Canalicular adenoma

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Canalicular adenoma is a type of growth that occurs in human salivary glands. It is a benign growth which occurs in the epithelial cells, and is typically arranged in columns of cells that form interconnecting cords. Canalicular adenoma is a very rare benign neoplasm; it constitutes about 1% of all salivary gland tumors and about 4% of all benign salivary gland tumors. [1] [2]

Contents

A hematoxylin and eosin stained slide of canalicular adenoma showing multifocality Salivary Canalicular Adenoma Multifocal.tif
A hematoxylin and eosin stained slide of canalicular adenoma showing multifocality

Presentation

Canalicular adenoma is most common in patients age 70 to 80, with females affected about four times as often as males. Most growths present in the upper lip; some also occur in the a few present in palate or buccal (cheek) tissue as a slowly enlarging mass. [3] The growths will often arise in multiple places at the same time or develop multiple nodes, despite not being clinically invasive or malignant. [1] [4]

Diagnosis

Canalicular adenoma growths are usually small at the time they are noticed, with an average size of about 1.6 cm. [1] Their histologic appearance is very distinct, with a channel-like pattern between cords and ribbons; the pattern has been described as resembling a "string of pearls."

A hematoxylin and eosin stained slide of canalicular adenoma showing large canaliculi Salivary Canalicular Adenoma Canalicular architecture.tif
A hematoxylin and eosin stained slide of canalicular adenoma showing large canaliculi
A hematoxylin and eosin stained slide of canalicular adenoma showing beading Salivary Canalicular Adenoma with Beading.tif
A hematoxylin and eosin stained slide of canalicular adenoma showing beading

The growths often contain are often small bight squamous balls, or morules. They also tyipcally contain a well-developed supporting tissue - a fibrous stroma - which is rich in hyaluronic acid and chondroitin sulphate. [1] In a few cases, the growths may contain small calcium deposits or microliths. Although it is seldom necessary, a pathologist can confirm the existence of canalicular adenoma through immunohistochemistry studies, with the cells reacting with pancytokeratin, S100 protein and SOX10, with a delicate GFAP reaction around the periphery. [5] [1] [6] [7] Although it is a benign tumor, a positive diagnosis of canalicular adenoma may be necessary to exclude the existence of other medical conditions such as a basal cell adenoma, pleomorphic adenoma, adenoid cystic carcinoma, and polymorphous adenocarcinoma.

Treatment

Most instances of canalicular adenoma are treated with conservative surgery. [1]

Related Research Articles

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<span class="mw-page-title-main">Adenoma</span> Type of benign tumor

An adenoma is a benign tumor of epithelial tissue with glandular origin, glandular characteristics, or both. Adenomas can grow from many glandular organs, including the adrenal glands, pituitary gland, thyroid, prostate, and others. Some adenomas grow from epithelial tissue in nonglandular areas but express glandular tissue structure. Although adenomas are benign, they should be treated as pre-cancerous. Over time adenomas may transform to become malignant, at which point they are called adenocarcinomas. Most adenomas do not transform. However, even though benign, they have the potential to cause serious health complications by compressing other structures and by producing large amounts of hormones in an unregulated, non-feedback-dependent manner. Some adenomas are too small to be seen macroscopically but can still cause clinical symptoms.

<span class="mw-page-title-main">Adenoid cystic carcinoma</span> Medical condition

Adenoid cystic carcinoma is a rare type of cancer that can exist in many different body sites. This tumor most often occurs in the salivary glands, but it can also be found in many anatomic sites, including the breast, lacrimal gland, lung, brain, Bartholin gland, trachea, and the paranasal sinuses.

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<span class="mw-page-title-main">Warthin's tumor</span> Medical condition

Warthin's tumor, also known as papillary cystadenoma lymphomatosum, is a benign cystic tumor of the salivary glands containing abundant lymphocytes and germinal centers. It is named for pathologist Aldred Scott Warthin, who described two cases in 1929.

<span class="mw-page-title-main">Pleomorphic adenoma</span> Medical condition

Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of epithelial (ductal) cells along with myoepithelial components, having a malignant potentiality. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. It derives its name from the architectural Pleomorphism seen by light microscopy. It is also known as "Mixed tumor, salivary gland type", which refers to its dual origin from epithelial and myoepithelial elements as opposed to its pleomorphic appearance.

<span class="mw-page-title-main">Perianal gland tumor</span>

A perianal gland tumor is a type of tumor found near the anus in dogs that arises from specialized glandular tissue found in the perineum. It is also known as a hepatoid tumor because of the similarity in cell shape to hepatocytes. It is most commonly seen in intact dogs and is the third most common tumor type in intact male dogs. There are two types of perianal gland tumors, perianal gland adenomas, which are benign, and perianal gland adenocarcinomas, which are malignant. Both have receptors for testosterone. Perianal gland adenomas are three times more likely to be found in intact male dogs than females, and perianal gland adenocarcinomas are ten times more common in male dogs than females. The most commonly affected breeds for adenomas are the Siberian Husky, Cocker Spaniel, Pekingese, and Samoyed; for adenocarcinomas the most commonly affected breeds are the Siberian Husky, Bulldog, and Alaskan Malamute.

<span class="mw-page-title-main">Polymorphous low-grade adenocarcinoma</span> Medical condition

Polymorphous low-grade adenocarcinoma (PLGA) is a rare, asymptomatic, slow-growing malignant salivary gland tumor. It is most commonly found in the palate.

<span class="mw-page-title-main">Acinic cell carcinoma</span> Medical condition

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<span class="mw-page-title-main">Salivary gland tumour</span> Medical condition

Salivary gland tumours, also known as mucous gland adenomas or neoplasms, are tumours that form in the tissues of salivary glands. The salivary glands are classified as major or minor. The major salivary glands consist of the parotid, submandibular, and sublingual glands. The minor salivary glands consist of 800 to 1000 small mucus-secreting glands located throughout the lining of the oral cavity. Patients with these types of tumours may be asymptomatic.

A mixed tumor is a tumor that derives from multiple tissue types. A biplastic tumor or biphasic tumor has two tissue types.

Juxtaglomerular cell tumor is an extremely rare kidney tumour of the juxtaglomerular cells, with fewer than 100 cases reported in literature. This tumor typically secretes renin, hence the former name of reninoma. It often causes severe hypertension that is difficult to control, in adults and children, although among causes of secondary hypertension it is rare. It develops most commonly in young adults, but can be diagnosed much later in life. It is generally considered benign, but its malignant potential is uncertain.

<span class="mw-page-title-main">Myoepithelioma of the head and neck</span> Medical condition

Myoepithelioma of the head and neck, also myoepithelioma, is a salivary gland tumour of the head and neck that is usually benign. When malignant, which is exceedingly rare, they are known as malignant myoepithelioma or Myoepithelial carcinoma, and they account for 1% of the salivary tumors with poor prognosis.

A sialoblastoma is a low-grade salivary gland neoplasm that recapitulates primitive salivary gland anlage. It has previously been referred to as congenital basal cell adenoma, embryoma, or basaloid adenocarcinoma. It is an extremely rare tumor, with less than 100 cases reported worldwide.

A ceruminous adenoma is a benign glandular neoplasm which arises from the ceruminous glands located within the external auditory canal. These glands are found within the outer one third to one half of the external auditory canal, more common along the posterior surface; therefore, the tumor develops within a very specific location.

Neuroendocrine adenoma middle ear (NAME) is a tumor which arises from a specific anatomic site: middle ear. NAME is a benign glandular neoplasm of middle ear showing histologic and immunohistochemical neuroendocrine and mucin-secreting differentiation.

<span class="mw-page-title-main">Ceruminous adenocarcinoma</span> Medical condition

Ceruminous adenocarcinoma is a malignant neoplasm derived from ceruminous glands of the external auditory canal. This tumor is rare, with several names used in the past. Synonyms have included cylindroma, ceruminoma, ceruminous adenocarcinoma, not otherwise specified (NOS), ceruminous adenoid cystic carcinoma (ACC), and ceruminous mucoepidermoid carcinoma.

<span class="mw-page-title-main">Carcinoma ex pleomorphic adenoma</span> Medical condition

Carcinoma ex pleomorphic adenoma is a type of cancer typically found in the parotid gland. It arises from the benign tumour pleomorphic adenoma.

<span class="mw-page-title-main">Parotidectomy</span> Surgical removal of the parotid gland

A parotidectomy is the surgical excision (removal) of the parotid gland, the major and largest of the salivary glands. The procedure is most typically performed due to neoplasms (tumors), which are growths of rapidly and abnormally dividing cells. Neoplasms can be benign (non-cancerous) or malignant (cancerous). The majority of parotid gland tumors are benign, however 20% of parotid tumors are found to be malignant. Parotidectomy is performed mostly by oral and maxillofacial surgeon and ENT surgeon.

Ectomesenchymal chondromyxoid tumor (ECT) is a benign intraoral tumor with presumed origin from undifferentiated (ecto)mesenchymal cells. There are some who think it is a myoepithelial tumor type.

References

  1. 1 2 3 4 5 6 Thompson LD, Bauer JL, Chiosea S, McHugh JB, Seethala RR, Miettinen M, Müller S (Jun 2015). "Canalicular adenoma: a clinicopathologic and immunohistochemical analysis of 67 cases with a review of the literature". Head Neck Pathol. 9 (2): 181–195. doi:10.1007/s12105-014-0560-6. PMC   4424207 . PMID   25141970.
  2. Nelson JF, Jacoway JR (Jun 1973). "Monomorphic adenoma (canalicular type). Report of 29 cases". Cancer. 31 (6): 1511–1513. doi: 10.1002/1097-0142(197306)31:6<1511::aid-cncr2820310630>3.0.co;2-o . PMID   4709966. S2CID   71093824.
  3. Suarez P, Hammond HL, Luna MA, Stimson PG (Aug 1998). "Palatal canalicular adenoma: report of 12 cases and review of the literature". Ann Diagn Pathol. 2 (4): 224–228. doi:10.1016/s1092-9134(98)80011-7. PMID   9845742.
  4. Penner CR, Thompson LD (Mar 2005). "Canalicular adenoma". Ear Nose Throat J. 84 (3): 132. doi: 10.1177/014556130508400306 . PMID   15871577.
  5. Ferreiro JA (Dec 1994). "Immunohistochemical analysis of salivary gland canalicular adenoma". Oral Surg Oral Med Oral Pathol. 78 (6): 761–765. doi:10.1016/0030-4220(94)90093-0. PMID   7534898.
  6. Huebner TA, Almubarak H, Drachenberg CB, Papadimitriou JC (Apr 2014). "Canalicular adenoma--search for the cell of origin: ultrastructural and immunohistochemical analysis of 7 cases and review of the literature". Ultrastruct Pathol. 38 (2): 74–82. doi:10.3109/01913123.2013.833564. PMID   24144157. S2CID   40082155.
  7. Curran AE, Allen CM, Beck FM, Damm DD, Murrah VA (Sep 2007). "Distinctive pattern of glial fibrillary acidic protein immunoreactivity useful in distinguishing fragmented pleomorphic adenoma, canalicular adenoma and polymorphous low grade adenocarcinoma of minor salivary glands". Head Neck Pathol. 1 (1): 27–32. doi:10.1007/s12105-007-0003-8. PMC   2807497 . PMID   20614277.