AUTHOR=Scarini João Figueira , de Lima-Souza Reydson Alcides , Lavareze Luccas , Ribeiro de Assis Maria Clara Falcão , Damas Ingrid Iara , Altemani Albina , Egal Erika Said Abu , dos Santos Jean Nunes , Bello Ibrahim Olajide , Mariano Fernanda Viviane TITLE=Heterogeneity and versatility of the extracellular matrix during the transition from pleomorphic adenoma to carcinoma ex pleomorphic adenoma: cumulative findings from basic research and new insights JOURNAL=Frontiers in Oral Health VOLUME=4 YEAR=2023 URL=https://www.frontiersin.org/journals/oral-health/articles/10.3389/froh.2023.942604 DOI=10.3389/froh.2023.942604 ISSN=2673-4842 ABSTRACT=

Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for 50%–60% of these neoplasms. If untreated, 6.2% of PA may undergo malignant transformation to carcinoma ex-pleomorphic adenoma (CXPA). CXPA is a rare and aggressive malignant tumor, whose prevalence represents approximately 3%–6% of all salivary gland tumors. Although the pathogenesis of the PA-CXPA transition remains unclear, CXPA development requires the participation of cellular components and the tumor microenvironment for its progression. The extracellular matrix (ECM) comprises a heterogeneous and versatile network of macromolecules synthesized and secreted by embryonic cells. In the PA-CXPA sequence, ECM is formed by a variety of components including collagen, elastin, fibronectin, laminins, glycosaminoglycans, proteoglycans, and other glycoproteins, mainly secreted by epithelial cells, myoepithelial cells, cancer-associated fibroblasts, immune cells, and endothelial cells. Like in other tumors including breast cancer, ECM changes play an important role in the PA-CXPA sequence. This review summarizes what is currently known about the role of ECM during CXPA development.