Time to Rethink Pathology Reporting in Adenoid Cystic Carcinoma.

Authors

Luigi Lorini, Emily Governini, Armando Di Bello, Silvia Uccella, Martina Iuzzolino, Carlo Resteghini, Paolo Bossi

Published in

Head & neck. Sep 29, 2026. Epub Sep 29, 2026.

Abstract

To propose a practical, biologically informed pathology reporting framework for adenoid cystic carcinoma (AdCC) that integrates conventional morphology with selective biomarker assessment.
A narrative review of current pathological reporting standards, emerging proteogenomic evidence, and clinically relevant biomarkers was performed. Based on available evidence, a stepwise reporting strategy was developed in which routine histopathological evaluation remains the foundation, while additional immunohistochemical and molecular analyses are selectively recommended for high-risk or clinically relevant cases.
Conventional morphology accurately establishes the diagnosis but does not fully capture the biological heterogeneity and complexity of AdCC. A selective biological addendum including MYC, p63, B7-H4, TROP2, Nectin-4, and selected molecular analyses may improve biological stratification, optimize tissue stewardship, and identify patients eligible for biomarker-driven therapeutic trials.
Morphology should remain the cornerstone of AdCC pathology reporting while guiding selective biological characterization to support precision oncology and future clinical trial enrollment.

PMID:
42811719
Bibliographic data and abstract were imported from PubMed on 30 Sep 2026.

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