The buccal minor salivary glands as starting point for a metastasizing adenocarcinoma – report of a case

Tobias Ettl¹ , Johannes Kleinheinz²^,5 , Ravi Mehrotra³ , Stephan Schwarz⁴ , Torsten Eugen Reichert¹ and Oliver Driemel¹

¹Department of Oral and Maxillofacial Surgery, Regensburg University, Germany

²Department of Oral and Maxillofacial Surgery, Muenster University, Germany

³Department of Pathology, Moti Lal Nehru Medical College, Allahabad University, India

⁴Department of Pathology, Erlangen University, Germany

⁵Department of Cranio-Maxillofacial Surgery, University Hospital Muenster, Waldeyerstr. 30, D-48149, Muenster, Germany

author email corresponding author email

Head & Face Medicine 2008, 4:16doi:10.1186/1746-160X-4-16


Published:	30 July 2008

Abstract

Background

With the 2005 WHO classification of salivary gland tumours and its increasingly recognized diagnostic entities, the frequency of adenocarcinoma (NOS) has decreased significantly.

Case presentation

This paper describes a fast growing adenocarcinoma (NOS), originating from the minor salivary glands of the left buccal mucosa with a rapid onset of multiple local and distant metastases, especially in the lung. A lung primary was unlikely as the tumour was characterized by positivity for cytokeratin 20 and negativity for the thyroid transcription factor-1 protein (TTF-1) in immunohistochemistry.

Conclusion

A rare case of an adenocarcinoma (NOS) of the minor salivary glands with a rapid development and an unfavourable clinical course is reported. It shows that additional immunohistochemical analysis can decisively contribute to determine the site of the primary tumour in cases with unknown primary.