J Korean Med Sci.  2011 Oct;26(10):1277-1285. 10.3346/jkms.2011.26.10.1277.

Carcinoma ex Pleomorphic Adenoma of the Salivary Glands: Distinct Clinicopathologic Features and Immunoprofiles Between Subgroups According to Cellular Differentiation

  • 1Department of Pathology, Hallym University College of Medicine, Kangnam Sacred Heart Hospital, Seoul, Korea.
  • 2Department of Pathology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, Seoul, Korea.
  • 3Department of Otorhinolaryngology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
  • 4Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea. kjc@amc.seoul.kr


In carcinoma ex pleomorphic adenoma (CXPA), pleomorphic adenoma (PA) and diverse carcinoma components showing luminal (ductal) or non-luminal (myoepithelial) differentiation coexist. To elucidate the clinicopathological implications of cellular differentiation in CXPA and the potential role of p53, vascular endothelial growth factor (VEGF), c-erbB-2, c-kit, and glucose transporter 1 (Glut-1) in carcinogenesis, we analyzed 11 CXPAs with luminal differentiation (CXPAs-LD) and 6 CXPAs with non-luminal differentiation (CXPAs-NLD) and compared protein expressions in residual PAs and carcinomas by immunohistochemistry. Among the CXPAs-LD, 5 were invasive and 8 were histologically high-grade tumors. The 5-year survival rate was 72.7%. P53, c-erbB-2, VEGF, and Glut-1 were more immunoreactive in carcinoma components than in PAs (P = 0.008, 0.004, 0.002, and 0.024, respectively); c-erbB-2 overexpression was associated with high histological grade (P = 0.024). Carcinoma components frequently lacked c-kit expression (P = 0.009). CXPAs-NLD were all low-grade and invasive with a larger mean tumor size (5.2 cm) than CXPAs-LD (3.3 cm) (P = 0.040). The patients remained disease-free without significant immunohistochemical expression. The immunoprofiles and clinical course of CXPA differed according to cellular differentiation. Therefore, it is important to report the histological subtype and to assess potential biomarkers in diagnostic and therapeutic trials.


Carcinoma ex Pleomorphic Adenoma; p53; c-erbB-2; Vascular Endothelial Growth Factor; c-kit; Glucose Transporter 1; Histological Types; Prognosis
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