SALIVARY-GLAND CYSTADENOCARCINOMAS - A CLINICOPATHOLOGICAL STUDY OF 57 CASES

Current classification schemes for salivary gland neoplasms categorize cystadenocarcinomas on the basis of a recurring histomorphologic patt ern of cystic, and often, papillary growth without features of other s pecific types of salivary gland tumors. To ascertain the clinicomorpho logic spectrum and biologic behavior of this tumor, the clinicopatholo gic features of 57 cystadenocarcinomas from the files of the Armed For ces Institute of Pathology were studied. Excluding five Veterans Admin istration military cases, men and women were equally affected. Patient s ranged in age from 20 to 86 years (mean, 58.8; median, 64), and pati ents aged over 50 years accounted for 71% of cases. Thirty-seven tumor s (65%) occurred in major salivary glands, 35 in the parotid, and two in the sublingual glands. The 20 minor salivary gland tumors (35%) inv olved, in descending order, the lips, buccal mucosa, palate, tongue, r etromolar area, and floor of mouth. Grossly, the lesions were cystic o r multicystic masses that ranged in size from 0.4 to 6.0 cm. Microscop ically, all tumors demonstrated an invasive, cystic growth pattern, an d 75% had a conspicuous papillary component, The predominant cell type varied among tumors and included small cuboidal cells (35 cases), lar ge cuboidal cells (nine cases), and tall columnar cells (seven cases). Six cases exhibited an admixture of cell types. Ruptured cysts with h emorrhage and granulation tissue were common. All 40 patients with fol low-up data were either alive or had died of other causes and were fre e of tumor a mean interval of 59 months after their initial surgery. T hree tumors recurred locally (mean interval, 76 months). Three tumors were metastatic to regional lymph nodes at the time of diagnosis, and one patient developed a regional lymph node metastasis after 55 months . Salivary gland cystadenocarcinomas represent a distinct group of mal ignancies that have an indolent biologic behavior.