Head and Neck Pathology

, Volume 7, Supplement 1, pp 68–76

Carcinoma Ex Pleomorphic Adenoma, with Particular Emphasis on Early Lesions

Invited Review: An Update on Salivary Gland Pathology

DOI: 10.1007/s12105-013-0454-z

Cite this article as:
Di Palma, S. Head and Neck Pathol (2013) 7(Suppl 1): 68. doi:10.1007/s12105-013-0454-z


Carcinoma ex pleomorphic adenoma (CXPA) is a broad category of carcinomas of the salivary glands which includes at least 2 clinically relevant categories; one is referred here as early CXPA (ECXPA), the other as widely invasive CXPA. The former includes several histological patterns ranging from non-invasive/in situ/intraductal/intratubular, early invasive/extratubular/intracapsular and extracapsular (up to 6 mm). The latter includes any CXPA with invasion of >6 mm. The clinical behaviour of ECXPA is not aggressive and tends to overlap that of a pleomorphic adenoma (PA) which makes the histological report of carcinoma contradictory. These early malignant changes in PA are known since the 1970s but it has been the use of immunohistochemical and molecular genetic analysis for HER-2 and TP53 gene in the last decade that has clarified the genuine malignant nature of the cells. HER-2 and TP53 gene and protein are involved in the early stages of malignant transformation of PA. Moreover the immunohistochemical over-expression HER-2, p53 protein and Mib-1 proliferation marker may be useful markers to identify malignant areas in PA.


Carcinoma ex pleomorphic adenoma (CXPA) ECXPA Salivary gland HER-2 gene and protein TP53 

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of HistopathologyThe Royal Surrey County HospitalGuildfordUK
  2. 2. Division of Clinical MedicineUniversity of SurreyGuildfordUK

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