1. High-Grade Transformation and Carcinosarcoma: A Review of Two Forms of Advanced Progression in the Salivary Gland.
- Author
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Verma, Anuj, Seethala, Raja R., and He Wang
- Subjects
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CANCER prognosis , *IMMUNOPHENOTYPING , *ADENOCARCINOMA , *SQUAMOUS cell carcinoma , *NEOPLASTIC cell transformation , *SARCOMA , *SALIVARY gland tumors , *SYMPTOMS , *CANCER patients , *ADENOMA , *ADENOID cystic carcinoma , *GENETIC polymorphisms , *MOLECULAR biology , *MICROSCOPY , *DISEASE progression , *SALIVARY gland cancer ,EPITHELIAL cell tumors - Abstract
Context.--High-grade transformation, previously known as dedifferentiation, in salivary gland carcinoma and carcinosarcoma ex pleomorphic adenoma is a rare phenomenon. It is, however, clinically relevant and affects treatment and prognosis. Objective.--To review the existing literature, describe the histologic and immunophenotypic features, and highlight the diagnostic criteria of high-grade transformation in various salivary gland carcinomas and carcinosarcomas; to review its effect on clinical presentation and prognosis; and to review relevant molecular characteristics and recent concepts and advances. Data Sources.--Literature search in PubMed using key words such as "high-grade transformation," "dedifferentiation," and "carcinosarcoma" in salivary gland. Relevant articles were reviewed, and additional articles were curated from the references of these articles. Conclusions.--High-grade transformation occurs rarely but has a significant impact on prognosis and management. By microscopy, the high-grade area is usually a distinct nodule and shows solid and nested architecture, cellular atypia, high mitotic count, and necrosis. The molecular features are not well established. Carcinosarcoma almost always arises in a pleomorphic adenoma and likely follows an adenoma-carcinoma-sarcoma pathway. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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