Primary carcinoma of Stensen's duct: recognition and management with literature review.

Primary carcinoma of Stensen's duct is a rare neoplasm with only 15 cases reported in the English literature since 1927. The authors present a recent additional patient and discuss their criteria for the determination of true primary ductal lesions based upon clinical presentation, operative findings, and tumor histology. This method of selection, most particularly involving electron microscopy in the reported case, is necessary to define whether the lesion originates from the ductal epithelium. All previously reported cases were reviewed, together with the actual pathologic slides in four available cases. Only ten were retained as primary ductal lesions. Most important, this analysis clarifies the natural history of these neoplasms and reinforces a recent theory of histogenesis of salivary gland tumors. In light of these findings, a rational treatment plan can be suggested.