Primary intestinal-type adenocarcinoma of the buccal mucosa: a case report and literature review

Publication date: Available online 30 May 2018
Source:Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
Author(s): Kentaro Kikuchi, Shuichi Fukunaga, Fumio Ide, Miyako Hoshino, Harumi Inoue, Yuji Miyazaki, Tie-Jun Li, Kaoru Kusama
Intestinal-type adenocarcinoma (ITAC) of the primary salivary glands is extremely rare. So far, only eleven cases of primary ITAC of the oral cavity and major salivary glands have been reported. Two of those tumors arose in the floor of mouth, seven in the tongue, and two in the major salivary glands. However, it has remained unclear whether these tumors are derived from mature salivary glands and primary ITAC of the buccal mucosa has not been reported previously. Here we present the first documented case of primary ITAC arising in a minor salivary gland of the buccal mucosa. Histopathologically, the tumor resembled a well differentiated or mucinous colonic adenocarcinoma. Immunohistochemically, the tumor cells were diffusely positive for AE1/AE3, CAM5.2, CK7, SATB2, β-catenin, p53, Ki-67, MUC2 and MUC5AC. CK14 and CK20 were positive in some of the tumor cells. CDX2, CA19-9, SP-A, TTF-1, PSA, SMA, p63 and cyclin D1 were negative in the tumor cells. The present case may have originated from salivary gland duct epithelium that underwent transformation to phenotypic intestinal-type epithelium. By reference to this very rare case of primary ITAC of the buccal mucosa, we consider diagnostic markers that could be indicative of mature salivary gland origin.



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