Perfil clínico-histopatológico do carcinoma ex adenoma pleomórfico de glândulas salivares: uma revisão sistemática

Abstract

Salivary gland epithelial neoplasms are a heterogeneous group of diseases that have complex clinicopathological characteristics and distinct behaviors. Carcinoma ex pleomorphic adenoma (CXAP) is defined as a malignant neoplasm that originates from a primary pleomorphic adenoma (de novo) or from recurrences, comprising a heterogeneous group of malignant histological aspects, with different degrees of invasiveness and aggressiveness. The objective of this study is to carry out a systematic review to analyze the clinical-pathological profile of patients affected by Carcinoma ex pleomorphic adenoma of the salivary glands. A systematic review of the literature was performed, and 141 articles were included, 111 cases disaggregated (DC) and 30 aggregated (AC). Data were analyzed using Excel v16 (Microsoft Office) and MedCalc software (MedCalc Software bv, version 19.2.6, Ostend, Belgium). CXPA was more frequent in males (56.4% - DC and 58.8% - AC), in the sixth decade of life, stage T2 (34.5% - DC, 36.8% - AC), N0 ( 67.4% - DC, 68% - AC), M0 (89.4% - DC, 92.5% - AC), in the major salivary glands (89.9% - DC and 95.0% - AC), the parotid gland ( 71.9% - DC and 82.7% - AC) the most affected. Adenocarcinoma (28.9% - DC, 34.4% - AC), salivary duct carcinoma (20.8% - DC, 20.8% - AC) and myoepithelial carcinoma (19.1% - DC, 25.2% - AC) were the most frequent histological subtypes. The mean evolution time was 99.67 months. The survival curve down dramatically over 10 years of follow-up in the DC group, reflecting the aggressiveness of this tumor. Systematic reviews facilitate and summarize the information available in the literature, however, new research, following the reporting protocols, are necessary to better elucidate the characteristics of this complex entity.