acid-phosphatase and Salivary-Gland-Neoplasms

Salivary duct carcinoma (SDC) is an uncommon, pathologically distinct entity characterized by its morphologic resemblance to ductal carcinoma of the breast and highly aggressive behavior. Approximately two thirds of patients die within 4 years of initial diagnosis despite aggressive, combined surgical resection and radiotherapy. Review of the literature indicates that androgen receptor (AR), a marker frequently detected in prostatic carcinoma, is expressed in over 90% of SDCs, whereas two common breast carcinoma markers, estrogen and progesterone receptors (ER and PR), are expressed in only 1.3% and 6% of the tumors, respectively, by immunohistochemistry. This hormonal profile suggests that SDC, in contrast to its histiologic similarity to ductal carcinoma of the breast, is immunophenotypically more related to prostatic carcinoma. To substantiate this hypothesis, we performed immunohistochemical staining of 13 cases of SDC for the presence of AR and two prostatic markers, prostate specific antigen (PSA) and prostatic acid phosphatase (PAP). Our results showed multifocal, scattered, moderate immunostaining for PAP and diffuse, moderate immunostaining for PSA in seven (58.3%) and two (16.7%) cases, respectively. These results create a potential diagnostic challenge to surgical pathologists who are dealing with a metastatic adenocarcinoma of AR+/PSA+/-/PAP+/- phenotype, particularly in male patients of unknown primary. Metastatic salivary duct carcinoma should be given serious thought if clinical investigation fails to reveal a prostatic primary. The immunophenotypic homology that exists between SDC and prostatic carcinoma also suggests that antiandrogen therapy as used in the treatment of prostatic carcinoma might be beneficial in patients with metastatic SDC when all other conventional modalities fail.

Topics: Acid Phosphatase; Adult; Aged; Aged, 80 and over; Carcinoma, Ductal, Breast; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Immunoenzyme Techniques; Male; Middle Aged; Prostate-Specific Antigen; Receptors, Androgen; Salivary Ducts; Salivary Gland Neoplasms

A 66-year-old man presented with a mass just behind the lower part of the left ear. A biopsy showed a moderately differentiated adenocarcinoma that was prostate-specific antigen (PSA)- and prostate-specific acid phosphatase (PSAP)-positive. This finding suggested a metastasis of a prostatic carcinoma. Extensive clinical and radiographical examination revealed no primary prostatic carcinoma or other metastases and serum levels of PSAP and PSA were not elevated. The reliability of the PSA and PSAP staining was studied in a series of 25 adenocarcinomas of various primary sites in females and in 26 salivary gland tumors in both males and females, because a primary adenocarcinoma of salivary gland seemed another possibility in this case. As expected, there was no immunoreactivity for PSA and PSAP in the adenocarcinomas from females, but 6 of 11 pleomorphic adenomas, 0 of 4 monomorphic adenomas, 1 of 6 mucoepidermoid carcinomas, and 1 of 2 adenocarcinomas not otherwise specified (NOS) of the salivary gland showed at least focal staining of both PSA and PSAP. The conclusion was that the patient had a primary salivary gland adenocarcinoma NOS. In males with PSA- and PSAP-positive adenocarcinoma without signs of primary prostatic carcinoma, a salivary gland origin should be considered.

Topics: Acid Phosphatase; Adenocarcinoma; Aged; Female; Humans; Immunohistochemistry; Male; Neoplasms, Unknown Primary; Prostate; Prostate-Specific Antigen; Reference Values; Salivary Gland Neoplasms; Salivary Glands; Staining and Labeling

Two types of salivary monomorphic adenomas, the so-called adenolymphoma and oncocytoma (75 cases in a series of 873 salivary gland tumors) were studied. These tumors were almost always located in major salivary glands (essentially in the parotid gland). They were much more common in men (85%) than in women. The oncocyte represented the characteristic cell in these two neoplasms. By electron microscopy, they were seen to contain numerous and abnormal mitochondriae and well-developed lysosomal systems. These findings were correlated with a high level of activity of oxidative enzymes and of acid phosphatases. The histogenesis of these tumors was discussed. They seemed to arise from aberrant striated ducts embedded in heterotopic lymph nodes. The tumoral oncocytes would suffer a primary disturbance of their oxidative metabolism followed by a compensative mitochondrial hypertrophy.

Topics: Acid Phosphatase; Adenolymphoma; Adenoma; Female; Humans; Male; Microscopy, Electron; Salivary Gland Neoplasms

Topics: Acid Phosphatase; Age Factors; Alkaline Phosphatase; Carcinoma, Adenoid Cystic; Female; Humans; Leucyl Aminopeptidase; Male; Microscopy, Electron; Middle Aged; Ribosomes; Salivary Gland Neoplasms

Topics: Acid Phosphatase; Alkaline Phosphatase; Bone Neoplasms; Breast Neoplasms; Esterases; Female; Histocytochemistry; Humans; Leukemia; Lipids; Lymphatic Metastasis; Male; Methods; Neoplasms; Peroxidases; Polysaccharides; Salivary Gland Neoplasms; Sex Chromatin; Skin Neoplasms; Staining and Labeling; Uterine Neoplasms

Topics: Acid Phosphatase; Adenocarcinoma, Mucinous; Adenoma; Adenoma, Pleomorphic; Adenosine Triphosphatases; Adult; Aged; Alkaline Phosphatase; Carcinoma, Adenoid Cystic; Cystadenoma; Dihydrolipoamide Dehydrogenase; Female; Glucosephosphate Dehydrogenase; Histocytochemistry; Humans; Leucyl Aminopeptidase; Male; Middle Aged; Monoamine Oxidase; Parotid Neoplasms; Salivary Gland Neoplasms; Succinate Dehydrogenase

Topics: Acid Phosphatase; Alkaline Phosphatase; Biopsy; Carcinoma, Adenoid Cystic; Ear Neoplasms; Ear, External; Esterases; Exocrine Glands; Glycogen; Histocytochemistry; Humans; Lipids; Microscopy, Electron; Salivary Gland Neoplasms; Succinate Dehydrogenase; Tracheal Neoplasms

Topics: Acid Phosphatase; Aged; Alkaline Phosphatase; Aminopeptidases; Carcinoma, Adenoid Cystic; Esterases; Female; Galactosidases; Humans; In Vitro Techniques; Male; Middle Aged; Salivary Gland Neoplasms; Salivary Glands; Succinate Dehydrogenase

Topics: Acid Phosphatase; Adenolymphoma; Alkaline Phosphatase; Cystadenoma; Cystadenoma, Papillary; Electron Transport Complex II; Esterases; Galactosidases; Glycosaminoglycans; Hamartoma; Histocytochemistry; Humans; Leucyl Aminopeptidase; Pathology; Salivary Gland Neoplasms; Succinate Dehydrogenase

Topics: Acid Phosphatase; Adenocarcinoma; Benz(a)Anthracenes; Carcinogens; Carcinoma, Squamous Cell; Esterases; Fibrosarcoma; Galactosidases; Histocytochemistry; Neoplasms, Experimental; Pathology; Rats; Research; Salivary Gland Neoplasms; Submandibular Gland; Submandibular Gland Neoplasms; Succinate Dehydrogenase; Toxicology

Topics: Acid Phosphatase; Aminopeptidases; Benzopyrenes; Cytoplasm; Esterases; Fibroblasts; Fibrosarcoma; Galactosidases; Histocytochemistry; Neoplasms; Neoplasms, Experimental; Pathology; Rats; Research; Salivary Gland Neoplasms; Submandibular Gland