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Ceruminous gland carcinomas: a clinicopathologic and immunophenotypic study of 17 cases.

Crain N, Nelson BL, Barnes EL, Thompson LD - Head Neck Pathol (2008)

Bottom Line: Retrospective.Ceruminous-type carcinomas, with the exception of ceruminous mucoepidermoid carcinoma, all demonstrated a dual cell population of basal myoepithelial-type cells and luminal apocrine cells.The specific histologic sub-type does not influence the long-term patient outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91367-6701, USA.

ABSTRACT

Background: Ceruminal gland carcinomas are rare neoplasms confined to the skin lining the cartilaginous part of the external auditory canal.

Design: Retrospective.

Results: The patients included 11 men and 6 women, aged 33-82 years (mean, 59.5 years). Patients presented clinically with a mass of the outer half of the external auditory canal (n = 14), hearing changes (n = 5), drainage (n = 4), or paralysis of the facial nerve (n = 3). The polypoid masses ranged in size from 0.5 to 3 cm in greatest dimension (mean, 1.8 cm). Histologically, the tumors demonstrated a solid to cystic pattern, composed of an infiltrating glandular to cribriform arrangement of epithelial cells. Histologic features included a dual cell population (although not the dominant histology), increased cellularity, moderate to severe nuclear pleomorphism, irregular nucleoli, increased mitotic figures (mean, 3/10 HPF), including atypical forms, and tumor necrosis (n = 2). Tumors were divided into three types of adenocarcinoma based on pattern of growth and cell type (ceruminous, NOS [n = 12], adenoid cystic [n = 4], mucoepidermoid [n = 1]). CK7 and CD117 highlighted the luminal cells, while S1-00 protein showed a predilection for the basal cells of ceruminous and adenoid cystic carcinomas. Metastatic adenocarcinoma or direct extension from salivary gland neoplasms are the principle differential considerations. Surgical resection was used in all patients with radiation used in four patients. Eleven patients were alive or had died of unrelated causes without evidence of disease (mean, 11.2 years); six patients had died with disease (mean, 4.9 years), all of whom had developed local recurrence.

Conclusion: Ceruminous-type carcinomas, with the exception of ceruminous mucoepidermoid carcinoma, all demonstrated a dual cell population of basal myoepithelial-type cells and luminal apocrine cells. The specific histologic sub-type does not influence the long-term patient outcome.

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Ceruminous adenocarcinoma, NOS demonstrates a “bi-phasic” immunoreactivity with the outer cell layer demonstrating a positive CK5/6 and p63 immunoreactivity. The Ki-67 demonstrated increased reactivity in some adenocarcinomas
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Fig12: Ceruminous adenocarcinoma, NOS demonstrates a “bi-phasic” immunoreactivity with the outer cell layer demonstrating a positive CK5/6 and p63 immunoreactivity. The Ki-67 demonstrated increased reactivity in some adenocarcinomas

Mentions: All lesions tested reacted strongly and diffusely with a keratin cocktail and with epithelial membrane antigen (Table 6). Where the surface epithelium was present, it was strongly and diffusely immunoreactive for the epithelial markers analyzed, and served as an internal quality control. The dual cell population was accentuated by the immunohistochemical studies. The luminal cells were strongly immunoreactive with CK7 and with CD117 (Fig. 11). The basal-myoepithelial cells were strongly and diffusely reactive in both the nucleus and cytoplasm with S-100 protein (63%), in the cytoplasm with CK5/6 (50%) and in the nucleus only with p63 (38%; Fig. 12). Thirty-seven percent of cases tested demonstrated Ki-67 immunoreactivity ranging from 2+ to 3+, affecting greater than 5% of the nuclei in the specimen, while the others showed <1% reactivity. p53 was identified in 57% of cases; although immunoreactivity ranged from 1+ to 3+, less than 10% of the nuclei in the specimen were affected in 3 cases, while 1 case demonstrated reactivity in about 30% of nuclei. CK20 was negative in all cases tested.Table 6


Ceruminous gland carcinomas: a clinicopathologic and immunophenotypic study of 17 cases.

Crain N, Nelson BL, Barnes EL, Thompson LD - Head Neck Pathol (2008)

Ceruminous adenocarcinoma, NOS demonstrates a “bi-phasic” immunoreactivity with the outer cell layer demonstrating a positive CK5/6 and p63 immunoreactivity. The Ki-67 demonstrated increased reactivity in some adenocarcinomas
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2807538&req=5

Fig12: Ceruminous adenocarcinoma, NOS demonstrates a “bi-phasic” immunoreactivity with the outer cell layer demonstrating a positive CK5/6 and p63 immunoreactivity. The Ki-67 demonstrated increased reactivity in some adenocarcinomas
Mentions: All lesions tested reacted strongly and diffusely with a keratin cocktail and with epithelial membrane antigen (Table 6). Where the surface epithelium was present, it was strongly and diffusely immunoreactive for the epithelial markers analyzed, and served as an internal quality control. The dual cell population was accentuated by the immunohistochemical studies. The luminal cells were strongly immunoreactive with CK7 and with CD117 (Fig. 11). The basal-myoepithelial cells were strongly and diffusely reactive in both the nucleus and cytoplasm with S-100 protein (63%), in the cytoplasm with CK5/6 (50%) and in the nucleus only with p63 (38%; Fig. 12). Thirty-seven percent of cases tested demonstrated Ki-67 immunoreactivity ranging from 2+ to 3+, affecting greater than 5% of the nuclei in the specimen, while the others showed <1% reactivity. p53 was identified in 57% of cases; although immunoreactivity ranged from 1+ to 3+, less than 10% of the nuclei in the specimen were affected in 3 cases, while 1 case demonstrated reactivity in about 30% of nuclei. CK20 was negative in all cases tested.Table 6

Bottom Line: Retrospective.Ceruminous-type carcinomas, with the exception of ceruminous mucoepidermoid carcinoma, all demonstrated a dual cell population of basal myoepithelial-type cells and luminal apocrine cells.The specific histologic sub-type does not influence the long-term patient outcome.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, Southern California Permanente Medical Group, Woodland Hills Medical Center, 5601 De Soto Avenue, Woodland Hills, CA 91367-6701, USA.

ABSTRACT

Background: Ceruminal gland carcinomas are rare neoplasms confined to the skin lining the cartilaginous part of the external auditory canal.

Design: Retrospective.

Results: The patients included 11 men and 6 women, aged 33-82 years (mean, 59.5 years). Patients presented clinically with a mass of the outer half of the external auditory canal (n = 14), hearing changes (n = 5), drainage (n = 4), or paralysis of the facial nerve (n = 3). The polypoid masses ranged in size from 0.5 to 3 cm in greatest dimension (mean, 1.8 cm). Histologically, the tumors demonstrated a solid to cystic pattern, composed of an infiltrating glandular to cribriform arrangement of epithelial cells. Histologic features included a dual cell population (although not the dominant histology), increased cellularity, moderate to severe nuclear pleomorphism, irregular nucleoli, increased mitotic figures (mean, 3/10 HPF), including atypical forms, and tumor necrosis (n = 2). Tumors were divided into three types of adenocarcinoma based on pattern of growth and cell type (ceruminous, NOS [n = 12], adenoid cystic [n = 4], mucoepidermoid [n = 1]). CK7 and CD117 highlighted the luminal cells, while S1-00 protein showed a predilection for the basal cells of ceruminous and adenoid cystic carcinomas. Metastatic adenocarcinoma or direct extension from salivary gland neoplasms are the principle differential considerations. Surgical resection was used in all patients with radiation used in four patients. Eleven patients were alive or had died of unrelated causes without evidence of disease (mean, 11.2 years); six patients had died with disease (mean, 4.9 years), all of whom had developed local recurrence.

Conclusion: Ceruminous-type carcinomas, with the exception of ceruminous mucoepidermoid carcinoma, all demonstrated a dual cell population of basal myoepithelial-type cells and luminal apocrine cells. The specific histologic sub-type does not influence the long-term patient outcome.

Show MeSH
Related in: MedlinePlus