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Open Access Case report

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

Tobias Ettl1, Johannes Kleinheinz25*, Ravi Mehrotra3, Stephan Schwarz4, Torsten Eugen Reichert1 and Oliver Driemel1

Author Affiliations

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

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

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

4 Department of Pathology, Erlangen University, Germany

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

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Head & Face Medicine 2008, 4:16  doi: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.