Contributed by Richard Freij, MD
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The patient is a 61 year old female who presents with a right-sided 1.9 cm submandibular gland mass.
Histological examination showed mucous, intermediate and epidermoid cells with invasive growth pattern, extensive tumor-associated lymphoid association and stromal desmoplasia (Figures 1 and 2). Additionally, solid nests with scant cystic structures consisting of primarily epidermoid cells and with few intermediate cells. Marked cellular pleomorphism, mitoses and focal necrosis is also seen (Figures 3, 4, 5 and 6).