Sclerosing microcystic adenocarcinoma of the tongue: a report of two further cases and review of the literature.

Publication date: Available online 9 January 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): A. Wood, B.I. Conn
We present two further cases of sclerosing microcystic adenocarcinoma occurring in the tongue of two female patients; one aged 68 years old and the other 49 years old. Histopathologically, both tumours were characterized by a diffusely infiltrative lesion consisting of small cuboidal cells arranged in discrete, dispersed cords, isolated tubules and bilayered strands with intervening microcystic lumina set in a sclerotic background. Both lesions showed striking neurotopism with perineural and intraneural infiltration. Extensive invasion of adjacent skeletal muscle was also observed. The tumour cells showed diffuse staining with antibodies to CK7. A dual population of ductal and myoepithelial cells was identified, with antibodies to CAM5.2 & CK5/6 decorating the inner epithelial layer and antibodies to p63, p40 and S100 staining the outer myoepithelial cell layer. The Ki-67 proliferation index in both cases was <5%. An initial diagnosis of adenocarcinoma NOS of salivary gland origin was made on both incisional biopsies with a possible metastatic origin, particularly from breast, also raised. A local minor salivary gland origin was confirmed after staging investigations and surgical resection. Both patients were treated by surgery alone and remain well five years and one year and two months post treatment respectively.



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