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Clinical Problem Solving: Pathology
Aug 2012

Pathology Quiz Case 3: Diagnosis

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Arch Otolaryngol Head Neck Surg. 2012;138(8):782-783. doi:10.1001/archotol.138.8.782

Diagnosis: Carcinoma ex pleomorphic adenoma (CXPA), salivary duct carcinoma type, noninvasive

Carcinoma ex pleomorphic adenoma is an uncommon, aggressive malignant neoplasm of the salivary glands that arises in the epithelial and/or myoepithelial component of a pleomorphic adenoma. Representing 11.7% of salivary gland malignant neoplasms, CXPA is the most common of the malignant mixed tumors, which also include carcinosarcoma and metastasizing pleomorphic adenoma.1 In 1 study, CXPA was found only in the parotid (86%) and submandibular (14%) glands, but it has also been reported to originate from the sublingual and minor salivary glands.2

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