J Alberty1, C August, W Stoll. 1. Klinik und Poliklinik für Hals-, Nasen- und Ohrenkrankheiten, Westfälische Wilhelms-Universität, Kardinal-von-Galen-Ring 10, 48129 Münster. alberty.hno@uni-muenster.de
Abstract
BACKGROUND AND OBJECTIVE: Oncocytic neoplasms of the salivary glands are rare. PATIENTS/ METHODS: We report on seven cases of oncocytic neoplasms of the parotid gland (one multifocal nodular oncocytic hyperplasia, five oncocytomas, and one oncocytic carcinoma). RESULTS: While the history, clinical presentation, and histology of all oncocytic neoplasms showed no characteristic differences, intraoperatively the well-differentiated oncocytic carcinoma displayed an infiltrative, locally aggressive growth pattern. A local carcinoma recurring 7 years later corresponded to the primary tumor. There were no metastases. Immunohistochemistry revealed that all oncocytic neoplasms were positive for markers of cytokeratins (KI-1) and negative for markers of carcinoembryonal antigen (CEA), S-100 protein, and smooth muscle actin (SMA). In contrast to the benign neoplasms, the oncocytic carcinoma showed an increased rate of proliferating cells (MIB-1) and a strongly positive reaction with the antibody MA-903 against high molecular weight cytokeratins. CONCLUSIONS: In a review of the literature, we could identify a group of locally aggressive, low-grade oncocytic carcinomas with a considerably better prognosis, similar to that of our case. The therapeutic significance of these findings is discussed.
BACKGROUND AND OBJECTIVE:Oncocytic neoplasms of the salivary glands are rare. PATIENTS/ METHODS: We report on seven cases of oncocytic neoplasms of the parotid gland (one multifocal nodular oncocytic hyperplasia, five oncocytomas, and one oncocytic carcinoma). RESULTS: While the history, clinical presentation, and histology of all oncocytic neoplasms showed no characteristic differences, intraoperatively the well-differentiated oncocytic carcinoma displayed an infiltrative, locally aggressive growth pattern. A local carcinoma recurring 7 years later corresponded to the primary tumor. There were no metastases. Immunohistochemistry revealed that all oncocytic neoplasms were positive for markers of cytokeratins (KI-1) and negative for markers of carcinoembryonal antigen (CEA), S-100 protein, and smooth muscle actin (SMA). In contrast to the benign neoplasms, the oncocytic carcinoma showed an increased rate of proliferating cells (MIB-1) and a strongly positive reaction with the antibody MA-903 against high molecular weight cytokeratins. CONCLUSIONS: In a review of the literature, we could identify a group of locally aggressive, low-grade oncocytic carcinomas with a considerably better prognosis, similar to that of our case. The therapeutic significance of these findings is discussed.