Browsing by Author "Poorten, Vincent Vander"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
- An evidence-based analysis of the management of N0 neck in patients with cancer of the parotid glandPublication . Vartanian, Jose Guilherme; Goncalves Filho, Joao; Kowalski, Luiz Paulo; Shah, Jatin P.; Suarez, Carlos; Rinaldo, Alessandra; De Bree, Remco; Rodrigo, Juan P.; Hamoir, Marc; Takes, Robert P.; Makitie, Antti A.; Zbaren, Peter; Andreasen, Simon; Poorten, Vincent Vander; Sanabria, Alvaro; Hellquist, Henrik; Robbins, K. Thomas; Boedeker, Carsten C.; Silver, Carl; Ferlito, AlfioIntroduction: Management of clinically negative neck (cN0) in patients with parotid gland cancer is controversial. Treatment options can include observation, elective neck dissection or elective radiotherapy. Areas covered: We addressed the treatment options for cN0 patients with parotid gland cancer. A literature review was undertaken to determine the optimal management of this group of patients. Expert opinion: Patients with parotid carcinoma and clinically negative neck have various options for their management. The analysis of tumor stage, histology and grade is essential to better define patients at risk for occult lymph node metastasis. These patients can be managed by surgery, radiotherapy or their combination, depending on the presence of risk factors, the moment at which such risk factors are detected, patient-related clinical conditions, medical provider expertise and institutional facilities.
- Analysis of the clinical relevance of histological classification of benign epithelial salivary gland tumoursPublication . Hellquist, Henrik; Paiva-Correia, António; Poorten, Vincent Vander; Quer, Miquel; Hernandez-Prera, Juan C.; Andreasen, Simon; Zbären, Peter; Skalova, Alena; Rinaldo, Alessandra; Ferlito, AlfioIntroductionA vast increase in knowledge of numerous aspects of malignant salivary gland tumours has emerged during the last decade and, forseveral reasons, thishas not been the case in benign epithelial salivary gland tumours. We have performed a literature review to investigate whether an accurate histological diagnosis of the 11 different types of benign epithelial salivary gland tumours is correlated to any differences in their clinical behaviour.MethodsA search was performed for histological classifications, recurrence rates and risks for malignant transformation, treatment modalities, and prognosis of these tumours. The search was performed primarily through PubMed, Google Scholar, and all versions of WHO classifications since 1972, as well as numerous textbooks on salivary gland tumours/head and neck/pathology/oncology. A large number of archival salivary tumours were also reviewed histologically.ResultsPleomorphic adenomas carry a considerable risk (5-15%) for malignant transformation but, albeit to a much lesser degree, so do basal cell adenomas and Warthin tumours, while the other eight types virtually never develop into malignancy. Pleomorphic adenoma has a rather high risk for recurrence while recurrence occurs only occasionally in sialadenoma papilliferum, oncocytoma, canalicular adenoma, myoepithelioma and the membranous type of basal cell adenoma. Papillomas, lymphadenoma, sebaceous adenoma, cystadenoma, basal cell adenoma (solid, trabecular and tubular subtypes) very rarely, if ever, recur.ConclusionsA correct histopathological diagnosis of these tumours is necessary due to (1) preventing confusion with malignant salivary gland tumours; (2) only one (pleomorphic adenoma) has a considerable risk for malignant transformation, but all four histological types ofbasal cell adenoma canoccasionally develop into malignancy, as does Warthin tumour; (3) sialadenoma papilliferum, oncocytoma, canalicular adenoma, myoepithelioma and Warthin tumour only occasionally recur; while (4) intraductal and inverted papilloma, lymphadenoma, sebaceous adenoma, cystadenoma, basal cell adenoma (apart from the membranous type) virtually never recur. No biomarker was found to be relevant for predicting recurrence or potential malignant development. Guidelines for appropriate treatment strategies are given.
- Molecularly defined sinonasal malignancies: an overview with focus on the current WHO classification and recently described provisional entitiesPublication . Skálová, Alena; Agaimy, Abbas; Bradova, Martina; Poorten, Vincent Vander; Hanna, Ehab; Guntinas-Lichius, Orlando; Franchi, Alessandro; Hellquist, Henrik; Simpson, Roderick H. W.; Lopéz, Fernando; Nuyts, Sandra; Chiesa-Estomba, Carlos; Ng, Sweet Ping; Homma, Akihiro; Teng, Yong; Leivo, Ilmo; Ferlito, AlfioClassification of tumors of the head and neck has evolved in recent decades including a widespread application of molecular testing in tumors of the sinonasal tract, salivary glands, and soft tissues with a predilection for the head and neck. The availability of new molecular techniques has allowed for the definition of multiple novel tumor types unique to head and neck sites. Moreover, an expanding spectrum of immunohistochemical markers specific to genetic alterations facilitates rapid identification of diagnostic molecular abnormalities. As such, it is currently possible for head and neck pathologists to benefit from a molecularly defined tumor classification while making diagnoses that are still based largely on histopathology and immunohistochemistry. This review covers the principal molecular alterations in sinonasal malignancies, such as alterations in DEK, AFF2, NUTM1, IDH1-2, and SWI/SNF genes in particular, that are important from a practical standpoint for diagnosis, prognosis, and prediction of response to treatment.
- Newly described entities in salivary gland pathologyPublication . Skalova, Alena; Gnepp, Douglas R.; Lewis, James S., Jr.; Hunt, Jennifer L.; Bishop, Justin A.; Hellquist, Henrik; Rinaldo, Alessandra; Poorten, Vincent Vander; Ferlito, AlfioSalivary glands may give rise to a wide spectrum of different tumors. This review concentrates on 4 salivary gland tumors that have been accepted in the recent literature as new neoplastic entities: mammary analog secretory carcinoma, cribriform adenocarcinoma of minor salivary glands (CASG), sclerosing polycystic adenosis/adenoma (SPA), and the mucinous/secretory variant of myoepithelioma. Mammary analog secretory carcinoma is a distinctive low-grade malignant salivary cancer that harbors a characteristic chromosomal translocation, t(12;15) (p13;q25), resulting in an ETV6-NTRK3 fusion. Cribriform adenocarcinoma (CASG) is a distinct tumor entity that differs from polymorphous low-grade adenocarcinoma by location (ie, most often arising on the tongue), by prominent nuclear clearing, differing alterations of the PRKD gene family, and clinical behavior with frequent metastases at the time of presentation of the primary tumor. Early nodal metastatic disease is seen in most cases of CASG; yet, they are still associated with indolent clinical behavior, making it a unique neoplasm among all low-grade salivary gland tumors. SPA is a rare sclerosing tumor of the salivary glands characterized by the combination of cystic ductal structures with variable cell lining including vacuolated, apocrine, mucinous, squamous, and foamy cells, by prominent large acinar cells with coarse eosinophilic cytoplasmic zymogen-like granules, and by closely packed ductal structures, surrounded by a peripheral myoepithelial layer and stromal fibrosis with focal inflammatory infiltrates. SPA frequently harbors intraductal epithelial dysplastic proliferations ranging from mild dysplasia to severe dysplasia/carcinoma in situ. Moreover, SPA has been proven to be a clonal process by HUMARA assay and is associated with considerable risk of recurrence. Therefore, on the basis of all these newly recognized findings, we believe that SPA is likely a neoplasm, and we suggest the name sclerosing polycystic adenoma. The mucinous variant of myoepithelioma is a myoepithelial tumor with foci of prominent cytoplasmic clearing frequently containing intracellular mucin material and having signet-ring morphology.