PRIMARY AND METASTATIC HIGH-GRADE CARCINOMAS OF THE SALIVARY-GLANDS -A CYTOLOGIC-HISTOLOGIC CORRELATION STUDY OF 20 CASES

We reviewed the clinical and fine-needle aspiration (FNA) findings in 20 patients with poorly differentiated carcinomas presenting initially as parotid or as submandibular masses. There were 11 primary tumors a nd nine metastatic malignancies in 14 males and six females ranging in age from 39 to 89 yr (median = 66). The tumor types included three pr imary carcinomas with oncocytic features, three additional cases of hi gh-grade parotid carcinoma, one case of primary neuroendocrine carcino ma two examples of malignant mixed tumor, one high-grade mucoepidermoi d carcinoma, and a single example of malignant lymphoepithelial lesion . Six patients with metastatic carcinoma had previous diagnoses of mal ignancy. In the three remaining individuals, primary carcinomas of the lung (two cases), and an unknown primary site presented initially as parotid masses. Five examples of metastatic squamous cell carcinoma on e metastatic basal cell carcinoma, and two metastatic renal cell carci nomas were identified. One parotid lymphoepithelioma was interpreted c ytologically as an atypical lymphoproliferative process suggestive of Hodgkin's disease. Nineteen cases (95%) were correctly classified as c arcinoma at the time of FNA. High-grade carcinomas aspirated from the parotid may be primary, but are frequently metastatic to either the gl and, or to an intraparotid lymph node. Our experience indicates that s ome metastatic carcinomas present at this site, without a previous his tory of malignancy. Distinguishing primary from metastatic lesions has important therapeutic implications. (C) 1995 Wiley-Liss, Inc.