Limits...
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.

Show MeSH

Related in: MedlinePlus

Remarkably atypical epithelial cells are seen surrounding an area of central comedonecrosis, an uncommon feature in ceruminous gland adenocarcinomas
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC2807538&req=5

Fig9: Remarkably atypical epithelial cells are seen surrounding an area of central comedonecrosis, an uncommon feature in ceruminous gland adenocarcinomas

Mentions: The ceruminous adenocarcinomas contained neoplastic cells which were arranged in a variety of different patterns within a single case as well as between cases (Table 5; Fig. 3). Whereas a glandular pattern predominated in most lesions (n = 15; Fig. 4), a “Swiss-cheese” or “cribriform” architecture is usually seen in ceruminous adenoid cystic carcinoma (Fig. 5). The lesional cells invaded into the surrounding stroma, a feature helpful in separating between ceruminous adenomas and carcinoma. At least focally, a dual cell population could always be identified, comprised of inner luminal epithelial cells subtended by basal/myoepithelial cells adjacent to the basement membrane (Figs. 6, 7). In the adenoid cystic carcinoma, the cells were “peg” or “carrot-shaped” with scant cytoplasm surrounding hyperchromatic nuclei (Fig. 8). When the luminal cells were identified, prominent apical caps with ceruminous-type decapitation secretion (n = 5) were displayed. The golden-yellow-brown pigment granules were not seen in this type of ceruminous adenocarcinoma. The tumors tended to have a moderate to high cellularity composed of cells with variably degrees of nuclear pleomorphism. Nucleoli were often prominent. Mitotic figures were usually easy to identify, with occasional atypical forms. Tumor necrosis (not degenerative change) was not observed in adenoid cystic carcinoma, but could be seen in ceruminous adenocarcinoma, NOS (Fig. 9). Inflammatory cells and areas of dense hyalinization (sclerosis) were seen. Mucoepidermoid carcinoma contained epidermoid cells, mucin-producing cells, and transitional cells, associated with focal apocrine snouts, confirming ceruminous derivation (Fig. 10).Table 5


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

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

Remarkably atypical epithelial cells are seen surrounding an area of central comedonecrosis, an uncommon feature in ceruminous gland adenocarcinomas
© Copyright Policy
Related In: Results  -  Collection

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

Fig9: Remarkably atypical epithelial cells are seen surrounding an area of central comedonecrosis, an uncommon feature in ceruminous gland adenocarcinomas
Mentions: The ceruminous adenocarcinomas contained neoplastic cells which were arranged in a variety of different patterns within a single case as well as between cases (Table 5; Fig. 3). Whereas a glandular pattern predominated in most lesions (n = 15; Fig. 4), a “Swiss-cheese” or “cribriform” architecture is usually seen in ceruminous adenoid cystic carcinoma (Fig. 5). The lesional cells invaded into the surrounding stroma, a feature helpful in separating between ceruminous adenomas and carcinoma. At least focally, a dual cell population could always be identified, comprised of inner luminal epithelial cells subtended by basal/myoepithelial cells adjacent to the basement membrane (Figs. 6, 7). In the adenoid cystic carcinoma, the cells were “peg” or “carrot-shaped” with scant cytoplasm surrounding hyperchromatic nuclei (Fig. 8). When the luminal cells were identified, prominent apical caps with ceruminous-type decapitation secretion (n = 5) were displayed. The golden-yellow-brown pigment granules were not seen in this type of ceruminous adenocarcinoma. The tumors tended to have a moderate to high cellularity composed of cells with variably degrees of nuclear pleomorphism. Nucleoli were often prominent. Mitotic figures were usually easy to identify, with occasional atypical forms. Tumor necrosis (not degenerative change) was not observed in adenoid cystic carcinoma, but could be seen in ceruminous adenocarcinoma, NOS (Fig. 9). Inflammatory cells and areas of dense hyalinization (sclerosis) were seen. Mucoepidermoid carcinoma contained epidermoid cells, mucin-producing cells, and transitional cells, associated with focal apocrine snouts, confirming ceruminous derivation (Fig. 10).Table 5

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