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Polymorphous adenocarcinoma of the salivary glands: reappraisal and update

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Abstract

Although relatively rare, polymorphous adenocarcinoma (PAC) is likely the second most common malignancy of the minor salivary glands (MiSG). The diagnosis is mainly based on an incisional biopsy. The optimal treatment comprises wide surgical excision, often with adjuvant radiotherapy. In general, PAC has a good prognosis. Previously, PAC was referred to as polymorphous low-grade adenocarcinoma (PLGA), but the new WHO classification of salivary gland tumours has also included under the PAC subheading, the so-called cribriform adenocarcinoma of minor salivary glands (CAMSG). This approach raised controversy, predominantly because of possible differences in clinical behaviour. For example, PLGA (PAC, classical variant) only rarely metastasizes, whereas CAMSG  often shows metastases to the neck lymph nodes. Given the controversy, this review reappraises the definition, epidemiology, clinical presentation, diagnostic work-up, genetics, treatment modalities, and prognosis of PAC of the salivary glands with a particular focus on contrasting differences with CAMSG.

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(Courtesy of Associate Professor Panagiota Economopoulou, University of Athens, Greece)

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Authors and Affiliations

  1. Department of Oncology-Section Head and Neck Oncology, Otorhinolaryngology-Head and Neck Surgery and Leuven Cancer Institute, University Hospitals Leuven, KU Leuven, Leuven, Belgium

    Vincent Vander Poorten & Simon Feys

  2. Multidisciplinary Salivary Gland Society, Geneva, Switzerland

    Vincent Vander Poorten, Alena Skálová, Göran Stenman, Miquel Quer & Orlando Guntinas-Lichius

  3. School of Dentistry, University of Liverpool, Liverpool, UK

    Asterios Triantafyllou

  4. Pathology Department, Liverpool Clinical Laboratories, Liverpool, UK

    Asterios Triantafyllou

  5. Department of Pathology, Charles University, Faculty of Medicine in Plzen, Plzen, Czech Republic

    Alena Skálová

  6. Department of Pathology and Genetics, Sahlgrenska Cancer Center, University of Gothenburg, Gothenburg, Sweden

    Göran Stenman

  7. Department of Pathology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Justin A. Bishop

  8. Department of Imaging and Pathology, University Hospitals Leuven, KU Leuven, Leuven, Belgium

    Esther Hauben

  9. Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Jennifer L. Hunt

  10. Epigenetics and Human Disease Laboratory, CBMR, Department of Biomedical Sciences and Medicine, University of Algarve, Faro, Portugal

    Henrik Hellquist

  11. Department of Head and Neck Surgical Oncology, University Medical Center Utrecht, Utrecht, The Netherlands

    Remco De Bree

  12. Department of Otorhinolaryngology-Head and Neck Surgery, University of Helsinki and Helsinki University Hospital, Helsinki, Finland

    Antti A. Mäkitie

  13. Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden

    Antti A. Mäkitie

  14. Department of Otolaryngology, Hospital Santa Creu i Sant Pau, Barcelona, Spain

    Miquel Quer

  15. Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia

    Primož Strojan

  16. Department of Otorhinolaryngology, Institute of Phoniatry/Pedaudiology, Jena University Hospital, Jena, Germany

    Orlando Guntinas-Lichius

  17. University of Udine School of Medicine, Udine, Italy

    Alessandra Rinaldo

  18. International Head and Neck Scientific Group, Padua, Italy

    Alfio Ferlito

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  1. Vincent Vander Poorten
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Correspondence to Vincent Vander Poorten.

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This paper was written by members and invitees of the International Head and Neck Scientific Group (http://www.IHNSG.com).

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Vander Poorten, V., Triantafyllou, A., Skálová, A. et al. Polymorphous adenocarcinoma of the salivary glands: reappraisal and update. Eur Arch Otorhinolaryngol 275, 1681–1695 (2018). https://doi.org/10.1007/s00405-018-4985-5

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