Secretory carcinoma of the salivary gland
| Secretory carcinoma of the salivary gland | |
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| Diagnosis in short | |
.jpg) Secretory carcinoma of the salivary gland. H&E stain. (WC/NormanDy) | |
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| Synonyms | Mammary analogue secretory carcinoma (previous name) |
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| LM | large cells with abundant cytoplasm, small nuclei, +/-lymphocytic infiltrate, solid and microcystic growth pattern |
| LM DDx | acinic cell carcinoma, mucoepidermoid carcinoma |
| Stains | PAS +ve |
| IHC | S-100 +ve, mammaglobin +ve, vimentin +ve |
| Molecular | ETV6-NTRK3 fusion gene |
| Site | salivary gland - usually parotid |
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| Prevalence | rare |
| Clin. DDx | other salivary gland tumours |
| Treatment | excision |
Secretory carcinoma of the salivary gland is an uncommon malignant salivary gland tumour that was first described in 2010.[1]
It was previously known as mammary analogue secretory carcinoma, abbreviated MASC.[2]
General
- Microscopic appearance similar to secretory breast carcinoma.[3]
- Rare - 21 cases in the world literature as of 2012.[1]
- Original paper described it only in adults.[3]
- Has been described in a pediatric patient.[4]
Gross
- Usually parotid gland.[3]
- Well-circumscribed.[citation needed]
Microscopic
Features:
- Large cells with abundant cytoplasm.
- Small nuclei.
- +/-Lymphocytic infiltrate.
- Solid and microcystic growth pattern.
- +/-Cystic changes lined by hobnail cells - useful feature.
DDx:
- Acinic cell carcinoma - very closely mimics.
- Abundant basophilic granular cytoplasm.[1]
- Mucoepidermoid carcinoma.
Images
Case 1
SC - low. (WC/NormanDy)
SC - med. (WC/NormanDy)
SC - high. (WC/NormanDy)
SC - high solid. (WC/NormanDy)
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,_solid.jpg)
Case 2
SCSG - low mag. (WC)
SCSG - intermed. mag. (WC)
SCSG - high mag. (WC)
SCSG - high mag. (WC)
www
Stains
Features:[3]
- PAS stain +ve - secretory material.
- Does not have PAS +ve cytoplasmic granules like AcCC.
- Secretory material also PASD stain +ve.
- Mucicarmine stain +ve.
IHC
Features:[3]
Others:
Panel:
- S-100, mammaglobin, p63, HMWCK.
Images
MASC - mammaglobin. (WC/NormanDy)
MASC - S-100. (WC/NormanDy)
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Molecular
Note:
- The translocation seen in secretory breast carcinoma, congenital-infantile fibrosarcoma and mesoblastic nephroma.
Sign out
Right Parotid Lesion, Core Biopsy:
- SECRETORY CARCINOMA of the salivary gland, see comment.
Comment:
Secretory carcinoma of the salivary gland was previously known as "mammary analogue secretory carcinoma" (MASC).
The tumour stains as follows:
POSITIVE: CK7 (strong, diffuse), mammaglobin (strong, diffuse), S100 (moderate, patchy), mucin (focal).
NEGATIVE: p63.
NTRK testing was ordered; the results will be reported in an addendum.
See also
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 1.6 Lei, Y.; Chiosea, SI. (Jun 2012). "Re-evaluating historic cohort of salivary acinic cell carcinoma with new diagnostic tools.". Head Neck Pathol 6 (2): 166-70. doi:10.1007/s12105-011-0312-9. PMID 22127547.
- ↑ Montalvo N, Galarza D, Redrobán L (2019). "Secretory Carcinoma of the Parotid: Making the Correct Diagnosis of a Rare Salivary Gland Carcinoma When Molecular Biology Testing Is Not Available". Case Rep Pathol 2019: 5103496. doi:10.1155/2019/5103496. PMC 6441535. PMID 31007960. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6441535/.
- ↑ 3.0 3.1 3.2 3.3 3.4 Skálová, A.; Vanecek, T.; Sima, R.; Laco, J.; Weinreb, I.; Perez-Ordonez, B.; Starek, I.; Geierova, M. et al. (May 2010). "Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity.". Am J Surg Pathol 34 (5): 599-608. doi:10.1097/PAS.0b013e3181d9efcc. PMID 20410810.
- ↑ Rastatter, JC.; Jatana, KR.; Jennings, LJ.; Melin-Aldana, H. (Mar 2012). "Mammary analogue secretory carcinoma of the parotid gland in a pediatric patient.". Otolaryngol Head Neck Surg 146 (3): 514-5. doi:10.1177/0194599811419044. PMID 21873597.