Skip to main content Accessibility help
  • Cited by 1
  • Print publication year: 2000
  • Online publication date: June 2014

Chapter 30 - Salivary gland neoplasms of the lung



Primary salivary gland tumors of the lung are extremely rare and comprise only 0.1% to 0.2% of all lung cancers. The seromucinous glands of trachea and bronchi are similar to the minor salivary glands, and therefore they share histologically identical tumors. Historically, the term bronchial adenoma was used for primary pulmonary salivary gland tumors and bronchial carcinoids. However, it is clear that salivary gland tumors of the lung represent distinct, usually slow growing, low-grade neoplasms. Patients with salivary gland lung tumors are, on average, younger than other bronchogenic carcinoma patients. Overall, these tumors have a weaker association with smoking, as up to 40% of patients are non-smokers. Since primary salivary gland lung tumors may present a diagnostic challenge, it is of vital importance that sufficient material be submitted for pathological analysis. The bronchoscopic evaluation should be carefully conducted while keeping in mind the goal of a bronchoplastic resection, whenever appropriate. Given the importance of lymph node involvement as a prognostic indicator, mediastinal lymph node sampling or dissection should be diligently performed in all patients. Since complete surgical resection appears to be the best predictor of long-term survival, every effort should be made to achieve this goal.

Only small case series are available to demonstrate the presentation, diagnosis and management of these tumors. It should be kept in mind that generalizations regarding the treatment and prognosis of these tumors are limited by the very small sample size of published case series. Similarly, a limited number of genetic studies have been published. It appears that besides morphology, salivary gland tumors of the lung have similar genetic abnormalities to their salivary gland counterparts.

Related content

Powered by UNSILO
Travis, W BE, Muller-Hermlink, H, Harris, C, eds. World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Lung, Pleura, Thymus and Heart. Lyon: IARC, 2004. pp. 63–4.
Moran, CA.Primary salivary gland-type tumors of the lung. Semin Diagn Pathol 1995;12:106–22.
Heitmiller, RF, Mathisen, DJ, Ferry, JA, Mark, EJ, Grillo, HC.Mucoepidermoid lung tumors. Ann Thorac Surg 1989;47:394–9.
Yousem, SA, Hochholzer, L.Mucoepidermoid tumors of the lung. Cancer 1987;60:1346–52.
Pandya, H, Matthews, S.Case report: mucoepidermoid carcinoma in a patient with congenital agenesis of the left upper lobe. Br J Radiol 2003;76:339–42.
Plaza, G, Barbera, R, Fogu, L, Martinez, San Millan J, Martinez, Vidal A.[Mucoepidermoid carcinoma of the larynx]. Acta otorrinolaringologica espanola 1999;50:324–6.
Molina, JR, Aubry, MC, Lewis, JE, et al. Primary salivary gland-type lung cancer: spectrum of clinical presentation, histopathologic and prognostic factors. Cancer 2007;110:2253–9.
Gol'dburt, NN, Kozlovskii, OM.[Mucoepidermoid cancer of the lung]. Voprosy onkologii 1974;20:16–20.
Lopushinsky, SR, Fowler, RA, Kulkarni, GS, et al. The optimal timing of intestinal transplantation for children with intestinal failure: a Markov analysis. Ann Surg 2007;246:1092–9.
Shilo, K, Foss, RD, Franks, TJ, DePeralta-Venturina, M, Travis, WD.Pulmonary mucoepidermoid carcinoma with prominent tumor-associated lymphoid proliferation. Am J Surg Pathol 2005;29:407–11.
Sanchez-Mora, N, Parra-Blanco, V, Cebollero-Presmanes, M, et al. Mucoepidermoid tumors of the bronchus. Ultrastructural and immunohistochemical study. Histiogenic correlations. Histo Histopathol 2007;22:9–13.
Dardick, I, Gliniecki, MR, Heathcote, JG, Burford-Mason, A.Comparative histogenesis and morphogenesis of mucoepidermoid carcinoma and pleomorphic adenoma. An ultrastructural study. Virchows Arch A Pathol Anat Histopathol 1990;417:405–17.
Nordkvist, A, Gustafsson, H, Juberg-Ode, M, Stenman, G.Recurrent rearrangements of 11q14–22 in mucoepidermoid carcinoma.[see comment]. Cancer Genet Cytogenet 1994;74:77–83.
Stenman, G, Petursdottir, V, Mellgren, G, Mark, J.A child with a t(11;19)(q14–21;p12) in a pulmonary mucoepidermoid carcinoma. Virchows Arch 1998;433:579–81.
Tonon, G, Gehlhaus, KS, Yonescu, R, Kaye, FJ, Kirsch, IR.Multiple reciprocal translocations in salivary gland mucoepidermoid carcinomas.[see comment]. Cancer Genet Cytogenet 2004;152:15–22.
Behboudi, A, Enlund, F, Winnes, M, et al. Molecular classification of mucoepidermoid carcinomas-prognostic significance of the MECT1-MAML2 fusion oncogene. GeneChromosome Canc 2006;45:470–81.
Okabe, M, Miyabe, S, Nagatsuka, H, et al. MECT1-MAML2 fusion transcript defines a favorable subset of mucoepidermoid carcinoma. [see comment]. Clin Cancer Res 2006;12:3902–7.
Serra, A, Schackert, HK, Mohr, B, et al. t(11;19)(q21;p12~p13.11) and MECT1-MAML2 fusion transcript expression as a prognostic marker in infantile lung mucoepidermoid carcinoma. J Ped Surg 2007;42:E23–9.
Tirado, Y, Williams, MD, Hanna, EY, et al. CRTC1/MAML2 fusion transcript in high grade mucoepidermoid carcinomas of salivary and thyroid glands and Warthin's tumors: implications for histogenesis and biologic behavior. Gene Chromosome Canc 2007;46:708–15.
Tonon, G, Modi, S, Wu, L, et al. t(11;19)(q21;p13) translocation in mucoepidermoid carcinoma creates a novel fusion product that disrupts a Notch signaling pathway.[erratum appears in Nat Genet 2003;33(3):430]Nat Genet 2003;33:208–13.
Achcar, R, Nikiforova, M, Dacic, S, Nicholson, A, Yousem, S.MAML2 11q21 gene rearrangement in bronchopulmonary mucoepidermoid carcinoma. Hum Pathol 2009;40(6):854–60.
Han, S-W, Kim, H-P, Jeon, YK, et al. Mucoepidermoid carcinoma of lung: potential target of EGFR-directed treatment. Lung Cancer 2008;61:30–4.
Macarenco, RS, Uphoff, TS, Gilmer, HF, et al. Salivary gland-type lung carcinomas: an EGFR immunohistochemical, molecular genetic, and mutational analysis study. Mod Pathol 2008;21:1168–75.
Vadasz, P, Egervary, M.Mucoepidermoid bronchial tumors: a review of 34 operated cases. Eur J Cardiothorac Surg 2000;17:566–9.
Carretta, A, Libretti, L, Taccagni, G, Zannini, P.Salivary gland-type mixed tumor (pleomorphic adenoma) of the lung. Inter Cardiovasc Thorac Surg 2004;3:663–5.
Chin, C-H, Huang, C-C, Lin, M-C, Chao, T-Y, Liu, S-F.Prognostic factors of tracheobronchial mucoepidermoid carcinoma – 15 years experience. Respirology 2008;13:275–80.
Bernheim, A, Toujani, S, Saulnier, P, et al. High-resolution array comparative genomic hybridization analysis of human bronchial and salivary adenoid cystic carcinoma. Lab Invest 2008;88:464–73.
Higashi, K, Jin, Y, Johansson, M, et al. Rearrangement of 9p13 as the primary chromosomal aberration in adenoid cystic carcinoma of the respiratory tract. Gene Chromosome Canc 1991;3:21–3.
Rao, PH, Roberts, D, Zhao, Y-J, et al. Deletion of 1p32-p36 is the most frequent genetic change and poor prognostic marker in adenoid cystic carcinoma of the salivary glands. Clin Cancer Res 2008;14:5181–7.
Chiles, C, Davis, KW, Williams, DW. Navigating the thoracic inlet. Radiographics 1999;19:1161–76.
Kwak, S-H, Lee, KS, Chung, MJ, et al. Adenoid Cystic Carcinoma of the Airways:Helical CT and Histopathologic Correlation. Am J Roentgenol 2004;183:277–81.
Spizarny, DL, Shepard, JA, McLoud, TC, Grillo, HC, Dedrick, CG.CT of adenoid cystic carcinoma of the trachea. Am J Roentgenol 1986;146:1129–32.
Campistron, M, Rouquette, I, Courbon, F, et al. Adenoid cystic carcinoma of the lung: interest of 18FDG PET/CT in the management of an atypical presentation. Lung Cancer 2008;59:133–6.
Aubry, M-C, Heinrich, MC, Molina, J, et al. Primary adenoid cystic carcinoma of the lung: absence of KIT mutations. Cancer 2007;110:2507–10.
Maziak, DE, Todd, TR, Keshavjee, SH, et al. Adenoid cystic carcinoma of the airway: thirty-two-year experience. J Thorac Cardiovasc Surg 1996;112:1522–31; discussion 31–2.
Ormos, J, Halasz, A.Electron microscopic study of adenoid cystic carcinoma. Ultrastruct Pathol 1991;15:149–57.
Sugio, K, Osaki, T, Oyama, T, et al. Genetic alteration in carcinoid tumors of the lung. Ann Thorac Cardiovasc Surg 2003;9:149–54.
Kanematsu, T, Yohena, T, Uehara, T, et al. Treatment outcome of resected and nonresected primary adenoid cystic carcinoma of the lung. Ann Thorac Cardiovasc Surg 2002;8:74–7.
Prommegger, R, Salzer, GM.Long-term results of surgery for adenoid cystic carcinoma of the trachea and bronchi. Eur J Surg Oncol 1998;24:440–4.
Martins, C, Fonseca, I, Roque, L, Pinto, AE, Soares, J.Malignant salivary gland neoplasms: a cytogenetic study of 19 cases. Eur J Cancer Boral Oncol 1996;32B:128–32.
Fulford, LG, Kamata, Y, Okudera, K, et al. Epithelial-myoepithelial carcinomas of the bronchus.[see comment]. Am J Surg Pathol 2001;25:1508–14.
Doganay, L, Bilgi, S, Ozdil, A, Yoruk, Y, Altaner, S, Kutlu, K.Epithelial-myoepithelial carcinoma of the lung. A case report and review of the literature. Arch Pathol Lab Med 2003;127:e177–80.
Pelosi, G, Fraggetta, F, Maffini, F, et al. Pulmonary epithelial-myoepithelial tumor of unproven malignant potential: report of a case and review of the literature. Mod Pathol 2001;14:521–6.
Wilson, RW, Moran, CA.Epithelial-myoepithelial carcinoma of the lung: immunohistochemical and ultrastructural observations and review of the literature. Hum Pathol 1997;28:631–5.
Nyguyen, C, Suster, S, Moran, C.Pulmonary epithelial-myoepithelial carcinoma: a clinicopathologic and immunohistochemical study of 5 cases. Hum Pathol 2009;40:366–73.
Miura, K, Harada, H, Aiba, S, Tsutsui, Y.Myoepithelial carcinoma of the lung arising from bronchial submucosa. Am J Surg Pathol 2000;24:1300–4.
Nistal, M, Garcia-Viera, M, Martinez-Garcia, C, Paniagua, R.Epithelial-myoepithelial tumor of the bronchus. Am J Surg Pathol 1994;18:421–5.
Fechner, RE, Bentinck, BR, Askew, JB Jr.Acinic cell tumor of the lung. A histologic and ultrastructural study. Cancer 1972;29:501–8.
Lee, H-Y, Mancer, K, Koong, H-N.Primary acinic cell carcinoma of the lung with lymph node metastasis.[see comment]. Arch Pathol Lab Med 2003;127:e216–9.
Moran, CA, Suster, S, Koss, MN.Acinic cell carcinoma of the lung (“Fechner tumor”). A clinicopathologic, immunohistochemical, and ultrastructural study of five cases. Am J Surg Pathol 1992;16:1039–50.
Rodriguez, J, Diment, J, Lombardi, L, et al. Combined typical carcinoid and acinic cell tumor of the lung: a heretofore unreported occurrence. Hum Pathol 2003;34:1061–5.
Sabaratnam, RM, Anunathan, R, Govender, D.Acinic cell carcinoma: an unusual cause of bronchial obstruction in a child. Pediatr Dev Pathol 2004;7:521–6.
Ukoha, OO, Quartararo, P, Carter, D, Kashgarian, M, Ponn, RB.Acinic cell carcinoma of the lung with metastasis to lymph nodes. Chest 1999;115:591–5.
Watanabe, K, Ono, N, Hoshi, T, Hanzawa, M, Ishida, T.Fine-needle aspiration cytology of bronchial acinic cell carcinoma: a case report. Diagn Cytopathol 2004;30:359–61.
el-Naggar, AK, Abdul-Karim, FW, Hurr, K, et al. Genetic alterations in acinic cell carcinoma of the parotid gland determined by microsatellite analysis. Cancer Genet Cytogen 1998;102:19–24.
Kamio, N.Coexpression of p53 and c-erbB-2 proteins is associated with histological type, tumour stage, and cell proliferation in malignant salivary gland tumours. Virchows Arch 1996;428:75–83.
Seethala, RR, Hunt, JL, Baloch, ZW, Livolsi, VA, Leon, Barnes E.Adenoid cystic carcinoma with high-grade transformation: a report of 11 cases and a review of the literature. Am J Surg Pathol 2007;31:1683–94.
Moran, CA, Suster, S, Askin, FB, Koss, MN.Benign and malignant salivary gland-type mixed tumors of the lung. Clinicopathologic and immunohistochemical study of eight cases. Cancer 1994;73:2481–90.
Hara, M, Sato, Y, Kitase, M, et al. CT and MR findings of a pleomorphic adenoma in the peripheral lung. Radiat Med 2001;19:111–4.
Sakamoto, H, Uda, H, Tanaka, T, et al. Pleomorphic adenoma in the periphery of the lung. Report of a case and review of the literature. Arch Pathol Lab Med 1991;115:393–6.
Takeuchi, E, Shimizu, E, Sano, N, et al. A case of pleomorphic adenoma of the lung with multiple distant metastases – observations on its oncogene and tumor suppressor gene expression. Anticancer Res 1998;18:2015–20.
Fitchett, J, Luckraz, H, Gibbs, A, O'Keefe, P.A rare case of primary pleomorphic adenoma in main bronchus. Ann Thorac Surg 2008;86:1025–6.
Chang, T, Husain, AN, Colby, T, et al. Pneumocytic adenomyoepithelioma: a distinctive lung tumor with epithelial, myoepithelial, and pneumocytic differentiation. Am J Surg Pathol 2007;31:562–8.
Matsumoto, M, Sonobe, H, Furihata, M, et al. A case of salivary gland-type mixed tumor of the lung differentiating toward type II alveolar epithelial cells in glandular components with a literature review. Virchows Arch 2002;441:618–21.
England, DM, Hochholzer, L.Truly benign “bronchial adenoma”. Report of 10 cases of mucous gland adenoma with immunohistochemical and ultrastructural findings. Am J Surg Pathol 1995;19:887–99.
Spencer, H.Bronchial mucous gland tumours. Virchows Arch A Pathol Anat Histol 1979;383:101–15.
Allen, MS Jr, Marsh, WL Jr, Geissinger, WT.Mucus gland adenoma of the bronchus. J Thorac Cardiovasc Surg 1974;67:966–8.
Heard, BE, Corrin, B, Dewar, A.Pathology of seven mucous cell adenomas of the bronchial glands with particular reference to ultrastructure. Histopathology 1985;9:687–701.
Edwards, CW, Matthews, HR.Mucous gland adenoma of the bronchus. Thorax 1981;36:147–8.
Key, BM, Pritchett, PS.Mucous gland adenoma of the bronchus. South Med J 1979;72:83–5.
Kwon, JW, Goo, JM, Seo, JB, Seo, JW, Im, JG.Mucous gland adenoma of the bronchus: CT findings in two patients. J Comput Assist Tomogr 1999;23:758–60.
Ishida, T, Kamachi, M, Hanada, T, et al. Mucous gland adenoma of the trachea resected with an endoscopic neodymium: yttrium aluminum garnet laser.[see comment]. Int Med 1996;35:890–3.
Black, WC 3rd.Pulmonary oncocytoma. Cancer 1969;23:1347–57.
Burrah, R, Kini, U, Correa, M, Srirangapatna, S.Pulmonary oncocytoma: a rare case. Asian Cardiovasc Thorac Ann 2006;14:e113–4.
Fechner, RE, Bentinck, BR.Ultrastructure of bronchial oncocytoma. Cancer 1973;31:1451–7.
Fernandez, MA, Nyssen, J.Oncocytoma of the lung. Can J Surg 1982;25:332–3.
Laforga, JB, Aranda, FI.Multicentric oncocytoma of the lung diagnosed by fine-needle aspiration. Diagn Cytopathol 1999;21:51–4.
Santos-Briz, A, Terron, J, Sastre, R, Romero, L, Valle, A.Oncocytoma of the lung. Cancer 1977;40:1330–6.
Tashiro, Y, Iwata, Y, Nabae, T, Manabe, H.Pulmonary oncocytoma: report of a case in conjunction with an immunohistochemical and ultrastructural study. Pathol Int 1995;45:448–51.
Tesluk, H, Dajee, A.Pulmonary oncocytoma. J Surg Oncol 1985;29:173–5.