Androgen Receptor Expression in Primary Nonsquamous Cell Rare-Variant Carcinomas of the Head and Neck

Abstract

Objective: Androgen receptor (AR) is a diagnostic immunohistochemical marker for salivary gland duct carcinoma (SDC), but other nonsquamous cell head and neck carcinomas (NSCCs) may also express it. The aim of this preliminary study was to investigate the immunohistochemical expression of AR in rare head and neck NSCCs.

Study design: Retrospective analysis of histologic records.

Setting: A large community hospital.

Subjects and methods: Twenty-seven patients with NSCC were selected (21 men, 6 women; average age, 69 years). Exclusion criteria were histologically confirmed primary and metastatic head and neck squamous cell carcinomas and thyroid carcinomas. AR immunohistochemistry was done on formalin-fixed, paraffin-embedded tissue blocks.

Results: Variable AR expression was found in 5 of 27 (25%) cases of NSCC. All 7 patients with SDC showed intense and extensive positive immunoreactivity. Of 27 NSCC tumors, 15 (56%) had negative staining.

Conclusion: In the head and neck, expression of AR is not limited to SDCs; other NSCCs also express it. When surgery or radiotherapy is not appropriate for recurrent or metastatic head and neck NSCC, palliative chemotherapy offers poor results. Antiandrogen therapy is well tolerated and is much less toxic than chemotherapy. Since androgen deprivation therapy has been used against SDCs, this therapy may theoretically be used in a small subset of head and neck NSCCs.

Keywords: androgen receptor; head and neck; immunohistochemistry; nonsquamous cell carcinoma; preliminary study.

Figure 1.

Immunohistochemistry shows intense positive nuclear staining with androgen receptor: A, carcinoma of the lacrimal drainage system (case 11); B, intestinal-type adenocarcinoma of tongue (case 12); C, submandibular gland high-grade NOS carcinoma (case 9); D, high-grade NOS carcinoma of orbit (case 10). NOS, not otherwise specified.