High-grade salivary gland tumors are extremely important to recognize in FNA samples. In contrast to benign and low-grade salivary gland neoplasms, which are managed conservatively, the diagnosis of a high-grade salivary gland tumor will usually result in an aggressive clinical response that can include radical surgical resection, nerve sacrifice, lymph node dissection, and chemoradiation therapy. Among the more common high-grade salivary gland cancers that will be discussed in this chapter are salivary duct carcinoma, high-grade mucoepidermoid carcinoma, and carcinoma ex pleomorphic adenoma. With regard to impact on clinical management, the primary goal is to diagnose the tumor as a “high-grade carcinoma,” rather than focusing on the specific subtype of high-grade carcinoma. As will be discussed in more detail, this is fortunate, since there is significant cytologic overlap between the 3 major high-grade salivary gland tumors. Other even rarer high-grade salivary gland malignancies that can be encountered include primary squamous cell carcinoma, small cell carcinoma, undifferentiated carcinoma, and certain metastatic cancers.
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Faquin, W.C., Powers, C.N. (2008). High-Grade Salivary Gland Tumors: Salivary Duct Carcinoma, High-Grade Mucoepidermoid Carcinoma, and Carcinoma ex Pleomorphic Adenoma. In: Faquin, W.C., Powers, C.N. (eds) Salivary Gland Cytopathology. Essentials in Cytopathology Series, vol 5. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-76623-2_10
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