Salivary duct carcinoma and the concept of early carcinoma ex pleomorphic adenoma

Christopher C. Griffith, Lester D.R. Thompson, Adel Assaad, Bibianna M. Purgina, Chi Lai, Julie E. Bauman, Ilan Weinreb, Raja R. Seethala, Simion I. Chiosea

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Aims: The data on the histological type of carcinomatous component and the extent of extracapsular invasion for salivary carcinomas ex pleomorphic adenoma (PA) are conflicting. We aimed to determine the prognostic value of extracapsular invasion in salivary duct carcinomas (SDC) ex PA. Methods and results: A total of 117 patients with SDC were identified retrospectively; 44 cases involving major salivary glands had pre-existing PA (44 of 117, 37%). The morphological spectrum of SDC ex PA was characterized. The primary endpoint was overall survival (OS). Most SDC ex PA were widely invasive at presentation (27 of 44; 61%). Five patients with intracapsular SDC ex PA experienced no disease progression. The assessment of extracapsular invasion was precluded in eight cases (e.g. positive margins of resection). The rate of lymph node involvement was similar in cases with extracapsular invasion of ≤2 mm (two of three) and >7 mm (22 of 26). Only pT correlated with OS [116 months, 95% confidence interval (CI) 22-210 months for pT1 versus 20 months (95% CI 6-34) for pT4; P = 0.013]. Conclusions: Intracapsular SDC ex PA are potentially indolent. SDC ex PA with extracapsular invasion of ≤2 mm are rare, and appear to be clinically aggressive. Several histological parameters preclude assessment of extracapsular invasion.

Original languageEnglish (US)
Pages (from-to)854-860
Number of pages7
Issue number6
StatePublished - Dec 1 2014
Externally publishedYes


  • Early carcinoma ex pleomorphic adenoma
  • Minimal invasion
  • Salivary duct carcinoma
  • pT in-situ stage

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Histology


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