Sclerosing Polycystic Adenosis of Minor Salivary Glands: A Systematic Review

Abstract

Introduction: Sclerosing polycystic adenosis (SPA) is a rare salivary gland condition resembling sclerosing adenosis of the breast, with both reactive and neoplastic characteristics. It has been reported in over 60 cases globally, primarily affecting major salivary glands, with fewer cases involving minor salivary glands. It is characterized by multiple cystic spaces within a sclerotic (fibrotic) stroma and often mimics other neoplastic lesions. The limited number of cases reported in the literature, necessitate a systematic review to understand its clinical behavior, histopathological features with their differential diagnosis and patient outcomes. Aim: This systematic review analyzes demographics, clinical features, histopathology, differential diagnosis, treatment, and outcomes of SPA cases in minor salivary glands. Method: A systematic review of case reports/series on minor salivary glands SPA was conducted. Data on demographics, clinical and histopathological features, diagnosis, and treatment were tabulated. Results: Thirteen cases were analyzed, out of 13 cases, 10 (76.9%) males and 3 (23.1%) females, aged 19–82 years. All presented with slowly-growing, painless masses lasting 2 months to 8 years. Histologically, lesions showed lobular proliferation of ducts, myoepithelial cells, and acini with hyalinized fibrosis. Six cases had apocrine metaplasia resembling atypical ductal hyperplasia of the breast; seven lacked apocrine features. Conclusion: The presence of apocrine metaplasia may correlate with SPA prognosis. Oral pathologists should recognize the clinical and histopathological features to ensure accurate diagnosis and treatment.