Carcinosarcomas, also known as true malignant mixed tumors, are rare tumors of the salivary gland and are composed of both malignant epithelial and malignant mesenchymal elements. They may occur in pre-existing pleomorphic adenomas or arise de novo. Here we report the first case of carcinosarcoma of the parotid gland composed of mucoepidermoid carcinoma and osteosarcoma. The tumor had originated from the parotid gland and extended into the parapharyngeal space. To the best of our knowledge, there have been no reports on mucoepidermoid carcinoma mixed with osteosarcoma ex pleomorphic adenoma in the parotid gland.
Adenoma, Pleomorphic ; Carcinoma, Mucoepidermoid ; Carcinosarcoma ; Mixed Tumor, Malignant ; Osteosarcoma ; Parotid Gland ; Salivary Glands

Carcinosarcoma, or true malignant mixed tumor of the salivary gland, is a very rare malignant tumor comprised of both carcinomatous and sarcomatous elements and accounts for only 0.04-0.16% of all salivary gland tumors. Carcinosarcoma usually occurs in the parotid gland. Other locations including submandibular gland, minor salivary gland, uterus, bladder or lung have been reported. We report a rare case of carcinosarcoma of the parotid gland in an 85-year-old female. The tumor was large, about 19x17 cm in size, and was successfully excised.
Aged, 80 and over ; Carcinosarcoma* ; Female ; Humans ; Lung ; Mixed Tumor, Malignant ; Parotid Gland* ; Salivary Glands ; Salivary Glands, Minor ; Submandibular Gland ; Urinary Bladder ; Uterus

Carcinosarcoma is an extremely rare tumor, composed of a mixture of both carcinomatous and sarcomatous elements. The two-thirds are derived from the parotid gland. Because carcinosarcoma is highly aggressive malignant tumor with high local recurrence and poor survival rates, the combination of radical surgical excision and chemotherapy or radiotherapy is regarded as treatment of choice. However, treatment protocol has not been established. A 73-year-old man presented with a painful mass in the left parotid gland that had been rapidly enlarging for 2 weeks. Fine-needle aspiration biopsy was performed and it showed atypical epithelium. Superficial parotidectomy and modified radical neck dissection were performed for the left parotid gland cancer. The pathological diagnosis was carcinosarcoma and sequential chemoradiotherapy was performed. After a clinical follow-up of 30 months, he has remained free of disease. Based on our experience, we suggest that conservative surgical procedure could be one of the effective therapies.
Aged ; Biopsy, Fine-Needle ; Carcinosarcoma ; Chemoradiotherapy ; Clinical Protocols ; Epithelium ; Follow-Up Studies ; Humans ; Mixed Tumor, Malignant ; Neck Dissection ; Parotid Gland ; Recurrence ; Survival Rate

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.
Adenoma, Pleomorphic ; Aged ; Cytosine ; Female ; Giant Cell Tumors ; Giant Cells ; Humans ; Korea ; Mixed Tumor, Malignant ; Monocytes ; Osteoclasts ; Parotid Gland ; Salivary Glands ; Stromal Cells

The origin of osteoclast-like giant cell tumor (OGCT) of the salivary gland has been debated because the prototypic cells of osteoclast-like cells and mononuclear stromal cells are largely unexplained in this gland. Bone marrow-derived CD14+ and CD45+ monocyte-derived multipotential cells (CD14+/CD45+ MOMC) may be one of the possible origins of OGCTs of salivary glands, which have never been explored in salivary OGCTs. We present a case of OGCT accompanied with carcinoma ex pleomorphic adenoma in the parotid gland of a 67-year-old Korean female. The tumor presented as a rapidly growing cervical mass comprising a central area of carcinoma ex pleomorphic adenoma and a peripheral circumferential area of OGCT. The immunohistochemical staining pattern was phenotypically consistent with bone marrow-derived CD14+/CD45+ MOMC. This case is the first report of a salivary OGCT in Korea.
Adenoma, Pleomorphic ; Aged ; Cytosine ; Female ; Giant Cell Tumors ; Giant Cells ; Humans ; Korea ; Mixed Tumor, Malignant ; Monocytes ; Osteoclasts ; Parotid Gland ; Salivary Glands ; Stromal Cells

INTRODUCTION: Epidermal growth factor receptor (EGFR) is expressed in human epithelial tumors including salivary cancers, and known to be correlated with tumor progression and poor clinical courses in some epithelial tumors. In this study, we determined the therapeutic effect of the anti-EGFR monoclonal antibody Erbitux (C225, cetuximab) in combination with the DNA topoisomerase I inhibitor irinotecan (CPT-11) on human salivary adenoid cystic carcinoma (SACC) cells growing in nude mice. MATERIALS AND METHODS: At first, immunocytochemical analysis for the expression of EGFR and phosphorylated EGFR (pEGFR) on a human salivary ACC cell line (ACC3). To determine the in vivo effects of Erbitux and CPT-11, nude mice with orthotopic parotid tumors were randomized to receive intraperitoneal Erbitux (1 mg) two times per week, intraperitoneal Irinotecan (50 mg/kg) once per week, Erbitux plus CPT-11, or placebo. (control) Tumor volume and weight were measured. And mechanisms of in vivo activity of Erbitux and/or CPT-11 were determined by immunohistochemical/immunofluorescent analyses. RESULTS: Immunocytochemical staining of ACC3 demonstrated that EGFR was expressed and phosphorylated. CPT-11 inhibited ACC tumor growth in nude mice. Tumors of mice treated with CPT-11 and CPT-11 plus Erbitux exhibited increased tumor cell apoptosis and decreased microvessel density, which correlated with a decrease in the tumor volume in nude mice. But, CPT-11 seems not to be synergistic with Erbitux in our ACC3 model system. CONCLUSION: These results suggest that anti-EGFR monoclonal antibody and the DNA topoisomerase I inhibitor will be effective in the treatment of recurred or metastatic lesions of salivary ACC.
Adenoids ; Animals ; Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Apoptosis ; Camptothecin ; Carcinoma, Adenoid Cystic ; Cell Line ; Cetuximab ; DNA ; DNA Topoisomerases, Type I ; Humans ; Mice ; Mice, Nude ; Microvessels ; Parotid Neoplasms ; Receptor, Epidermal Growth Factor ; Salivary Gland Neoplasms ; Tumor Burden

The intensity-modulated radiation therapy (IMRT) planning strategies for nasopharyngeal cancer among Korean radiation oncology facilities were investigated. Five institutions with IMRT planning capacity using the same planning system were invited to participate in this study. The institutions were requested to produce the best plan possible for 2 cases that would deliver 70 Gy to the planning target volume of gross tumor (PTV1), 59.4 Gy to the PTV2, and 51.5 Gy to the PTV3 in which elective irradiation was required. The advised fractionation number was 33. The planning parameters, resultant dose distributions, and biological indices were compared. We found 2-3-fold variations in the volume of treatment targets. Similar degree of variation was found in the delineation of normal tissue. The physician-related factors in IMRT planning had more influence on the plan quality. The inhomogeneity index of PTV dose ranged from 4 to 49% in Case 1, and from 5 to 46% in Case 2. Variation in tumor control probabilities for the primary lesion and involved LNs was less marked. Normal tissue complication probabilities for parotid glands and skin showed marked variation. Results from this study suggest that greater efforts in providing training and continuing education in terms of IMRT planning parameters usually set by physician are necessary for the successful implementation of IMRT.
Female ; Humans ; Male ; Middle Aged ; Nasopharyngeal Neoplasms/*radiotherapy ; Parotid Gland/radiation effects ; Radiotherapy Dosage ; Radiotherapy Planning, Computer-Assisted/*methods ; Radiotherapy, Intensity-Modulated/*methods ; Relative Biological Effectiveness ; Skin/radiation effects ; Tumor Burden ; Young Adult

Background: Parotid gland tumor is a quite common pathology in salivary gland tumor. The exact diagnosis for parotid gland tumors has an important significance because it will help to plan appropriate surgical strategies. Objective: To remark some characteristics of ultrasonographic image of the parotid gland tumors and evaluate the role of ultrasonography in diagnosis of the parotid gland tumors. Subject and methods: A cross-sectional, descriptive study was conducted on 24 patients with parotid gland tumors, operated on at the Department of Plastic and Maxilofacial Surgery of Hospital 103 and the Department of Odonto - Stomatology of Ha Dong General Hospital, Hanoi from January, 2007 to July, 2008. Results: The size of tumors was 2-4cm (58.33%), 21/24 of tumors were in superficial lobe areas. 46.66% of pleomorphic adenomas had a lobulated shape. 2/3 of Warthin\u2019s tumors had an oval shape. 79.17% of the benign lesions were well-defined. 87.5% of all tumors had echogenicity decreased. Almost equal percentages of Warthin\u2019s tumors were echogenicity decreased and structure in heterogeneous. Conclusion: Ultrasonography is a useful method in the diagnosis of the parotid gland tumors, helping to determine clearly the natural basis of some tumors and contributing to early screening for acute parotid gland tumors.
Parotid gland tumor ; ultrasonography

Carcinoma ex pleomorphic adenoma of the salivary gland is a relatively uncommon tumor that accounts for roughly 4% of all malignancies at this location. The lesion occurs when a malignant tumor arises in the epithelial component of a pleomorphic adenoma. It usually arises in the parotid gland. Typically, it is a high grade carcinoma, frequently leading to metastasis and disease-related death. We experienced a case of a salivary duct carcinoma that arose in the epithelial component of a pleomorphic adenoma in the parotid gland with neck metastasis. After total parotidectomy and modified radical neck dissection, he was given 10, 980 cGy of radiation postoperatively for 7 weeks. The clinicopathologic feature of this tumor are presented with a review of literatures.
Adenoma, Pleomorphic* ; Mixed Tumor, Malignant ; Neck ; Neck Dissection ; Neoplasm Metastasis ; Parotid Gland* ; Salivary Ducts* ; Salivary Glands

OBJECTIVETo investigate the effects of human cytomegalovirus (HCMV) on the proliferation of duct epithelial cells of human salivary gland (HSG).

METHODSThe expression of proliferating cell nuclear antigen (PCNA) and p53 were studied in 11 cases of parotid cytomegalic inclusive disease (PCID) using immunohistochemical staining method. The effects of human cytomegalovirus (HCMV) on the proliferation of HSG were investigated by MTT method in vitro. The expression of PCNA in HSG infected by HCMV was examined using immunocytochemical staining and Western blotting.

RESULTSPCNA was expressed weakly in most of megalic inclusion cells which were positive for HCMV, while all the megalic inclusion cells were p53 negative in all 11 cases of PCID. HCMV inhibited proliferation of HSG in vitro in a time dependent and dose dependent manner. Down-regulation of PCNA was shown in infected cells.

CONCLUSIONHCMV inhibits proliferation of HSG and down-regulation of PCNA may be an expression of the inhibition.

Cell Division ; Cells, Cultured ; Cytomegalovirus ; genetics ; pathogenicity ; physiology ; Cytomegalovirus Infections ; genetics ; pathology ; Down-Regulation ; Epithelial Cells ; pathology ; Female ; Humans ; Male ; Parotid Gland ; pathology ; virology ; Proliferating Cell Nuclear Antigen ; analysis ; Salivary Ducts ; pathology ; virology ; Tumor Suppressor Protein p53 ; analysis