytological, histological, and immunohistochemical features which should be recognized by the pathologists for the appropriate management of the patient., (© 2024 Wiley Periodicals LLC.)

Purpose: Salivary gland tumors include numerous subtypes that vary from benign to highly aggressive, with many showing overlapping histopathological features that can make diagnosis challenging. Most subtypes express driver fusion genes that are tumor specific, and detection of such fusions is useful for differentiating amongst specific diagnoses, determining appropriate tumor grading, and guiding effective treatment. Currently, fusions can be detected by FISH, RT-PCR or through next-generation sequencing approaches, all of which are highly effective methodologies but can be costly or time consuming., Methods: We developed a rapid NanoString nCounter platform-based assay to detect salivary gland tumor fusions using a combination of fusion junction-specific probes and an approach through differential exon expression analysis. The assay includes 68 junction-specific probes and analysis of exon expression across 9 fusion-associated genes in a single multiplex assay., Results: Out of 55 retrospective and 171 prospective cases assayed, we accurately detected the majority of cases of pleomorphic adenoma, adenoid cystic carcinoma, cribriform adenocarcinoma, clear cell carcinoma, secretory carcinoma and NUT-rearranged carcinoma, including cases of these tumor types arising in non-salivary gland sites, with the major drawback being an inability to detect MAML2-containing mucoepidermoid samples. With mucoepidermoid carcinoma excluded, the assay shows an overall sensitivity of 96.1% and specificity of 100%., Conclusion: We show that the majority of salivary gland tumor fusions can be effectively detected with a single rapid NanoString based assay, which can serve as a useful adjunctive tool for routine diagnostic head and neck pathology. The assay is low cost with a rapid turnaround time (30 h total assay time per sample batch, with minimal technician input required) compared to alternate detection methods., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: To investigate the clinicopathologic characteristics, therapeutic methods, and prognosis of secretory carcinoma of salivary gland (SCSG)., Methods: The clinicopathologic data of 13 patients with SCSG admitted to Shanxi Cancer Hospital from January 2018 to June 2023 were retrospectively analyzed, and a literature review was performed., Results: A total of eight males and five females aged 22-78 years old were enrolled, and they commonly presented with painless masses in the parotid or submandibular gland. They all underwent surgical treatment, accompanied by typical pathological examinations postoperatively. Fluorescence in situ hybridization (FISH) was conducted in seven cases, the results were all positive, and no gene fusion other than ETV6-NTRK3 was found. Two patients developed local relapse during follow-up, both of which were in the surgical area. By the end of the follow-up, 12 patients survived and one patient died., Conclusions: SCSG is a rare low-grade malignancy with a good prognosis. Pathological and immunohistochemical characteristics are the key to secretory carcinoma (SC) diagnosis, and surgical excision is the major treatment means for SCSG. Whether to perform simultaneous cervical lymph node dissection and other adjuvant therapies should be determined based on the pathological stage and the presence or absence of high-risk factors., (© 2024. The Author(s).)

Sialadenoma papilliferum (SP) is a rare salivary gland tumor mostly reported in the oral cavity. Here we describe a bronchial SP in the left upper lobe bronchus of a 10-year-old boy. At bronchoscopy, a well-circumscribed polypoid lesion protruding into the bronchial lumen was identified. The tumor was excised, but eventually, the patient had to undergo a sleeve resection after 2 recurrences. Pathology revealed a papillocystic lesion with exophytic and endophytic components. The cells lining the exophytic surface and papillary structures were columnar and squamous, and the cells lining endophytic cystic and papillary structures were cuboidal to columnar, all of which were diffusely reactive with antibodies to SOX10 protein. The presence of basal cells was demonstrated by p63 immunoreactivity. The cells failed to immunohistochemically express BRAF V600E. Fluorescence in situ hybridization analysis revealed no MAML2 or RET gene rearrangement. The patient is alive 24 years after resection with no additional recurrences. Bronchial SP needs to be recognized and distinguished from other benign and malignant salivary gland and pulmonary neoplasms so that patients can receive appropriate treatment and follow-up., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Cystadenocarcinoma is a malignant tumor that has undergone various classifications due to its wide variety of pathological forms since the World Health Organization (WHO) classification in 2005. We present a case involving a 72-year-old man who reported pain and swelling in the left floor of his mouth during eating. Examination demonstrated a thumb-sized, mobile mass with elastic softness. Resection of the sublingual gland tumor and left submandibular neck dissection were performed under general anesthesia. The lesion was encased in a thin fibrous capsule and consisted of tall columnar epithelium with papillary proliferation of homogeneous eosinophilic columnar cells with minimal pleomorphism. It demonstrated continuous proliferation from the sublingual gland, extracapsular invasion, infiltrative growth, and mild nuclear atypia, leading to a diagnosis of cystadenocarcinoma. Owing to multiple lymph node metastases, left radical neck dissection was performed 21 months post surgery. The patient remains disease-free 85 months after surgery., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Yasui et al.)

Introduction Salivary gland lesions include a diverse range of histological types and biological behaviors, making accurate diagnosis and effective treatment challenging for specialists. Fine needle aspiration cytology (FNAC) plays a significant role in making preoperative diagnoses and further plans of surgery. In differentiating malignant from benign salivary gland tumors, the diagnostic accuracy of fine needle aspiration cytology (FNAC) is high. However, the final diagnosis is histopathological. The aim of this study is to correlate cytological and histopathological interpretations in salivary gland lesions. Materials and method Thirty patients were included in this study, all of them were diagnosed with salivary gland swellings and operated on in the ear, nose, and throat (ENT) department of Mata Gujri Memorial (MGM) Medical College, Kishanganj, in the northeastern region of India, between December 2020 and November 2022. Ultrasonography (USG) and computed tomography (CT) scans were performed in each case, and FNAC was done to make a preoperative diagnosis. After surgery, specimens were collected for histopathological examination. A correlation was then made between the findings of the preoperative cytological examination and the results of the postoperative histopathological examination. The comparison was performed using a 2×2 table, and the analysis of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) was carried out using Microsoft Excel (Microsoft Corp., Redmond, WA) and SPSS software (IBM SPSS Statistics, Armonk, NY). Results An equal number of male and female samples were included in the study, in which parotid involvement was predominant (60%). On FNAC, 53% of parotid gland tumors were found to be benign, whereas only 23.3% of submandibular gland tumors were benign. Pleomorphic adenoma was the most common finding. In the present study, the sensitivity, specificity, positive predictive value, and negative predictive value of USG-guided FNAC, compared to the gold standard histopathology, were 96%, 33.3%, 92.3%, and 50%, respectively. The diagnostic accuracy was found to be 89.3%. Conclusion The findings of this study suggest that FNAC is a reliable technique for the preoperative diagnosis of salivary gland tumors, as it is minimally invasive and offers valuable diagnostic information. An accurate cytological diagnosis can help avoid unnecessary surgery., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The Ethical Committee of Mata Gujri Memorial (MGM) Medical College and Lions Seva Kendra (LSK) Hospital, Kishanganj, issued approval MGM/IEC-72/2023. The required permission for the proposed research methodology was obtained from the Ethical Committee of Mata Gujri Memorial (MGM) Medical College and Lions Seva Kendra (LSK) Hospital, and it subsequently satisfied all institutional rules and regulations during the period of research in this hospital. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Kumar et al.)

Adenoid cystic carcinoma (ACC) is an aggressive form of salivary gland cancer that mostly affects the accessory, parotid, and submandibular salivary glands. This tumor is characterized by slower development, perineural invasion, and possible local recurrence in clinical and pathological findings. A male patient, aged 71, who was from a remote area, appeared with a lesion affecting the right submandibular gland and had been experiencing discomfort in the same region for four months. Following a biopsy and the histological confirmation of ACC in the right submandibular gland, the tumor was widely excised locally., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Dadgal et al.)

The most commonly occurring malignant salivary gland tumor is mucoepidermoid carcinoma (MEC). It consists of intermediate cells, squamous cells, and mucous-secreting cells. It is usually not capsulated and is identified by mucocarmine staining. Mucoepidermoid carcinoma exists in the thyroid gland and lungs as well. This report presents a case of a very rare sclerosing variant of MEC of the parotid gland in a 48-year-old patient. The patient presented with a small swelling below the left earlobe. Ultrasound-guided fine-needle aspiration cytology (FNAC) was carried out. A diagnosis of pleomorphic adenoma was given. The patient underwent a partial parotidectomy under general anesthesia. The final diagnosis was made through histopathological examination after the surgical removal of the tumor. The patient is now under close follow-up to look out for a recurrence. This case highlights the importance of recognizing and managing rare variants of MEC to optimize patient outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. The scientific review board of Saveetha Dental College issued approval (SRB/SDC/OMFS-2206/23/156). Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Singh et al.)

Benign salivary gland tumors are a rare and diverse group of neoplasms with significant variations in their site of origin, histological features, and biological behavior. This report describes the case of a 93-year-old woman with a markedly enlarged left cervical mass. Physical inspection uncovered a tumor of approximately 32 x 30 cm, featuring necrotic and ulcerated areas. The neoplasm, diagnosed as a pleomorphic adenoma (PA) through prior biopsies, had been growing gradually over fifteen years, with delayed surgical intervention due to concerns about her age and the tumor's size. Preoperative contrast-enhanced CT imaging showed a large left-sided cervical mass in close proximity to the airway, but without displacement or infiltration into major structures. An elective surgical approach was undertaken, involving complete resection of the giant PA, confirmed by histopathological evaluation. During the first month of postoperative follow-up, the patient experienced partial facial nerve paralysis but showed no evidence of tumor recurrence. Despite the tumor's considerable size, proximity to the airway, and the patient's advanced age, curative surgical intervention proved feasible. This case underscores that, with meticulous preoperative planning and careful surgical execution, age should not be a contraindication for surgery., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Palomino-Payan et al.)

Pleomorphic adenoma (PA) most commonly manifests in the parotid gland, though it occasionally emerges in atypical locations. We present a case involving an 87-year-old female who exhibited chronic left-sided nasal symptoms, leading to the diagnosis of PA in the nasal cavity. This diagnosis was confirmed through rhinoscopy and subsequent pathological examination following the surgical excision of an 8x8 mm mass. The procedure, which included tumor-based cautery, alleviated her symptoms effectively. A follow-up strategy was established to monitor for any signs of recurrence. The patient has shown no signs of recurrence at subsequent three-month follow-up visits, highlighting the success of the intervention. This case underscores the importance of early recognition and intervention in atypical presentations of PA, which is crucial to prevent potential complications and ensure favorable outcomes., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Basharat et al.)

Calculus represents a mineralized form of bacterial plaque, commonly developing on natural tooth surfaces exposed to a continuous supply of saliva. The salivary composition significantly influences the degree of calculus formation in individuals, exerting a pivotal role in this aspect. Reduced salivary output elevates vulnerability to oral diseases. Numerous contributing elements might be associated with the development of significant calculus, potentially implicating the existence of a salivary gland tumor, notably related to the left parotid gland. This report stands as notable documentation of an extraordinary and infrequent occurrence of calculus formation associated with a salivary gland tumor, presenting an exceptional case within the scope of medical literature., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Journal of Family Medicine and Primary Care.)

Pleomorphic adenoma is a benign tumor that can occur in the salivary glands, most commonly in the parotid gland. While it primarily occurs in the major salivary glands, it can sometimes be found in the minor salivary glands. Within the minor salivary glands, it most often originates in the hard palate and soft palate, and less frequently in the upper lips. Due to its location in the minor salivary glands, most pleomorphic adenoma involve and protrude on the mucosa. A 61-year-old man presented with 1.5 cm exophytic mass on the skin of his upper lip. This mass was exophytic on the skin and did not involve or protrude into the inner lip mucosa. The mass was entirely excised, and a subsequent permanent biopsy diagnosed it as a pleomorphic adenoma. In such situations, it can be challenging to suspect pleomorphic adenoma during a physical examination, leading to potential diagnostic confusion. It might also be mistaken for an inclusion cyst or another type of mass, making it tempting to treat without verifying the pathological results.

Salivary gland tumors (SGT) display morphological diversity and pose diagnostic challenges. Preoperative fine needle aspiration cytology (FNAC) is a minimally invasive and efficient diagnostic test. However, due to the limited sample size, the final diagnosis may not be established based on FNAC alone. Although cytomorphology and architecture are usually preserved on FNAC, morphologic changes specific to FNAC can complicate the diagnosis. The Milan System for Reporting Salivary Gland Cytopathology categorizes complex FNAC interpretations. Because the cytological diagnosis is closely linked to the histological diagnosis, a multidimensional approach considering the possibility of several differential diagnoses is necessary. From the standpoint of treatment, distinguishing high-grade malignancy from low-grade malignancy is more important than distinguishing malignancy from benign tumors., Competing Interests: Declaration of competing interest The author declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. The author is a Guest Editor for Seminars in Diagnostic Pathology and was not involved in the editorial review or the decision to publish this article., (Copyright © 2024 Elsevier Inc. All rights reserved.)

The differential diagnosis of salivary gland lesions with epithelial components and lymphoid stroma is often challenging. Salivary gland carcinoma with tumor-associated lymphoid proliferation, tumors composed of both epithelial and lymphoid components, lymphoid neoplasms in the salivary gland, and inflammatory lesions are all included in this category. It encompasses inflammatory lesions and neoplastic lesions. With the exception of Warthin tumors, these lesions are rare, making them more difficult to diagnose. Carcinoma showing thymus-like elements has recently been reported in the salivary gland. Similar to thymic carcinoma, tumor cells are positive for CD5 and are accompanied by T lymphocytes., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: Treatment of salivary gland tumors (SGTs) remains challenging. Little is known about the immune landscape of SGTs. We aimed to characterize the tumor microenvironment in benign and malignant SGTs., Methods: Eleven benign and nine malignant tumors were collected from patients undergoing curative intent surgery. Specimens were analyzed using mass cytometry by time-of-flight. Immune cell populations were manually gated, and T cells were clustered using the FlowSOM algorithm. Population frequencies were compared between high-grade and low-grade malignancies, corrected for multiple hypothesis testing., Results: There were trends towards increased CD4+ and CD8+ T cells among malignant tumors. High-grade malignancies exhibited trends towards higher frequencies of CD8+ PD-1+ CD39+ CD103+ exhausted T cells, CD4+ FoxP3+ TCF-1+ CD127- Tregs, and CD69+ CD25- CD4+ T cells compared to low-grade malignancies., Conclusion: SGTs exhibit significant immunologic diversity. High-grade malignancies tended to have greater infiltration of exhausted CD8+ T cells and Tregs, which may guide future studies for immunotherapy strategies., (© 2024 The Authors. Head & Neck published by Wiley Periodicals LLC.)

Adenoid cystic carcinoma (ACC) is an uncommon and aggressive head and neck cancer mainly affecting minor salivary glands. It affects more women than men in their 60s and 70s. The tumor is typically locally aggressive and has a high rate of distant metastatic disease. This report unveils a potential avenue for targeted therapy for the management of metastatic disease: a patient with ACC who harbored a specific fibroblast growth factor receptor 2 (FGFR-2) mutation and responded significantly to a novel FGFR-2 inhibitor. This finding could pave the way for personalized treatment options for ACC patients with similar genetic alterations. Nevertheless, the use of futibatinib requires further investigation to optimize treatment protocols, including exploring combination therapies, identifying predictive biomarkers for treatment response, and developing strategies to overcome potential resistance., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Rodriguez et al.)

Introduction: Acinic cell carcinoma (AciCC) is a rare clinical entity and a salivary gland malignancy. It is associated with wide histological variations in the cytomorphological patterns., Methods: Sixty cases diagnosed as AciCC from 2002 to 2023 were assessed for diverse cytomorphological patterns., Results: The mean age of patients at the time of diagnosis was 44.35±16.8 years ranging from 15 to 81 years. Females comprised 58.3% for a F: M ratio of 1.4:1. Fifty three cases (88.3%) occurred in the parotid gland, two cases in the nasal region (3.3%), and one case each in the soft plate and upper lip (1.7%). The location of the remaining three cases was not specified. The most common presenting complaint was a well-defined facial swelling associated with pain. The average tumor size was 3.8±1.9 cm. The most predominant architectural pattern was solid (83.3%) followed by microcystic (60%), then follicular (41.7%), papillary cystic (14.3%), and tubulocystic (28.6%), and AciCC with de-differentiation/high-grade transformation was reported in three cases (5%). In 83.3% of the cases (50 out of 60), we noticed a mixture of two or more growth patterns. Other degenerative changes included prominent lymphoid stroma, hemorrhage, and cystic change., Conclusion: Awareness and recognition of diverse cytomorphological patterns of AciCC, especially in institutions of a developing country where there is limited availability of highly specific and sensitive immunohistochemical stains or molecular diagnostics, are crucial and essential., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Aga Khan University Ethics Review Committe issued approval 2023-7495-27326. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Suleman et al.)

Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction and Importance: Polymorphous low-grade adenocarcinoma (PLGA) is a rare neoplasm arising from minor salivary glands, representing approximately 3 % of head and neck tumors. The clinical presentation of PLGA is defined as a painless, slow-growing tumor, mostly occurring in the palate. We report a case of PLGA with a rare presentation., Case Presentation: A 76-year-old male, known case of hepatitis B, diabetes, and hypertension, presented to the emergency department complaining of spitting blood and dysphagia. Imaging showed a heterogeneous enlarged left tonsil with hyperemia of the mucosa, and air foci. Biopsy with excisional biopsy confirmed the diagnosis of PLGA. The patient underwent completion tonsillectomy and selective neck dissection which yielded tonsillar tissue with underlying PLGA, and reactive lymph nodes with no malignant tissue respectively, margins were negative for malignancy., Clinical Discussion: Polymorphous low-grade adenocarcinoma is a rare lesion with clinical behavior resembling that of a benign neoplasm. Predominantly occurring in the oral cavity, especially on the hard palate, buccal mucosa, and retromolar region, with fewer cases in the upper lip. Occurrence in the nasopharynx and oropharynx is rare. PLGA presents as painless slow-growing masses, typically in females aged 50-60. Local excision with careful margin evaluation is the preferred treatment, with good prognosis compared to other carcinomas., Conclusion: PLGA is rare, with limited reported case from around the world. It is mostly seen in adults between their fifth and sixth decades with female predominance. PLGA is diagnosed using imaging, immunohistochemistry. Owing to the limited cases there is no standard approach to treating PLGA. However, most cases are managed with local excision and showed an excellent response in terms of tumor nonrecurrence., Competing Interests: Conflict of interest statement The authors declare that they have no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Diagnosing a soft tissue tumor in the head and neck region can be challenging due to its complex anatomy and diverse histological spectrum. This case report highlights the case of a woman who presented with a painless neck lump in the posterior triangle of the neck. Various pathological and imaging studies were suggestive of pleomorphic adenoma, which arises from the left prevertebral space. The patient underwent complete surgical excision via the transcervical approach. Pleomorphic adenoma in the posterior triangle of the neck is extremely rare and causes a diagnostic dilemma in managing soft tissue tumors of the neck., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Musa et al.)

Objectives: Secretory Carcinoma is a malignant salivary gland tumor, initially described in 2010. This rare tumor is associated with the translocation t(12;15) (p13;q25), resulting in the fusion gene ETV6-NTRK3. Since this tumor is quite rare, most publications describe only small cohorts of patients. We aimed to investigate the clinical, pathological, and prognostic features of this newly defined malignant entity., Data Sources: Pubmed, Google Scholar, and Web of Science databases., Review Methods: All published articles between 2010 and 2023 were reviewed. Search terms included the terms "Mammary Analogue Secretory Carcinoma" and "Secretory Carcinoma". All articles published in English reporting on Secretory Carcinoma of salivary glands were retrieved., Results: One-hundred and 12 retrospective articles reporting a total of 674 patients were included, with 52% males and a mean age of 44.9 ± 18.9. The event rate for patients with advanced-stage disease (Stage 3/4) at presentation was 24.1% (95% CI 17.6%-31.9%, I 2  = 9.2%), 14.6% for regional metastases (95% CI 10.5%-20%, I 2  = 12%), and the event rate of distant metastasis was 8.4% (95% CI 5.5%-12.7%, I 2  = 4.2%). Adjuvant radiotherapy was administered for 30.3% of patients (95% CI 24.1%-37.2%, I 2  = 21.5%). The recurrence rate was 19% (95% CI 15.1%-23.8%, I 2  = 5%). Survival outcomes showed a 17.2% death of disease rate for Secretory Carcinoma patients (95% CI 13.5%-21.8%, I 2  = 7.3%)., Conclusions: Secretory Carcinoma is a rare and relatively newly defined entity arising in the parotid gland most commonly. Characterized as a low-grade tumor, the majority of patients are diagnosed at an early stage, without regional or distant disease, and the prognosis is relatively good., Level of Evidence: NA Laryngoscope, 134:1716-1724, 2024., (© 2023 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Of all the head and neck tumors, salivary gland tumors account to 3%. Pleomorphic adenomas are one of the most common benign tumors arising from major salivary glands, although it could also develop from minor salivary glands situated at accessory sites like nasal cavity, pharynx, parapharyngeal space, lacrimal glands etc. Tumors of infratemporal fossa are quite unusual, mainly because of its hidden location in retromaxillary region. We report an unusual case of 65 years old male presenting with complaint of progressive left cheek swelling for 4 years. FNAC revealed pleomorphic adenoma of minor salivary gland tumor. Intraoperatively a giant lobulated tumor was seen occupying almost whole space of infratemporal fossa, which was removed in-toto via open approach. Patient was kept on regular follow up with no evidence of recurrence reported till date., Competing Interests: Conflict of interestThe authors have no conflicts of interest., (© Association of Otolaryngologists of India 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Objectives: To analyze and summarize the clinicopathological features, risk factors for cervical nodal metastasis, and prognostic factors of malignant sublingual gland tumors (MSLGT)., Methods: Patients diagnosed with MSLGT were retrospectively reviewed from January 2005 to December 2017 at Shanghai Ninth Hospital. The clinicopathological features were summarized, and the correlations between clinicopathological parameters, cervical nodal metastasis, and local-regional recurrence were evaluated using the Chi-square test. Kaplan-Meier method and Cox regression analysis were performed to assess the survival and independent prognostic factors., Results: Seventy-nine patients were included, and the 5-year overall survival and disease-free survival rates was 85.7% and 71.7%, respectively. Gender and clinical tumor stage were risk factors for cervical nodal metastasis. Tumor size and pathological lymph node (LN) stage were independent prognostic factors for adenoid cystic carcinoma (ACC) of the sublingual gland; while age, pathological LN stage, and distant metastasis were prognostic factors for patients with non-ACC of the sublingual gland. Patients with higher clinical stage were more likely to undergo tumor recurrence., Conclusions: Malignant sublingual gland tumors are rare, and neck dissection should be performed in male MSLGT patients with higher clinical stage. Among patients with both ACC and non-ACC MSLGT patients, pN+ indicate a poor prognosis., (© 2023 Wiley Periodicals LLC.)

Mucoepidermoid carcinoma (MEC) is a common malignancy arising in the parotid gland. The diagnosis of MEC is typically based on its morphological features alone, characteristically containing mucocytes, intermediate cells and epidermoid cells. However, when cystic degeneration is diffuse, it is challenging to distinguish MEC from other benign cystic tumors. This is a case report of a 58-year-old Caucasian man who presented with a parotid mass. H&E sections of the mass reveal multiloculated cysts lined by bland-looking epithelium with only rare papillary architectures. The papillary proliferation contains mucocytes, and epidermoid cells highlighted by the p63 immunohistochemistry study. The diagnosis was confirmed by FISH result of positive MAML2 (11q21) rearrangement. Patient underwent parotidectomy and is disease-free 6 months post-surgery. MEC with cystic degeneration is a common diagnostic pitfall which can mimic many benign lesions in the salivary gland. We present a rare case with MEC with extensive cystic change, its molecular and pathologic findings and review the diagnostic features of MEC, its benign mimickers and useful tools for distinguishing these entities., Competing Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article., (© The Author(s) 2024.)

Facial nerve palsy (FNP) is a well-recognized complication following parotidectomy, with varying reported incidence rates in the literature. Understanding the incidence and factors contributing to FNP is crucial for optimizing patient care and surgical outcomes. A retrospective analysis was conducted on 78 patients who underwent parotidectomy at a tertiary care institution (Hospital de Especialidades Carlos Andrade Marin, Quito) over a 36-month period. Demographic data, preoperative pathology reports, surgical details, and postoperative outcomes, including FNP incidence and severity, were analyzed. The mean age of the cohort was 53 years, with a male-to-female ratio of 0.8:1. Fine needle aspiration revealed benign pathology in 70.5% of cases, with superficial parotidectomy being the most common surgical approach (84.6%). Postoperatively, FNP was observed in 51.2% of cases, with transient paralysis in 62.5% and persistent paralysis in 37.5%. The majority of FNP cases were classified as grade II and III according to the House-Brackmann grading system. A tumor size larger than 4 cm was associated with a higher incidence of FNP (57.5%). This study provides valuable insights into the incidence and severity of FNP following parotidectomy. Despite efforts to standardize surgical techniques, persistent paralysis remains a significant concern., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Otanez et al.)

Dysgenetic polycystic disease, also known just as polycystic disease, is a very rare developmental abnormality affecting the salivary gland duct system. This entity has been reported in only 21 patients previously, although a careful review suggests only 16 patients have histological evidence of the disease. In previously reported cases, this lesion most commonly presents as either an incidental finding or as a swelling affecting the parotid glands bilaterally, or rarely the submandibular glands bilaterally. This case report details the first time dysgenetic polycystic disease is found affecting the minor salivary glands of the tongue in a 55-year-old male. Histochemical and immunohistochemical stains are presented and include positivity for AE1/AE3 and p63, and negativity for progesterone receptor, androgen receptor, mammaglobin, S100 and BRAF V600E. PAS-D and Congo Red highlight special microamyloid spheroliths structures intraluminally., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Purpose: Different pathologies of the submandibular gland are an indication of submandibular gland excision-ranging from inflammatory causes and sialolithiasis to malignant tumors. The purpose of this study was to get an overview of the different indications for submandibular gland excision. Methods: The main goal of this study was to evaluate the different indications for submandibular gland excision during a 20-year period. In addition, epidemiological information and therapy concepts were investigated with a special focus on Tumor Lymph nodes Metastasis (TNM) classification and recurrence rate. Procedures during which the submandibular gland was removed while not being the primary cause for surgery (eg, neck dissection in Level Ib) were not included. Results: During the period of observation, 359 submandibular gland excisions were performed. The most common cause for submandibular gland excision was sialolithiasis (n = 129) with intraparenchymal stone localization. Up next were inflammatory causes (n = 115) in particular chronic submandibular sialadenitis followed by only a few cases of Sjögren's syndrome, sarcoidosis, and tuberculosis. In 115 cases, surgery was performed for tumors of the submandibular gland, with 88 of them being benign and 27 malignant. Malignancies were then divided into lymphomas (n = 9) and primary salivary gland malignancies (n = 18). Conclusion: This retrospective study of a large cohort of patients displays a representative overview of the indications for submandibular gland excision. Sialolithiasis was the most common underlying cause of gland excision. The malignancy rate in our cohort was lower than described in the literature., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Venous vascular malformations of the parotid gland are very rare vascular tumors, especially among adults. This case report discusses the presentation and challenges of diagnosing a venous vascular malformation of the parotid gland in a patient with previous oncologic history. Our patient is a 45-year-old female with a history of breast cancer, meningioma, and secreting pituitary adenoma who presented with a malformation on magnetic resonance imaging, incidentally demonstrating a T2 intense mass in the superficial lobe of the right parotid gland. She was otherwise asymptomatic. Ultrasound-guided fine needle aspiration was nondiagnostic. She underwent a right inferior superficial parotidectomy. Histologic section analysis demonstrated a well-delineated vascular tumor made of large vascular spaces with thin walls surrounded by a parotid tissue consistent with a venous vascular malformation of the parotid gland. Venous vascular malformations are exceedingly rare, especially among adults. Ultrasound-guided fine needle aspiration can be of limited value. Parotidectomy may be electively considered for diagnostic and therapeutic purposes., Competing Interests: The authors declare no conflict of interest., (© 2024 The Authors. World Journal of Otorhinolaryngology ‐ Head and Neck Surgery published by John Wiley & Sons Ltd on behalf of Chinese Medical Association.)

Introduction and Importance: Lipomatous neoplasms of the parotid gland represent an exceptionally rare and often underdiagnosed category of tumors, accounting for an incidence ranging from 0.6 % to 4.4 % of all neoplasms detected within the parotid gland. Sialolipoma is defined as an uncommon variant of lipoma, characterized by a well-defined proliferation of mature adipocytes with secondary entrapment of salivary gland elements, including serous acini, ducts, and myoepithelial cells., Case Presentation: The current case pertains to a 17-year-old female who presented with a one-year history of enlargement in the left preauricular region., Clinical Discussion: The case we present poses a complex diagnostic challenge due to two distinct characteristics. The diagnostic challenge lies in its remarkably low incidence and the propensity for confusion with pleomorphic adenoma, which is the most common tumor of the parotid gland. It is a benign disease entity characterized by the absence of dysplasia, in marked contrast to pleomorphic adenoma., Conclusions: The infrequency in the manifestation of these tumor types, coupled with their prolonged asymptomatic course, can pose a diagnostic challenge. Enhancing our knowledge to comprehensively delineate these entities is imperative to effectively address the diagnostic complexities from both clinical and histopathological standpoints., Competing Interests: Conflict of interest statement Nothing to declare., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Basal cell adenoma (BCA) is a rare, benign tumor originating from the epithelial cells of the salivary glands. It was earlier categorized as a subtype of monomorphic adenoma with distinctive histopathological features. BCA usually manifests as asymptomatic, slow-growing masses that exhibit a site and age predilection, commonly affecting the major salivary glands of elderly female patients. Histologically, solid, trabecular, tubular, and membranous patterns are recognized. It is imperative to establish a precise distinction between BCA, pleomorphic adenoma, and malignant salivary gland tumors before initiating treatment to ensure effective management. The standard treatment approach is surgical resection of the tumor. Recurrence and malignant transformation rarely occur, except for the membranous subtype. This article aims to report an unusual case of BCA arising from a minor salivary gland in the upper lip. The post-operative course was unremarkable, with complete healing of the surgical site. No recurrence was observed during a one-year follow-up. BCA arising from a minor salivary gland in the upper lip is an extremely uncommon entity. A comprehensive review of BCA in the upper lip, reported from 1991 to December 2023, revealed only 14 cases., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ahmad et al.)

Salivary gland tumors (SGTs) are a relevant, highly diverse subgroup of head and neck tumors whose entity determination can be difficult. Confocal Raman imaging in combination with multivariate data analysis may possibly support their correct classification. For the analysis of the translational potential of Raman imaging in SGT determination, a multi-stage evaluation process is necessary. By measuring a sample set of Warthin tumor, pleomorphic adenoma and non-tumor salivary gland tissue, Raman data were obtained and a thorough Raman band analysis was performed. This evaluation revealed highly overlapping Raman patterns with only minor spectral differences. Consequently, a principal component analysis (PCA) was calculated and further combined with a discriminant analysis (DA) to enable the best possible distinction. The PCA-DA model was characterized by accuracy, sensitivity, selectivity and precision values above 90% and validated by predicting model-unknown Raman spectra, of which 93% were classified correctly. Thus, we state our PCA-DA to be suitable for parotid tumor and non-salivary salivary gland tissue discrimination and prediction. For evaluation of the translational potential, further validation steps are necessary.

Background: Salivary carcinosarcoma is an extremely rare tumor containing both malignant epithelial and mesenchymal constituents. This article reports a rare case of carcinosarcoma with salivary duct carcinoma and osteosarcoma as the tumor components. The clinicopathological characteristics, treatment, and prognosis are discussed in conjunction with the literature., Case Summary: A 48-year-old man presented with a complaint of a mass in the right parotid region. Osteosarcoma was first considered for assessment by fine-needle aspiration cytology. Physical examination revealed a mass measuring approximately 4 cm × 3.5 cm × 3 cm. The mass, the whole lobe of the right parotid gland, and the right mandible were completely removed during surgery. Postoperative histopathology confirmed carcinosarcoma of the salivary gland., Conclusion: A definite diagnosis of salivary gland carcinosarcoma can only be obtained after complete surgical resection., Competing Interests: Conflict-of-interest statement: All the authors have declared that they have no potential conflicts of interest and no financial relationships relevant to this article., (©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.)

Ultrasound is the primary tool for evaluating salivary gland tumors (SGTs); however, tumor diagnosis currently relies on subjective features. This study aimed to establish an objective ultrasound diagnostic method using deep learning. We collected 446 benign and 223 malignant SGT ultrasound images in the training/validation set and 119 benign and 44 malignant SGT ultrasound images in the testing set. We trained convolutional neural network (CNN) models from scratch and employed transfer learning (TL) with fine-tuning and gradual unfreezing to classify malignant and benign SGTs. The diagnostic performances of these models were compared. By utilizing the pretrained ResNet50V2 with fine-tuning and gradual unfreezing, we achieved a 5-fold average validation accuracy of 0.920. The diagnostic performance on the testing set demonstrated an accuracy of 89.0%, a sensitivity of 81.8%, a specificity of 91.6%, a positive predictive value of 78.3%, and a negative predictive value of 93.2%. This performance surpasses that of other models in our study. The corresponding Grad-CAM visualizations were also presented to provide explanations for the diagnosis. This study presents an effective and objective ultrasound method for distinguishing between malignant and benign SGTs, which could assist in preoperative evaluation.

Cribriform adenocarcinoma of salivary gland (CASG) is a rare form of salivary gland neoplasm that mostly arises from minor salivary glands. We report a case of CASG with high-grade transformation harboring a novel STRN3::PRKD1 fusion. A 59-year-old male presented with a palatal mass. Morphologically, the tumor consisted of two components: solid high-grade and glandular low-grade areas. The solid high-grade area comprised solid nests of high-grade carcinoma with central necrosis arranged in lobules delineated with prominent stromal septa. The glandular low-grade area comprised of cribriform and microcystic architecture in a hyalinized and hypocellular stroma. Immunophenotypically, the tumor was positive for S100 but negative for p40 and actin. However, due to the high-grade component, tissue was sent for salivary gland NGS fusion panel analysis to confirm the diagnosis. The current case illustrates high-grade transformation in CASG. Furthermore, identification of a STRN3::PRKD1 fusion expands the genetic spectrum of CASG., (© 2023 Wiley Periodicals LLC.)

Objectives: The present study aimed to characterize the ultrasonography (US) features of cystic components in salivary gland tumors (SGTs)., Materials and Methods: A total of 207 patients (218 lesions) with pathologically confirmed primary SGTs were analyzed. Preoperative US revealed the presence of cystic components in lesions. Lesion size, shape, margin, and US findings of the cystic components, including number, distribution, margin, occupying rate, and internal characteristics, were evaluated., Results: Similarities were observed between the US performance of benign SGTs (B-SGTs) and malignant SGTs (M-SGTs) with cystic components. Differences in sex and age of patients, number, distribution, and internal characteristics of cystic components were statistically significant. For SGTs with cystic components, the proportions of M-SGTs to ill-defined margins (P = 0.002), eccentric distribution (P = 0.019), and none of the internal characteristics (P = 0.019) were significantly higher than those of B-SGTs. Younger age (P = 0.001), eccentric distribution (P = 0.034) and ill-defined margin (P < 0.001) were risk factors for diagnosing M-SGTs. Cystic component features needed to be combined with lesion indicators (border and shape) to improve diagnostic sensitivity., Conclusions: US features of the B-SGTs and M-SGTs were significantly different. Cystic component is of interest in the US-related differential diagnosis of B-SGT and M-SGT., Clinical Relevance: Cystic components are potentially valuable in the differential diagnosis of B-SGTs and M-SGTs on US., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Lymphadenomas are rare benign tumors of the major salivary glands that are further classified as sebaceous and non-sebaceous. No association with viruses has been reported so far. Little is known about the mechanisms that allow lymphadenomas to undergo malignant transformation. Among these rare instances, there has never been a malignant transformation to Epstein-Barr virus (EBV)-associated lymphoepithelial carcinoma., Methods: Clinical data of the reported case were retrieved from the patient's electronic medical record. Hematoxylin & eosin-stained slides, immunohistochemical tests, and in situ hybridization performed for routine diagnostic purposes were reviewed., Results: We report a salivary gland sebaceous lymphadenoma in which the luminal components were mostly replaced by malignant epithelial cells with markedly atypical nuclear features. Presence of EBV was demonstrated in all components by EBER. The morphological and immunohistochemical findings were consistent with a lymphoepithelial carcinoma arising from a sebaceous lymphadenoma., Conclusion: We report the first case of an Epstein-Barr virus-associated lymphoepithelial carcinoma arising from a sebaceous lymphadenoma., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: The histopathological classification of salivary gland tumors is extremely complex. The imaging manifestations of some tumors are nonspecific. It is particularly important to improve the value of ultrasound in the diagnosis of salivary gland tumors. This study aimed to analyze the diagnostic value of different parameters of shear wave elastography (SWE) in the quantitative diagnosis of salivary gland tumors, and to evaluate the value of SWE combined with conventional ultrasound., Methods: The study was conducted retrospectively. Patients who underwent salivary gland tumor resection from April 2021 to November 2022 in the Ninth People's Hospital, Shanghai Jiaotong University School of Medicine were randomly recruited to the study. A total of 305 masses were divided into an elastography group (150 cases) and a control group (155 cases). The control group underwent conventional ultrasonography, whereas the elastography group underwent conventional ultrasonography and elastography. The Young's modulus E of the mass was quantitatively measured in the elastography group, including maximum cross-sectional area (S), maximum Young's modulus (Emax), mean Young's modulus (Emean), and Young's modulus standard deviation (SD). Pathologic diagnosis was used as the reference standard to determine the cut-off of shear wave elastography of salivary gland tumors, and the diagnostic performance of the 2 groups was compared., Results: In the elastography group, the diagnostic value of Emax·S (the product of the maximum Young's modulus of the mass and the maximum cross-sectional area of the mass) in the differential diagnosis of malignant tumors (MT) and non-malignant tumors (NMT) was the highest, with a sensitivity and specificity of 72.0% and 80.0%, respectively. The diagnostic value of Emax/D (the quotient of the maximum Young's modulus of the mass and the maximum diameter of the mass) in the differential diagnosis of pleomorphic adenoma (PA) and adenolymphoma (AL) was the highest, with a sensitivity and specificity of 62.3% and 82.4%, respectively. The receiver operating characteristic (ROC) curves for the diagnosis of salivary gland tumors were compared between the elastography group and the control group. The area under the curve (AUC) of the elastography group was 0.915, the sensitivity, specificity, and Youden index were 84.0%, 88.0%, and 0.720, respectively. The AUC of the control group was 0.906, the sensitivity, specificity, and Youden index were 76.0%, 90.0%, and 0.660, respectively, which is the main finding of the study., Conclusions: SWE can be used as a complementary method for the diagnosis of salivary gland tumors, which has certain value in improving the diagnostic performance. As a result, the sensitivity is improved but the specificity is worsened by addition of SWE to B-mode ultrasound and color Doppler flow imaging (CDFI)., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://qims.amegroups.com/article/view/10.21037/qims-23-103/coif). All authors report this work was supported by the National Natural Science Foundation of China (No. 81971618), the Shanghai Municipal Commission of Science and Technology (No. 23ZR1438000), and the Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine (No. JYJC202132). The authors have no other conflicts of interest to declare., (2023 Quantitative Imaging in Medicine and Surgery. All rights reserved.)

Salivary duct carcinoma (SDC) is an aggressive type of salivary gland carcinoma. Recently, immunotherapies targeting immune checkpoints, including PD1, PD-L1, CTLA4, and LAG3, have had a considerable prognostic impact on various malignant tumors. The implementation of such immune checkpoint inhibitor (ICI) therapies has also been attempted in cases of salivary gland carcinoma. The tumor immune microenvironment (TIME) is implicated in tumorigenesis and tumor progression and is closely associated with the response to ICI therapies. However, the TIME in SDC has not been fully explored. We examined the immunohistochemical expression of CD8, FOXP3, PD1, PD-L1, CTLA4, LAG3, and mismatch repair (MMR) proteins, tumor-infiltrating lymphocytes (TILs), and microsatellite instability (MSI) status in 175 cases of SDC. The associations between these TIME-related markers and the clinicopathological factors and prognosis were evaluated. An elevated expression of CD8, FOXP3, PD1, CTLA4, and LAG3 was associated with more aggressive histological features and an advanced N and/or M classification, elevated Ki-67 index, and poor prognosis. Furthermore, cases with a high PD-L1 expression exhibited more aggressive histological features and adverse clinical outcomes than those with a low expression. Alternatively, there was no significant correlation between TILs and clinicopathological factors. No SDC cases with an MSI-high status or MMR deficiency were found. The coexistence of both an immunostimulatory and immunosuppressive TIME in aggressive SDC might play a role in the presence of T-cell exhaustion. The contribution of multiple immune escape pathways, including regulatory T cells and immune checkpoints, may provide a rationale for ICI therapy, including combined PD1/CTLA4 blockade therapy., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Liquid-based cytology (LBC), now used globally for the head and neck region, has been used at our hospital since 2011. This study was designed to analyze the efficacy of LBC with immunocytochemical staining on preoperative diagnosis of salivary gland tumors., Methods: This retrospective analysis of fine-needle aspiration (FNA) performance for salivary gland tumors was conducted at Fukui University Hospital. Salivary gland tumor operations conducted during April 2006 - December 2010 (84 cases) were classified as the Conventional Smear (CS) group, which were diagnosed morphologically by Papanicolaou and Giemsa staining. Those done during January 2012 - April 2017 (112 cases) were classified as the LBC group, which were diagnosed using LBC samples with immunocytochemical staining. The FNA results and pathological diagnosis of both groups were analyzed to calculate the FNA performance., Results: Compared to the CS group, cases of inadequate and indeterminate FNA sample were not reduced significantly by LBC with immunocytochemical staining. As for FNA performance, the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of CS group were, respectively, 88.7%, 53.3%, 100%, 100%, and 87.0%. Those of LBC group were all 100%, representing significant improvement over the CS group., Conclusions: Analysis results indicated the usefulness of LBC with immunocytochemical staining for preoperative diagnosis of salivary gland tumors., Competing Interests: Declaration of Competing Interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Norihiko Narita reports a relationship with University of Fukui Faculty of Medical Sciences that includes: employment., (Copyright © 2023 The Authors. Published by Elsevier GmbH.. All rights reserved.)

The aim of this study was to analyze the clinical outcomes of three types of minor salivary gland carcinomas (adenoid-cystic carcinomas (ACC), adeno carcinomas not otherwise specified (AC-NOS), and mucoepidermoid carcinomas (MEC)) after primary surgical therapy. A retrospective cohort study was designed and patients with cancer of the minor oral salivary glands treated in our department in the years 2011 to 2022 were included. Clinicopathological data were evaluated to compare overall survival and progression-free survival between the entities. Eighty-one patients were included. The rates of cervical metastases were 38.9% for ACC, 25% for MEC, and 9.1% for AC-NOS. ACC exhibited significantly higher rates of local and systemic disease recurrence ( p = 0.02), and the presence of neck node metastases was confirmed as an independent prognostic factor for progression-free survival ( p = 0.014). Treatment success in terms of oncological outcome varied significantly between the different entities and implies different treatment regimens for each tumor entity.

Objectives: To evaluate the prognostic and locoregional metastatic features of carcinoma ex pleomorphic adenoma of submandibular gland (SMG-CXPA) and improve the understanding of this uncommon condition., Patients and Methods: We retrospectively reviewed patients who were diagnosed with SMG-CXPA. The survival data of SMG-CXPA patients were statistically analyzed using Cox regression and Kaplan-Meier method. The associations between cervical metastasis and clinicopathological parameters were evaluated using chi-squared test. Additionally, two different histological categories (histological grade and invasiveness) and their combination were evaluated with the Kaplan-Meier method and receiver operating characteristic curves., Results: In total, 86 patients were diagnosed: 38 clinically node-negative, 31 pathologically node-negative, and 17 node-positive patients. Clinical tumor stage and histological grade were two independent prognostic factors for SMG-CXPA. There were significant correlations between sex, tumor size, clinical tumor stage, clinical lymph node stage, histological grade, invasiveness, malignant components, perineural invasion, and no specific criteria exist for the clinical outcome., Conclusion: SMG-CXPA is a high-grade malignancy with an unfavorable prognosis. Elective neck dissection should be performed in SMG-CXPA patients with a risk of locoregional metastasis. Histological grade seems to be a more valuable predictor of lymph node involvement than invasiveness., (© 2022 Wiley Periodicals LLC.)

Salivary gland-type intraductal carcinoma (IC) is a rare malignant salivary gland neoplasm. Primary salivary gland-type IC has never been described in the lung. Herein, we present a primary pulmonary IC in a 63-year-old woman. The tumor originated in the bronchus wall of the right middle lobe. The tumor consisted of two histological types, intercalated component and oncocytic component. The intercalated component showed tubular/cystic pattern composed of column to cube-shaped cells and scattered mucous cells. The oncocytic component showed solid nests composed of large cells with abundant eosinophilic granular cytoplasm. Immunohistochemically, both histological components were positive for cytokeratin 7 (CK7), S-100 protein, SOX10, and mammaglobin. The rimming myoepithelial cells were highlighted by p63 and smooth muscle actin (SMA). The tumor cells were negative for androgen receptor (AR), HER-2, Dog-1, TTF-1, napsin A, GCDFP-15, and GATA3. In the present case, we detected KIAA1217::RET fusion via DNA-based next-generation sequencing (NGS) and RT-PCR, which established the diagnosis of IC at a molecular level. The present case expands the categories of bronchopulmonary salivary gland-type tumors., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: Mammary analogue secretory carcinoma (MASC) is characterized by similar histologic, immunohistochemical, and molecular features with breast secretory carcinoma. MASC usually occurs in adults. Case report: A 4-year-old boy presented with a right infra-auricular mass. Features of the tumor include solid, tubular, and papillary growth patterns, with homogenous eosinophilic secretions inside microcystic structures. Immunohistochemical stains showed strong, diffuse staining for CK7, S100, pan-TRK protein. P63 was positive in a peripheral pattern. Fluorescence in situ hybridization (FISH) analysis showed the characteristic ETV6-NTRK3 gene fusion. Conclusion: Typical histological, immunohistochemical, and molecular features are present in MASC occurring early in childhood.