Cystadenoma of Minor Salivary Glands With Cervical Metastasis: A Diagnostic Pitfall Revealing Underlying Cystadenocarcinoma

Papillary cystadenocarcinoma of the salivary glands is an exceptionally rare neoplasm. Despite advances in immunohistochemistry and molecular studies, the distinction between malignant and benign cystadenomatous tumors of salivary glands remains poorly defined. This case report details the pathological characteristics, highlighting the diagnostic difficulties and underscoring the importance of precise differentiation to guide effective clinical interventions. We report the case of a 58-year-old woman who was initially diagnosed with papillary cystadenoma of a minor salivary gland. Two years later, she developed a cervical lymph node (LN) mass. Clinical, radiological, and histopathological examinations confirmed metastasis to the cervical LNs, characterized by low-grade papillary cystadenocarcinoma originating from the salivary gland. Despite its potential to recur and metastasize, all specimens should be thoroughly examined and included, even in low-grade cases. Patients diagnosed with salivary gland cystadenomas should be closely monitored for early signs of relapse and/or metastasis. Therefore, understanding these pathological nuances is essential for clinicians and pathologists. Analyzing the molecular differences between the localized and metastatic forms of this neoplasm would enhance our understanding and documentation of this exceptional case.