Quiz-summary
0 of 1 questions completed
Questions:
- 1
Information
Presented by William Westra, M.D. and prepared by Hillary Elwood, M.D.
Case 1: 60 year-old man with a longstanding parotid mass with recent enlargement.
You have already completed the quiz before. Hence you can not start it again.
Quiz is loading...
You must sign in or sign up to start the quiz.
You have to finish following quiz, to start this quiz:
Results
Time has elapsed
Categories
- Not categorized 0%
- 1
- Answered
- Review
-
Question 1 of 1
1. Question
Week 483: Case 1
60 year-old man with a longstanding parotid mass with recent enlargementimages/1alex/06202011case2image1.jpg
images/1alex/06202011case2image2.jpg
images/1alex/06202011case2image3.jpg
images/1alex/06202011case2image4.jpg
images/1alex/06202011case2image5.jpgCorrect
Answer: Carcinoma ex-pleomorphic adenoma, non-invasive type
Histology: The tumor is seen as a rounded nodule that is thinly encapsulated throughout. A portion of the nodule exhibits a proliferation of bland ducts in a myxochondroid matrix. Throughout much of the tumor, however, the ducts exhibit high grade features including cellular atypia and a high mitotic rate with atypical mitotic forms. Some of the ducts take on a cribriforming pattern with central necrosis resembling high grade intraductal carcinoma of the breast. The cells have abundant pink cytoplasm and prominent nucleoli.
Discussion: Carcinoma ex-pleomorphic carcinoma is a diagnostic term that refers to malignant transformation of a pre-existing pleomorphic adenoma. The diagnosis is certainly facilitated by identifying the pre-existing pleomorphic adenoma, but the benign component is often completely overrun by the carcinomatous element. When diagnosing carcinoma ex-pleomorphic adenoma, it is always important to include the type and grade of the carcinomatous component as well as the extent of tumor invasion. The carcinomatous component is usually (not always) high grade, generally either an adenocarcinoma N.O.S. or a salivary duct carcinoma. In the present case, the presence of a cribriforming component resembling comedo intraductal carcinoma of the breast supports the diagnosis of salivary duct carcinoma.
The current W.H.O. recognizes three subtypes of carcinoma ex- pleomorphic adenoma that are separated based on the extent of tumor invasion. The non-invasive form is completely confined by the tumor capsule and is associated with excellent clinical outcomes. The minimally invasive subtype invades into the extra-capsular tissue, but the extent of invasion is less than 1.5 mm. The invasive subtype invades the extra-capsular tissue beyond 1.5 mm. Based on its morphology and absence of invasive growth, this tumor is based classified as a carcinoma ex-pleomorphic adenoma, non-invasive type, where the carcinomatous component is represented by a high grade adenocarcinoma with features of salivary duct carcinoma.
Incorrect
Answer: Carcinoma ex-pleomorphic adenoma, non-invasive type
Histology: The tumor is seen as a rounded nodule that is thinly encapsulated throughout. A portion of the nodule exhibits a proliferation of bland ducts in a myxochondroid matrix. Throughout much of the tumor, however, the ducts exhibit high grade features including cellular atypia and a high mitotic rate with atypical mitotic forms. Some of the ducts take on a cribriforming pattern with central necrosis resembling high grade intraductal carcinoma of the breast. The cells have abundant pink cytoplasm and prominent nucleoli.
Discussion: Carcinoma ex-pleomorphic carcinoma is a diagnostic term that refers to malignant transformation of a pre-existing pleomorphic adenoma. The diagnosis is certainly facilitated by identifying the pre-existing pleomorphic adenoma, but the benign component is often completely overrun by the carcinomatous element. When diagnosing carcinoma ex-pleomorphic adenoma, it is always important to include the type and grade of the carcinomatous component as well as the extent of tumor invasion. The carcinomatous component is usually (not always) high grade, generally either an adenocarcinoma N.O.S. or a salivary duct carcinoma. In the present case, the presence of a cribriforming component resembling comedo intraductal carcinoma of the breast supports the diagnosis of salivary duct carcinoma.
The current W.H.O. recognizes three subtypes of carcinoma ex- pleomorphic adenoma that are separated based on the extent of tumor invasion. The non-invasive form is completely confined by the tumor capsule and is associated with excellent clinical outcomes. The minimally invasive subtype invades into the extra-capsular tissue, but the extent of invasion is less than 1.5 mm. The invasive subtype invades the extra-capsular tissue beyond 1.5 mm. Based on its morphology and absence of invasive growth, this tumor is based classified as a carcinoma ex-pleomorphic adenoma, non-invasive type, where the carcinomatous component is represented by a high grade adenocarcinoma with features of salivary duct carcinoma.
