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The presence of lymphovascular invasion is considered a prognostic determinant for different human neoplasms and is frequently taken into account by surgeons and oncologists to determine patients' treatment. However, the exact frequency of this microscopic event and its prognostic impact for patients affected by adenoid cystic carcinoma (AdCC) remains unclear. Therefore, the aim of this study was to carry out a systematic review and meta-analysis to address the prevalence and the prognostic potential of lymphovascular invasion in head and neck AdCC. A literature search on PubMed, Scopus, ClinicalTrials.gov, Web of Science and ProQuest databases was undertaken in January 2019. The primary outcomes of interest were overall survival (OS) and disease-free survival (DFS). The relative frequency of lymphovascular invasion and its possible association with other clinicopathological parameters were addressed. A total of 22 studies and 2117 patients were included in this study. The frequency of lymphovascular invasion ranged from 5.2% to 72.5%. Lymphovascular invasion was associated with an increased likelihood of lymph node metastasis (OR = 2.58; 95% CI 1.61-4.12; p = 0.0001) and death (OR = 3.09; 95% CI 1.82-5.26; p = 0.0001), solid/higher-grade AdCC were more likely to present lymphovascular invasion (OR = 5.51; 95% CI 1.87-16-21; p = 0.002) and patients with this microscopic finding had a significantly lower OS (HR = 8.30; 95% CI 1.68-40.91; p = 0.009) and DFS (HR = 3.76; 95% CI 1.13-12.53; p = 0.03). In conclusion, lymphovascular invasion seems to be a significant predictor of poor prognosis for head and neck AdCC patients. [ABSTRACT FROM AUTHOR]

Summary: We compared the outcomes and rates of survival provided by surgery alone and surgery combined with postoperative radiotherapy for patients with adenoid cystic carcinoma of the palate (ACP), a rare, low-grade malignant tumor arising within the salivary glands. Fifty-eight patients with ACP were included in this retrospective study. ACP at stages T1, T2, T3, and T4 was found in 11, 32, 5, and 10 patients, respectively. The patients were treated with surgery alone or underwent surgery combined with postoperative radiotherapy. The 5, 10, and 15year survival rates were 75%, 37.5%, and 25%, respectively, among the 24 patients who underwent surgery alone. These were not significantly different from the rates of 70.6%, 35.3%, and 20.8%, respectively, among the 34 patients who underwent surgery plus postoperative radiotherapy (P= 0.21). The 5 and 10year survival rates were significantly greater among patients receiving ⩾60Gy of radiotherapy than those among patients receiving <60Gy of radiotherapy (83.3% and 45.8% vs. 40.0% and 10.0%, respectively) (P= 0.04). ACP exhibited good long-term survival rates when treated with surgery alone. Addition of postoperative radiotherapy at doses of ⩾60Gy had no effect on survival, but postoperative radiotherapy at doses of <60Gy reduced survival. Recurrence within the palate was the main cause of treatment failure. [ABSTRACT FROM AUTHOR]

Summary: The aims of this study were to investigate midkine (MK) expression patterns in salivary gland tumors (SGTs) and to evaluate the correlation between MK expression and the degree of malignancy. We performed immunohistochemistry to examine MK expression in specimens of adenoid cystic carcinoma (ACC), mucoepidermoid carcinoma (MEC), and pleomorphic adenoma (PA). In addition, we performed immunohistochemistry for CD31 and measured microvessel density (MVD), which is an indicator of angiogenesis. Immunohistochemistry showed that MK protein expression was significantly higher in specimens of malignant SGTs (ACC [P <0.01] and MEC [P <0.001]) than in benign SGT (PA) samples. Furthermore, MVD values tended to be higher in cases that exhibited high expression of MK, which indicated a significant correlation between the degree of MK expression and MVD (P <0.001). These results suggest that MK may play important roles in malignant transformation and tumor angiogenesis in SGTs. [ABSTRACT FROM AUTHOR]

Summary: The objective of this study was to investigate the expression of Glucose transporter type 1 (GLUT1) and its relation to clinicopathologic parameters in patients with salivary gland tumors. Tissue samples were 49 cases of malignant tumors, 38 cases of benign tumors, mainly pleomorphic adenoma and 10 cases of normal salivary glands. Immunohistochemically, GLUT1 Labeling Index of malignant tumor was significantly higher than benign tumor. In RT-PCR assay, GLUT1 mRNA level in malignant tumor were higher than that of normal tissue. In malignant tumors, expression of GLUT1 correlated significantly with tumor size (p =0.002) and distant metastasis (p =0.007). Cumulative survival rate of high expression group was significantly lower than that of low (p <0.001). In multivariable analysis, overall survival significantly correlated with lymph node metastasis (p =0.042) and GLUT1 expression (p =0.022). These results suggest that GLUT1 expression may provide useful prognostic information in patients with salivary gland carcinoma. [Copyright &y& Elsevier]

Summary: Alteration of the p63 protein expression has been associated with several human cancers including salivary gland tumors. We sought to assess the p63 expression in pleomorphic adenomas (PA) and carcinoma ex-pleomorphic adenomas (Ca ex-PA), since this protein has been related to myoepithelial phenotype and the biological behavior of cancer. Ten samples of PA and ten of Ca ex-PA were submitted to immunohistochemistry using a monoclonal anti-p63 antibody, clone 4A4. p63 was regularly expressed in myoepithelial cells’ nuclei of the normal glandular parenchyma and in PA, but it was completely absent in five out of the ten samples of Ca ex-PA. (P <0.05 by Fisher’s exact test). Apparently, only those cases depicting some myoepithelial differentiation were positive. Our data suggest that loss of myoepithelial differentiation is important in the evolution of Ca ex-PA, and corroborate the hypothesis that p63 antigen may be a useful marker of myoepithelial cells in salivary glands neoplasms. [Copyright &y& Elsevier]

Summary: It has been reported that cyclooxygenase-2 (COX-2) plays roles in cell proliferation, tumor invasion and inhibition of apoptosis. We reported COX-2 expression in salivary adenoma and its involvement in inhibition of apoptosis. COX-2 is known to induce a number of cytokines and growth factors. On the other hand, hepatocyte growth factor (HGF) plays roles such as cell migration, proliferation, angiogenesis and inhibition of apoptosis. Recently it has been reported that HGF also plays a role in tumor differentiation in salivary gland tumors. So, we investigated that whether COX-2 expression affected HGF expression clinicopathologically, and discussed the roles of COX-2 pathway in salivary gland tumors. Tissues samples were pleomorphic adenomas (n =40) obtained surgically. COX-2 expression and HGF expression were examined immunohistochemically. Immunostaining intensities of COX-2 and HGF were classified as +3 to 0. Spearman’s rank correlation was used to examine correlation of COX-2 and HGF expression. Furthermore, a salivary gland tumor cell line, HSG, was cultured after administration of either 0, 10, 100 units of COX-2 and quantification of HGF mRNA was analyzed by Real Time PCR using the Light Cycler System. In pleomorphic adenoma, COX-2 and HGF were mainly expressed in luminal tumor cells, and the sites of expression of the two were almost the same. Immunostaining intensity of COX-2 expression was significantly correlated with intensity of HGF expression (p =0.003, r =0.457). Moreover, the content of HGF mRNA expression increased when COX-2 was administered to salivary gland tumor cell line HSG. It is suggested that COX-2 expression may induce HGF expression in salivary gland tumors. [Copyright &y& Elsevier]

Summary: Adenoid cystic carcinoma (ACC) of the salivary gland is characterized by a prolonged but inevitably unfavorable clinical course. Recent studies suggested the transmembrane tyrosine kinase KIT to be involved in ACC pathogenesis. To investigate KIT expression in histologically defined subgroups of ACC and to clarify whether KIT gene copy number gain contributes to KIT overexpression, tumor tissue microarray sections including 55 ACC tumors were analyzed by fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC). The prevalence of positive KIT immunostaining was 89% (49/55). Strong immunostaining of KIT was only found in cribriform and tubular but never in solid subtypes (p =0.02). Average KIT staining intensity was higher in cribriform and tubular (n =37) compared to solid (n =18) ACC subtypes (p =0.005). FISH analysis revealed copy number gains of the KIT gene in 6.1% (3/49) of tumors analyzed. Our results implicate that specific KIT tyrosine kinase inhibitors such as imatinib, might be used in future therapeutic approaches against subgroups of ACC. [Copyright &y& Elsevier]

We evaluated magnetic resonance images (MRI) and the value of dynamic contrast enhanced MRI (DCE-MRI) of pleomorphic adenomas retrospectively. MRI was performed for 18 pleomorphic adenomas, including 11 cases with DCE-MRI. We obtained the following results on the MRI and DCE-MRI. (a) Pleomorphic adenomas showed a predilection for homogeneous intermediate signal intensity on T1-weighted images (T1WI), heterogeneous high signal intensity on T2-weighted images, and heterogeneous enhancement on Gd-T1WI. (b) Of 11 contrast index (CI) curves of pleomorphic adenomas, nine CI curves (81.8%) increased gradually to 600 s or increased gradually, reached a plateau, and sustained the plateau to 600 s. The remaining two (18.2%) increased gradually and decreased gradually thereafter. (c) CI curves reached the maximum CI index at 135–300 s. [Copyright &y& Elsevier]

We examined three patients with multiple synchronous Warthin’s tumors in the bilateral parotid and described the value of using dynamic MRI. The time course of the contrast index (CI curves) was calculated from a dynamic series. Warthin’s tumors showed intermediate signal intensity on T1WI, heterogeneous high and intermediate signal intensity on T2WI and a slight enhancement on Gd-T1WI. Warthin’s tumors of CI curves showed specific findings. CI curves in each lesion showed the same pattern. It was difficult to diagnose masses as Warthin’s tumors using only MR images on T1, T2 and Gd-T1WI. Dynamic MRI can distinguish Warthin’s tumors from other possible tumors except for oncocytoma. Therefore, the use of dynamic MRI is recommended as a diagnostic method for Warthin’s tumors in multiple synchronous lesions of the parotid gland. [ABSTRACT FROM AUTHOR]

Oncocytoma or oncocytic change in salivary glands normally occurs in old patients and mostly in the parotid gland, but those arising from the grossopalatine gland in young patients are extremely rare. The present case shows that oncocytic ductal structures were observed in myoepithelioma, consisting of spindle, plasmacytoid or epithelioid cells. The oncocytic tumor contained large amounts of eosinophilic granular cytoplasm and small nuclei. [Copyright &y& Elsevier]