Low Grade Intraductal Carcinoma of Palate: An Extremely Rare Entity with Review of Literature
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CLINICAL REPORT
Low Grade Intraductal Carcinoma of Palate: An Extremely Rare Entity with Review of Literature Anju Devi1
•
Anjali Narwal1 • Mala Kamboj1 • Monika Gupta2 • Deepak Pandiar1 • Ambika Gupta3
Received: 28 May 2020 / Accepted: 24 August 2020 Ó Association of Otolaryngologists of India 2020
Abstract Low-grade intraductal carcinoma (LG-IDC) is the new World Health Organization designation for tumors previously called ‘‘low-grade cribriform cystadenocarcinoma’’ and ‘‘low-grade salivary duct carcinoma’’. LG-IDC is a rare low grade malignant salivary gland neoplasm. A 56-year old woman presented with a painless swelling on the right posterior part of palate of 2 months duration. Radiographic examination revealed heterogenously enhancing soft tissue mass on right side of palate. A provisional diagnosis of pleomorphic adenoma was executed and local excision was done. The tumor had a typical feature of intraductal growth pattern composed of low grade ductal epithelial cells with cribriform and
micropapillary patterns forming true ‘‘Roman bridges’’. Immunohistochemically myoepithelial cells displayed p63 around all tumor islands. The case was diagnosed as LGIDC. LG-IDC is an extremely rare entity and awareness of this entity is important to avoid erroneous diagnosis and inappropriate treatment.
& Anju Devi [email protected]
The term lntraductal carcinoma was first described by Chen [1] in 1983 as a subtype of salivary duct carcinoma (SDC). Conventional salivary duct carcinoma usually presenting as a rapidly growing tumor is considered to be one of the most aggressive malignancies in the parotid gland. SDC presents both with intraductal as well as widely invasive components, resembling high grade carcinoma of breast. The biologic behaviour of both these tumors differ substantially, although both share common characteristic feature of ductal proliferative architecture, which suggested a lack of relationship with these tumors [2]. Thus in 2005 World Health Organization adopted this as Low-grade cribriform cystadenocarcinoma (LGCCC) to be a variant of cystadenocarcinoma, because of its cystic morphology [3]. Subsequently several other such tumors have been reported in the literature under the name of low-grade salivary duct carcinoma (LG-SDC). Kuo Y J [4] in 2013 reviewed the literature and stated that LGCCC and LG-SDC should be replaced with ‘‘low-grade intraductal carcinoma’’ (LGIDC) of salivary gland or ‘‘low-grade intraductal carcinoma with areas of invasive carcinoma’’ in those cases
Anjali Narwal [email protected] Mala Kamboj [email protected] Monika Gupta [email protected] Deepak Pandiar [email protected] Ambika Gupta [email protected] 1
Department of Oral Pathology, Post Graduate Institute of Dental Sciences, Pt. B. D Sharma, University of Health Sciences, Rohtak, Haryana, India
2
Department of General Pathology, Post Graduate Institute of Medical Sciences, Pt. B. D Sharma, University of Health Sciences, Rohtak, Haryana, India
3
Department of Oral Medicine, Post G
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