Differential Diagnosis

Adenoid SCCs must be differentiated from adenocarci-nomas, particularly adenoid cystic carcinomas, adeno-squamous carcinomas, and mucoepidermoid carcinomas. This is best achieved by demonstrating that there is no true gland formation and that stains for mucin are negative in adenoid SCCs.

Differential diagnosis also includes angiosarcoma, but immunohistochemistry helps to distinguish between the two tumours. Angiosarcomas typically express vascular antigens (CD31, CD34, von Willebrand factor) that are negative in adenoid SCCs. Cytokeratin, however, may also be positive in some angiosarcomas [139].

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