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Salivary glands have essential roles in maintaining oral health, mastication, taste and speech, by secreting saliva. Salivary glands are composed of several types of cells, and each cell type is predicted to be involved in the carcinogenesis of different types of cancers including adenoid cystic carcinoma (ACC), acinic cell carcinoma (AciCC), salivary duct carcinoma (SDC), myoepithelial carcinoma (MECA) and other histology. In our study, we performed single nucleus RNA-seq on three human salivary gland samples to clarify the gene expression profile of each complex cellular component of the salivary glands and related these expression patterns to expression found in salivary gland cancers (SGC) to infer cell of origin. By single nucleus RNA-seq, salivary gland cells were stratified into four clusters: acinar cells, ductal cells 1, ductal cells 2 and myoepithelial cells/stromal cells. The localization of each cell group was verified by IHC of each cluster marker gene, and one group of ductal cells was found to represent intercalated ductal cells labeled with HES1. Furthermore, in comparison with SGC RNA-seq data, acinar cell markers were upregulated in AciCC, but downregulated in ACC and ductal cell markers were upregulated in SDC but downregulated in MECA, suggesting that markers of origin are highly expressed in some SGC. Cell type expressions in specific SGC histology are similar to those found in normal salivary gland populations, indicating a potential etiologic relationship.

Background: The extent of surgery in cases of parotid gland pleomorphic adenoma (PA) remains challenging. This study aims to evaluate the importance of surgical margins in ensuring safe surgery for patients with PA. Materials and Methods: This prospective study was conducted to evaluate the risk of local recurrence based on surgical margins in patients with parotid PA who underwent superficial or total parotidectomy between May 2019 and November 2021 at a tertiary referral hospital in Tehran, Iran. Patients were followed for at least 2 years. Data were analyzed using SPSS version 23. The normality of data distribution was assessed using the Kolmogorov–Smirnov test. Quantitative and qualitative variables were analyzed with the independent t -test and Chi-square test, respectively. A P < 0.05 was considered statistically significant. Results: Fifty-seven cases were included in the study. The mean age was 40.7 years, with 37 of 57 (64.9%) patients being female. Of these, 35 of 57 (61.4%) underwent superficial parotidectomy. All tumors were resected with negative margins, with an average safe margin of 0.58 cm (range: 0–3.7 cm). The greatest margin was found at the anterior side (average: 0.76 cm), whereas the smallest margin was at the vertical side (average: 0.39 cm). Postoperative radiotherapy was not administered to patients with close surgical margins. No recurrence was observed after a 2-year follow-up. Conclusion: In the surgical resection of parotid PA, negative margins are sufficient, and there is no need to obtain additional safe margins to reduce the risk of recurrence. Therefore, extracapsular dissection (which carries higher morbidities) can be replaced by superficial parotidectomy with negative margins (which carries lower morbidities). [ABSTRACT FROM AUTHOR]

Background: Primary salivary gland carcinomas (SGC) are rare neoplasms that present therapeutic challenges especially in recurrent tumors. The aim of this study was to investigate the incidence and distribution of tumor recurrence, associated risk factors, and survival. Methods: This analysis includes data from 318 patients treated for SGC between 1992 and 2020. Survival analysis was performed using the Kaplan–Meier method. Univariate and multivariate analyses were used to identify risk factors associated with recurrence. Results: 21.7% of the patients developed recurrent disease after a mean of 38.2 months. In multivariate analysis, positive‐resection margins, vascular invasion, and tumor localization in the submandibular gland and small salivary glands were independent factors for recurrence. The 5‐year overall survival was 67%, the 5‐year disease‐free survival was 54%. Conclusion: Tumor recurrence in SGC occurred in one out of five patients. In highly aggressive entities and patients with risk factors, treatment intensification should be considered. [ABSTRACT FROM AUTHOR]

Abstract Background While statistically rare in comparison to other head and neck tumours, parotid gland swellings are often encountered in clinical practice where one of the primary goals of examination becomes distinction between benign and malignant lesions. Hallmarks of malignancy are characterized by a female preponderance, history of radiation exposure, a positive family history, and clinical features like heterogenous consistency, fixity to skin/underlying tissues and involvement of facial nerve. Case presentation Here we present a case of parotid swelling in a 72-year old gentleman from south India that had a curious amalgamation of both benign and malignant features. Conclusions While benign, the risk of malignant transformation and rare multicentric occurrence indicates a need to keep basal cell adenoma in mind in case of parotid swellings and their surgical management.

\nIntroduction: This study aimed to report the efficacy and safety of adjuvant sequential chemotherapy after definitive treatment of salivary duct carcinoma (SDC) compared with the standard treatment alone (surgery with postoperative radiation therapy). Methods: This was a retrospective study of pathologically confirmed 135 SDC patients (study period 2009 to 2022). After curative surgery and adjuvant radiation therapy, 55 of 135 patients decided to receive additional chemotherapy (OP + RT + chemo group), while 80 opted for surgery and radiation (OP + RT group). Treatment outcomes of overall survival (OS), disease-free survival (DFS), and distant metastasis-free survival (DMFS) were compared using a propensity score matching (PSM) analysis. Results: Adjuvant chemotherapy consisted of three cycles of cisplatin-based regimen, which was well tolerated in most patients with minimal adverse events. Multivariable analyses indicated that the addition of chemotherapy did not improve OS (p = 0.05), DFS (p = 0.386), and DMFS (p = 0.735), although there was a trend toward favoring adjuvant chemotherapy in terms of OS. With PSM analysis, OS (OP + RT + chemo to OP + RT, hazard ratio [HR] = 0.40, 95% confidence interval [95% CI] = 0.12–1.29, p = 0.126), DFS (HR = 0.69, 95% CI = 0.30–1.56, p = 0.367), and DMFS (HR = 0.96, 95% CI = 0.46–1.99, p = 0.903) were not statistically different. Conclusions: Current cisplatin-based adjuvant chemotherapy did not significantly improve treatment outcomes of SDC patients over the surgery and adjuvant radiation. Further development or clinical studies are required to improve the outcomes of SDC, including chemotherapeutic, biomarkers, immune checkpoint inhibitors, or treatment strategies. Salivary duct carcinoma (SDC) is a rare and aggressive cancer that arises in the salivary glands. While the standard treatment involves surgery followed by radiation therapy, the prognosis remains poor, with many patients experiencing recurrence or distant spread of the disease. This study looked at whether adding chemotherapy to the standard treatment could improve SDC patient outcomes. Researchers analyzed 135 patients treated over 13 years and found that while chemotherapy was safe and well tolerated, it did not significantly improve survival or reduce the risk of recurrence. New approaches, such as targeted therapies or immune treatments, are needed to improve outcomes for patients with this challenging disease. [ABSTRACT FROM AUTHOR]

Simple Summary: Adenoid Cystic Carcinoma (AdCC) is a rare malignancy of the head and neck and is a heterogenous tumor both histologically and clinically; its prolonged asymptomatic clinical course often leads to a delayed diagnosis. Moreover, the risk of local and distant recurrence also years after primary treatment is high. In this setting, the ability to stratify patients' prognosis is crucial to better identify patients at risk of recurrence. This article explores a radiomics and clinical model to evaluate the Relapse-Free Survival (RFS) in patients with AdCC. Background/Objectives: Adenoid Cystic Carcinoma (AdCC) is a rare malignant salivary gland tumor, with high rates of recurrence and distant metastasis. This study aims to stratify patients Relapse-Free Survival (RFS) using a combined model of clinical and radiomic features from preoperative MRI. Methods: This retrospective study included patients with primary AdCC who underwent surgery and adjuvant radiotherapy. Segmentations were manually performed by two head and neck radiologists. Radiomic features were extracted using the 3D Slicer software. Descriptive statistics was performed. A Survival Random Forest model was employed to select which radiological feature predict RFS. Cox proportional hazards models were constructed using clinical, radiological variables or both. Synthetic data augmentation was applied to address the small sample size and improve model robustness. Models were validated on real data and compared using the C-index and Prediction Error Curves (PEC). Results: Three Cox models were developed: one with clinical features (C-index = 0.67), one with radiomic features (C-index = 0.68), and one combining both (C-index = 0.77). The combined clinical-radiomic model had the highest predictive accuracy and outperformed models based on clinical or radiomic features. The combined model also exhibited the lowest mean Brier score in PEC analysis, indicating better predictive performance. Conclusions: This study demonstrate that a combined radiomic-clinical model can predict RFS in AdCC patients. This model may provide clinicians a valuable tool in patient's management and may aid in personalized treatment planning. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to conduct a systematic review summarizing the clinicopathological, prognostic, and molecular features of salivary gland intraductal carcinoma (SGIC). Methods: This study followed the PRISMA 2020 guidelines and was registered in the PROSPERO database. It included case reports, case series studies, and cohort studies of SGIC indexed in the PubMed, Web of Science, Scopus, and Embase databases published between 1983 and 2024. Collected variables underwent descriptive analysis, association analysis using Fisher's tests, and Kaplan–Meier analysis. The quality assessment of the included studies was conducted using the Joanna Briggs Institute tools. Results: This systematic review yielded 59 studies, comprising 186 SGIC cases. Most of cases involved the parotid gland of male patients around 60 years old. Lesions predominantly exhibited noninvasive growth, an intercalated duct phenotype, and minimal pleomorphism. Most of the patients did not develop recurrent or metastatic disease, indicating a good prognosis. However, male sex, invasive lesions, adjuvant treatments, high-grade lesions, as well as lymph node or distant metastasis negatively affected the survival rates. Overall SGIC cases showed S100, mammaglobin, SOX10, AR, CK7, p63, calponin, CK14, SMA, and p40 positivity and a low Ki67 index. Common molecular alterations included NCOA4-RET, TRIM33-RET, and TRIM27-RET fusions, and HRAS, PIK3CA, and BRAF V600E mutations. Conclusion: SGIC is a histopathologically and molecularly heterogeneous lesion with an overall excellent prognosis. The presence of invasive lesions, as well as lymph node or distant metastasis, has emerged as one of the most critical prognostic factors in SGIC patients. [ABSTRACT FROM AUTHOR]

Although rare overall, salivary gland carcinomas (SGCs) are among the most common oral and maxillofacial malignancies. The aim of this study was to develop a machine learning-based model to predict the survival of patients with SGC. Patients in whom SGC was confirmed by histological testing and who underwent primary extirpation at the authors' institution between 1963 and 2014 were identified. Demographic and clinicopathological data with complete follow-up information were collected for analysis. Feature selection methods were used to determine the correlation between prognosis-related factors and survival in the collected patient data. The collected clinicopathological data and multiple machine learning algorithms were used to develop a survival prediction model. Three machine learning algorithms were applied to construct the prediction models. The area under the receiver operating characteristic curve (AUC) and accuracy were used to measure model performance. The best classification performance was achieved with a LightGBM algorithm (AUC = 0.83, accuracy = 0.91). This model enabled prognostic prediction of patient survival. The model may be useful in developing personalized diagnostic and treatment strategies and formulating individualized follow-up plans, as well as assisting in the communication between doctors and patients, facilitating a better understanding of and compliance with treatment. [ABSTRACT FROM AUTHOR]

Adenoid cystic carcinoma (AdCC) is a rare malignant salivary gland tumor of epithelial origin and accounts for 10% of all salivary gland neoplasms and 1% to 2% of all head and neck malignancies. It is the fifth most common malignancy of salivary gland origin. Cribriform, tubular and solid are the three recognized histopathological patterns. It is a slowgrowing tumor, but the long-term prognosis is poor with a 15-year survival rate of less than 50%. An accurate pathological diagnosis of AdCC is essential if patients are to receive timely and appropriate treatment. Present article describes a case of a 80 year old female patient with Cribriform type of AdCC on palate. [ABSTRACT FROM AUTHOR]

Background: While statistically rare in comparison to other head and neck tumours, parotid gland swellings are often encountered in clinical practice where one of the primary goals of examination becomes distinction between benign and malignant lesions. Hallmarks of malignancy are characterized by a female preponderance, history of radiation exposure, a positive family history, and clinical features like heterogenous consistency, fixity to skin/underlying tissues and involvement of facial nerve. Case presentation: Here we present a case of parotid swelling in a 72-year old gentleman from south India that had a curious amalgamation of both benign and malignant features. Conclusions: While benign, the risk of malignant transformation and rare multicentric occurrence indicates a need to keep basal cell adenoma in mind in case of parotid swellings and their surgical management. [ABSTRACT FROM AUTHOR]