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Yosefof E, Boldes T, Dan D, Robenshtok E, Strenov Y, Bachar G, Shpitzer T, Mizrachi A. Salivary Gland Secretory Carcinoma; Review of 13 Years World-Wide Experience and Meta-Analysis. Laryngoscope 2024; 134:1716-1724. [PMID: 37909690 DOI: 10.1002/lary.31123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 09/15/2023] [Accepted: 10/10/2023] [Indexed: 11/03/2023]
Abstract
OBJECTIVES Secretory Carcinoma is a malignant salivary gland tumor, initially described in 2010. This rare tumor is associated with the translocation t(12;15) (p13;q25), resulting in the fusion gene ETV6-NTRK3. Since this tumor is quite rare, most publications describe only small cohorts of patients. We aimed to investigate the clinical, pathological, and prognostic features of this newly defined malignant entity. DATA SOURCES Pubmed, Google Scholar, and Web of Science databases. REVIEW METHODS All published articles between 2010 and 2023 were reviewed. Search terms included the terms "Mammary Analogue Secretory Carcinoma" and "Secretory Carcinoma". All articles published in English reporting on Secretory Carcinoma of salivary glands were retrieved. RESULTS One-hundred and 12 retrospective articles reporting a total of 674 patients were included, with 52% males and a mean age of 44.9 ± 18.9. The event rate for patients with advanced-stage disease (Stage 3/4) at presentation was 24.1% (95% CI 17.6%-31.9%, I2 = 9.2%), 14.6% for regional metastases (95% CI 10.5%-20%, I2 = 12%), and the event rate of distant metastasis was 8.4% (95% CI 5.5%-12.7%, I2 = 4.2%). Adjuvant radiotherapy was administered for 30.3% of patients (95% CI 24.1%-37.2%, I2 = 21.5%). The recurrence rate was 19% (95% CI 15.1%-23.8%, I2 = 5%). Survival outcomes showed a 17.2% death of disease rate for Secretory Carcinoma patients (95% CI 13.5%-21.8%, I2 = 7.3%). CONCLUSIONS Secretory Carcinoma is a rare and relatively newly defined entity arising in the parotid gland most commonly. Characterized as a low-grade tumor, the majority of patients are diagnosed at an early stage, without regional or distant disease, and the prognosis is relatively good. LEVEL OF EVIDENCE NA Laryngoscope, 134:1716-1724, 2024.
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Affiliation(s)
- Eyal Yosefof
- Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Tomer Boldes
- Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Daniel Dan
- Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Eyal Robenshtok
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center, Petah Tikva, Israel
| | - Yulia Strenov
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Pathology, Rabin Medical Center, Petah Tikva, Israel
| | - Gideon Bachar
- Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Thomas Shpitzer
- Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aviram Mizrachi
- Department of Otorhinolaryngology and Head and Neck Surgery, Rabin Medical Center-Beilinson Hospital, Petach Tikva, Israel
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Sharma P, Sivakumar N, Pandiar D. Diagnostic accuracy of pan-TRK immunohistochemistry in differentiating secretory carcinoma from acinic cell carcinoma of salivary gland-A systematic review. J Oral Pathol Med 2023; 52:255-262. [PMID: 36207812 DOI: 10.1111/jop.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/18/2022] [Accepted: 09/29/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Secretory carcinoma (SC) is a well-established salivary gland malignancy that has earned its popularity for its unique clinicopathological behavior. Although it is an indolent malignancy, few of them have been reported with high grade transformation making it mandatory to differentiate it from its prime histological mimicker, acinic cell carcinoma (AciCC). Recently, many studies have been directed toward validating the sensitivity and specificity of pan-TRK IHC for confirming ETV6::NTRK3 gene fusion in SCs involving salivary gland. AIM The aim of the present systematic review was to establish the diagnostic utility of pan-TRK immunostaining in histological differentiation of SC from AciCC. MATERIAL AND METHODS An electronic search was carried out using MEDLINE by PubMed, Scopus, Google scholar, Trip, Cochrane library and EMBASE databases. Articles in which SC assessed with pan-TRK immunohistochemical expressions were included for systematic review and their staining pattern (cytoplasmic, nuclear and/or combined), sensitivity, specificity, positive as well as negative predictive were gathered. Risk of bias was analyzed for each study using QUADAS-2 tool. RESULTS Thirteen eligible articles were included for the quantitative analysis, which revealed positive immunostaining of pan-TRK by nearly all the ETV6::NTRK3 fusion prevalent SCs alongside negative expression in almost all the cases of AciCC with 100% of sensitivity as well as specificity. CONCLUSION The evidence from the included studies supports that pan-TRK immunostaining could be used as a reliable preliminary screening tool for discerning SC from AciCC. PROSPERO No: CRD42022308913.
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Affiliation(s)
- Pooja Sharma
- Department of Oral Pathology, King George's Medical University, Lucknow, India
| | - N Sivakumar
- Department of Oral Pathology, King George's Medical University, Lucknow, India
| | - Deepak Pandiar
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, India
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Ogawa M, Yokoo S, Yamaguchi T, Suzuki K, Seki-Soda M, Shimizu T, Kurihara J, Makiguchi T. Diagnosis and treatment of secretory carcinoma arising from the oral minor salivary gland: Two case reports. Medicine (Baltimore) 2021; 100:e28390. [PMID: 34941172 PMCID: PMC8702035 DOI: 10.1097/md.0000000000028390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/02/2021] [Indexed: 01/05/2023] Open
Abstract
INTRODUCTION Secretory carcinoma (SC) is a malignancy of the salivary glands, which is similar to SC of the breast regarding its association with neurotrophic tyrosine receptor kinase fusion-positive gene. SC is a recently described salivary gland tumor, and there are a few reports describing oral minor salivary gland-derived SC. We reported two cases of SC in the oral cavity and reviewed the literature. PATIENT CONCERNS The patients included a 65-year-old Japanese woman who presented with a mass of the upper lip and an 84-year-old Japanese man who presented with a mass on the buccal mucosa. DIAGNOSIS Diagnosis was based on histomorphological and immunohistochemical findings and identification of a specific translocation of the ETS variant 6-neurotrophic receptor tyrosine kinase 3 gene fusion. Case 1 was finally diagnosed using reverse transcription-polymerase chain reaction with formalin-fixed paraffin-embedded tissue samples, while case 2 was diagnosed using fluorescence in situ hybridization analysis. INTERVENTIONS AND OUTCOMES In case 1, excisional biopsy was done and there was no recurrence observed in five-year follow-up. In case 2, tumor resection was done and there was no recurrence observed in two-year follow-up. CONCLUSION It is highly likely for many cases of SC to be initially diagnosed as acinic cell carcinoma (AciCC) owing to their similar histological findings. The treatment strategy for minor salivary gland-originated SC is similar to that of AciCC; however, SC is often highly malignant and involves a high risk of cervical lymph node metastasis. Thus, establishing an accurate diagnosis together with pathologists and confirming the presence of the ETS variant 6-neurotrophic receptor tyrosine kinase 3 fusion gene using genetic analysis is important.
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Affiliation(s)
- Masaru Ogawa
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
| | - Satoshi Yokoo
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
| | - Takahiro Yamaguchi
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
| | - Keisuke Suzuki
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
| | - Mai Seki-Soda
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
- Department of Diagnostic Pathology, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
| | - Takahiro Shimizu
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
| | - Jun Kurihara
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
| | - Takaya Makiguchi
- Department of Oral and Maxillofacial Surgery, and Plastic Surgery, Gunma University Graduate School of Medicine, 4-39-15 Showa-machi, Maebashi, Gunma, Japan
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Clinicopathological characteristics and outcomes of 23 patients with secretory carcinoma of major salivary glands. Sci Rep 2021; 11:22639. [PMID: 34811395 PMCID: PMC8609010 DOI: 10.1038/s41598-021-01970-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 11/08/2021] [Indexed: 02/06/2023] Open
Abstract
This retrospective study investigated the clinicopathological characteristics of secretory carcinoma of salivary glands (SCSG) in 23 patients with histopathologically confirmed SCSG between January 2010 and December 2020. In total, 13 males and 10 females (ratio, 1.3:1) aged 10 − 69 years (median, 45 years) were enrolled in this study; the average disease duration was 2.44 years (0.25–20 years). Twenty-one patients (91.3%) had SCSG in the parotid gland, and two (8.7%) in the submandibular gland. All patients had single nodules of diameters 0.8–4.8 cm (average 2.6 cm); five with lymph node metastases, and two with distant metastases. Immunohistochemically, tumors stained positive for S-100, mammaglobin, CK7, GATA3 and pan-Trk, and negative for DOG1, P63, and calponin, with Ki-67 positivity from 1 to 50%. ETV6 gene rearrangement was confirmed in 15 patients. All patients underwent oncological resection, four had radioactive particles implanted postoperatively, one received chemotherapy, and seven underwent chemoradiotherapy. Six patients had regional recurrences, two distant metastases, and one died before the last follow-up. SCSGs are typically indolent, with a low locoregional recurrence rate and excellent survival. Prognosis is correlated to clinical stage, pathological grade, and surgical procedures.
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Alves LDB, de Melo AC, Farinha TA, de Lima Araujo LH, Thiago LDS, Dias FL, Antunes HS, Amaral Eisenberg AL, Santos Thuler LC, Cohen Goldemberg D. A systematic review of secretory carcinoma of the salivary gland: where are we? Oral Surg Oral Med Oral Pathol Oral Radiol 2021; 132:e143-e152. [PMID: 32493686 DOI: 10.1016/j.oooo.2020.04.007] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/22/2020] [Accepted: 04/11/2020] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The aim of this systematic review was to describe the epidemiology, diagnostic criteria, differential diagnosis, treatment, prognostic factors, and treatment outcomes of secretory carcinoma. STUDY DESIGN A comprehensive search of Lilacs, PubMed, Science Direct, and Web of Science databases was conducted to identify all case reports, letter to the editor, and histopathologic reclassifications regarding salivary gland secretory carcinoma published in English, Spanish, French, and Portuguese. RESULTS The final analysis included 119 studies, which totaled 642 secretory carcinoma diagnoses, with 239 case reports and 403 diagnostic reclassifications, mostly in the United States. The age range was 5 to 87 years, and cases were predominantly in males (58.7%) and mostly affecting the parotid glands (73.7%). The disease usually presents as a slow-growing, painless mass. The main differential diagnosis is acinic cell carcinoma, and the tumor is usually treated with surgery. The prognosis is considered favorable, although there have been reports of local recurrences, distant metastases, and deaths. CONCLUSIONS It is important that clinicians become aware of this salivary gland neoplasm and report clinical data, clinical course, management and long-term follow-up. There is an urgent need to conduct more clinical trials, especially on tropomyosin receptor kinase (TRK) inhibitors and other potential target therapy modalities.
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Affiliation(s)
| | | | - Thayana Alves Farinha
- Scientific Initiation Student, Clinical Research Division, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA)
| | | | - Leandro de Souza Thiago
- Clinical Research Division, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA)
| | - Fernando Luiz Dias
- Head and Neck Surgery Service, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA)
| | | | | | | | - Daniel Cohen Goldemberg
- Clinical Research Division, National Cancer Institute of Brazil, Rio de Janeiro, Brazil (INCA).
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Venkat S, Fitzpatrick S, Drew PA, Bhattacharyya I, Cohen DM, Islam MN. Secretory Carcinoma of the Oral Cavity: A Retrospective Case Series with Review of Literature. Head Neck Pathol 2021; 15:893-904. [PMID: 33660147 PMCID: PMC8384990 DOI: 10.1007/s12105-021-01310-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 02/12/2021] [Indexed: 12/30/2022]
Abstract
Secretory carcinoma (SC) is an uncommon salivary gland neoplasm of the oral cavity that microscopically may mimic acinic cell carcinoma (ACC) and mucoepidermoid carcinoma (MEC). This study describes a series of SC in minor glands with a literature review. We performed a retrospective search for oral SC, within the archives of the University of Florida, Oral Pathology and Surgical Pathology Biopsy services from 2010 to 2018. A total of 10 SCs were identified in the oral and maxillofacial region, four of which were in the minor salivary glands. The demographic, clinical, histological, and molecular findings were aggregated for all 4 cases. Patient age varied from 30 to 60 years, with an average of 45 years. Two cases each were in female and male patients. Two cases presented on the labial mucosa, and one each on the hard and soft palate. Immunohistochemical (IHC) staining showed mammaglobin positivity in all cases, GATA3 positivity in two cases, S100 positivity in three cases, and SOX10 positivity in only one case. Fluorescence in situ hybridization demonstrated positivity for ETV6-NTRK3 fusion in 4 cases. Although oral SC is rare, pathologists should be aware of the histologic overlap between the SC and other salivary gland neoplasms such as ACC and MEC. A judicious application of IHC staining would aid in diagnosis. SC should be considered in the differential diagnosis for intraoral salivary gland tumors.
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Affiliation(s)
- Shankar Venkat
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL, 32610, USA.
| | - Sarah Fitzpatrick
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL, 32610, USA
| | - Peter A Drew
- Department of Pathology, Immunology and Laboratory Medicine College of Medicine, 1395 Center Drive, Gainesville, FL, 32610, USA
| | - Indraneel Bhattacharyya
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL, 32610, USA
| | - Donald M Cohen
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL, 32610, USA
| | - Mohammed N Islam
- Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, 1395 Center Drive, Gainesville, FL, 32610, USA
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Alves LDB, de Melo AC, de Lima Araujo LH, Thiago LS, Dos Santos Guimarães I, Fernandes PV, Rodrigues EM, Dias FL, Antunes HS, Eisenberg ALA, Cohen Goldemberg D. Secretory carcinoma of salivary glands at the National Cancer Institute: A 20-year retrospective clinical, pathological, immunohistochemical and molecular study. Oral Oncol 2021; 117:105198. [PMID: 33573874 DOI: 10.1016/j.oraloncology.2021.105198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/15/2021] [Accepted: 01/17/2021] [Indexed: 11/15/2022]
Abstract
OBJECTIVES This study aim was to review cases of acinic cell carcinoma (the main differential diagnosis of secretory carcinoma) that were diagnosed and treated at the National Cancer Institute of Brazil (INCA) between 1996 and 2016. The primary objective was to identify underdiagnosed cases of secretory carcinoma via a clinical, immunopathological and molecular reassessment. MATERIALS AND METHODS This is a cross sectional study, with retrospective data collection from medical records and histological specimen review, with staining for periodic acid-Schiff (PAS) and PAS with diastase, immunohistochemistry for S-100, mammaglobin, and DOG-1, and droplet digital RT-PCR for ETV6-NTRK3. The Research Ethics Committee approved this study, and the patients allowed their participation through informed consent. RESULTS Eighty-three cases of acinic cell carcinoma were diagnosed and treated in the specified period at INCA, of which, seven had their diagnosis changed to secretory carcinoma. CONCLUSION The present study adds seven cases of secretory carcinoma to the literature, contributing to a better understanding of the epidemiological, histological, immunohistochemical and molecular characteristics of this recently described tumor. Also, the use of a comprehensive diagnostic approach, including immunohistochemical and molecular methods, along with classical morphological studies, allowed the reclassification of acinic cell carcinoma to secretory carcinoma.
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Affiliation(s)
| | | | | | - Leandro Souza Thiago
- Clinical Research Division, National Cancer Institute of Brazil, Rio de Janeiro, Brazil
| | | | | | | | - Fernando Luiz Dias
- Head and Neck Surgery Service, National Cancer Institute of Brazil, Rio de Janeiro, Brazil
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A Challenging Case of Mammary Analogue Secretory Carcinoma: Case Study with Ultrastructural and Cytogenetic Correlation. Case Rep Pathol 2019; 2019:7468691. [PMID: 31929931 PMCID: PMC6939431 DOI: 10.1155/2019/7468691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 10/15/2019] [Indexed: 11/17/2022] Open
Abstract
Mammary analogue secretory carcinoma (MASC) is a rare salivary gland tumor analogous to secretory carcinoma of the breast. The diagnosis of MASC can be challenging due to substantial morphologic and immunohistochemical similarities with other salivary gland tumors. The differential diagnosis of MASC is broad and includes intraductal carcinoma, acinic cell carcinoma, and adenocarcinoma, not otherwise specified. Although molecular testing for ETV6 gene rearrangement is characteristic of MASC and has not been shown in any other salivary gland tumor, a particular challenge arises when such testing is unavailable, or when molecular testing for ETV6 gene rearrangement is negative in a suspected case of MASC. Our study presents the diagnostic workup of a challenging case of MASC with immunohistochemistry, electron microscopy, and cytogenetic studies performed to resolve the diagnosis.
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Hung YP, Jo VY, Hornick JL. Immunohistochemistry with a pan-TRK antibody distinguishes secretory carcinoma of the salivary gland from acinic cell carcinoma. Histopathology 2019; 75:54-62. [PMID: 30801752 DOI: 10.1111/his.13845] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 02/21/2019] [Indexed: 01/01/2023]
Abstract
AIMS Secretory carcinoma (previously known as mammary analogue secretory carcinoma) is characterised by ETV6 rearrangements, most often ETV6-NTRK3 fusion. Given its histological overlap with other salivary gland tumours, secretory carcinoma can be difficult to diagnose without genetic confirmation. A recently developed pan-TRK antibody shows promise for identifying tumours with NTRK fusions. The aim of this study was to evaluate the utility of pan-TRK immunohistochemistry in distinguishing secretory carcinoma from mimics. METHODS AND RESULTS We examined whole-tissue sections from 86 tumours, including 14 secretory carcinomas (12 parotid primaries and one buccal primary, and one metastasis; five with ETV6 rearrangement confirmed by fluorescence in-situ hybridisation, and one with ETV6-NTRK3 fusion and one with ETV6-RET fusion detected by targeted sequencing), 14 acinic cell carcinomas, 18 polymorphous adenocarcinomas, 20 low-grade mucoepidermoid carcinomas, and 20 pleomorphic adenomas. Immunohistochemistry was performed with a pan-TRK rabbit monoclonal antibody. Pan-TRK staining was detected in nine (64%) secretory carcinomas, all with a nuclear pattern and four with diffuse staining (>50% of cells). Among other tumour types, pan-TRK immunoreactivity was observed in all (100%) pleomorphic adenomas (particularly myoepithelial cell-rich, myxoid areas), 15 (83%) polymorphous adenocarcinomas, and four (20%) low-grade mucoepidermoid carcinomas, all with predominantly membranous/cytoplasmic immunoreactivity; only six cases showed focal (<10%) nuclear staining. All acinic cell carcinomas were entirely negative. CONCLUSIONS Although pan-TRK expression is not entirely sensitive or specific for secretory carcinoma, nuclear staining distinguishes secretory carcinoma from mimics. Acinic cell carcinomas are negative for pan-TRK, though membranous expression of TRK is common in other salivary gland neoplasms. The lack of pan-TRK immunoreactivity in a subset of secretory carcinomas may suggest non-NTRK fusion partners.
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Affiliation(s)
- Yin P Hung
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Jason L Hornick
- Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
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Secretory Carcinoma of Minor Salivary Gland in Buccal Mucosa: A Case Report and Review of the Literature. Case Rep Pathol 2019; 2019:2074504. [PMID: 31032132 PMCID: PMC6457284 DOI: 10.1155/2019/2074504] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/13/2019] [Accepted: 03/18/2019] [Indexed: 12/04/2022] Open
Abstract
Secretory carcinoma (SC) of the salivary gland was recently added to the fourth edition of the World Health Organization classification of head and neck tumors. Some salivary tumors, including acinic cell carcinoma, have been reclassified as SC. Most of these tumors are located on the parotid gland with very few cases reported in the minor salivary glands of the buccal mucosa. Herein, we present a case of SC of buccal mucosa, which appeared clinically as a benign lesion in a 54-year-old Japanese female patient. Histopathologically, the tumor cells presented with an eosinophilic cytoplasm with microcytic structure along with eosinophilic secretory material and hemosiderin deposit. Immunohistochemical staining revealed strongly positive staining for S100, vimentin, and mammaglobin and negative staining for DOG-1. The tumor was finally diagnosed as secretory carcinoma of the buccal mucosa. We present a review of the medical literature of SC arising from minor salivary glands. We found only 15 cases of SC of buccal mucosa out of 63 cases of SC in the minor salivary glands. They showed good prognoses and only one case of SC in the buccal mucosa exhibited local recurrence and lymph node metastases.
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Guilmette J, Dias-Santagata D, Nosé V, Lennerz JK, Sadow PM. Novel gene fusions in secretory carcinoma of the salivary glands: enlarging the ETV6 family. Hum Pathol 2019; 83:50-58. [PMID: 30130630 DOI: 10.1016/j.humpath.2018.08.011] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 08/03/2018] [Accepted: 08/09/2018] [Indexed: 01/06/2023]
Abstract
Secretory carcinoma (SC) of the salivary gland is a low-grade malignancy associated with a well-defined clinical, histologic, immunohistochemical, and cytogenetic signature. Although the t(12;15) (p13;q25) translocation resulting in an ETV6-NTRK3 gene fusion is well documented, advances in molecular profiling in salivary gland tumors have led to the discovery of RET as another ETV6 gene fusion partner in SC. Here, we applied an RNA-based next-generation sequencing (NGS) approach for fusion detection on 14 presumed SC. The cases included 7 SC with classic ETV6-NTRK3 gene fusion and 3 SC harboring ETV6-RET gene fusion. In addition, 2 cases revealed a NCOA4-RET gene fusion and were subsequently reclassified as intraductal carcinomas. One case with an unusual dual-pattern morphology revealed a novel translocation involving ETV6, NTRK3, and MAML3 gene rearrangements. Interestingly, no ETV6-NTRK3 or ETV6-RET SC was ever documented to have this unique dual-pattern morphology or harbor a MAML3 mutation. The remaining case had no detected chromosomal abnormalities. Advances in molecular profiling of SC have led to the discovery of novel fusion partners such as RET and now MAML3. Further molecular characterization of salivary gland neoplasms is needed as these mutations may present alternative therapeutic targets in patients with these tumors.
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Affiliation(s)
- Julie Guilmette
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114-2696, USA; Department of Pathology, Harvard Medical School, Boston, MA 02115, USA
| | - Dora Dias-Santagata
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114-2696, USA; Department of Pathology, Harvard Medical School, Boston, MA 02115, USA
| | - Vânia Nosé
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114-2696, USA; Department of Pathology, Harvard Medical School, Boston, MA 02115, USA
| | - Jochen K Lennerz
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114-2696, USA; Department of Pathology, Harvard Medical School, Boston, MA 02115, USA
| | - Peter M Sadow
- Department of Pathology, Massachusetts General Hospital, Boston, MA 02114-2696, USA; Department of Pathology, Harvard Medical School, Boston, MA 02115, USA.
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Ayre G, Hyrcza M, Wu J, Berthelet E, Skálová A, Thomson T. Secretory carcinoma of the major salivary gland: Provincial population-based analysis of clinical behavior and outcomes. Head Neck 2018; 41:1227-1236. [PMID: 30592355 DOI: 10.1002/hed.25536] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 10/15/2018] [Accepted: 10/16/2018] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND Our aim was to identify the number of cases of secretory carcinoma (SC) of the major salivary gland in a population-based cohort and review its clinical behavior with long-term follow-up. METHODS All malignant salivary gland tumors (MSGTs) diagnosed between 1980 and 2014 were assessed for histological features compatible with SC and 140 were selected for further analysis. RESULTS Twenty two new cases of SC were identified, 19 of which were originally classified as acinic cell carcinoma, and 3 as adenocarcinoma, not otherwise specified (NOS). Lymph node involvement was less common in SC tumors (5%) than in the control group (11%). Disease recurrence was seen less frequently in SC (9%) than the control group (20%). Mean disease-free survival was 192 months for SC compared with 162 months for controls (P = 0.15). CONCLUSION The clinical course of SC is typically indolent with a low risk of relapse not significantly different from other low-grade MSGT.
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Affiliation(s)
- Gareth Ayre
- Department of Clinical Oncology, Bristol Cancer Institute, Bristol, United Kingdom
| | - Martin Hyrcza
- St. Joseph's Healthcare & Hamilton Health Sciences, Department of Pathology and Molecular Medicine, McMaster University, Hamilton, Canada.,Department of Pathology, BC Cancer Agency - Vancouver Centre, Vancouver, Canada
| | - Jonn Wu
- Department of Radiation Oncology, BC Cancer Agency - Vancouver Centre, Vancouver, Canada
| | - Eric Berthelet
- Department of Radiation Oncology, BC Cancer Agency - Vancouver Centre, Vancouver, Canada
| | - Alena Skálová
- Department of Pathology, Faculty of Medicine in Plzen, Charles University, Czech Republic
| | - Tom Thomson
- Department of Pathology, BC Cancer Agency - Vancouver Centre, Vancouver, Canada
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Bao Y, Li J, Zhu Y. Mammary Analog Secretory Carcinoma With ETV6 Rearrangement Arising in the Conjunctiva and Eyelid. Am J Dermatopathol 2018; 40:531-535. [PMID: 29251639 DOI: 10.1097/dad.0000000000001062] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Mammary analog secretory carcinoma (MASC) of salivary gland is a recently described neoplasm that morphologically and immunohistochemically resembles secretory carcinoma of the breast. Genetically, both of them harbor ETV-6-NTRK-3 fusion rearrangement. One case of primary MASCs arising from the eyelid is reported. The patient was a 52-year-old man. Microscopically, the tumor exhibited nodular aggregation of solid, tubular, and microcystic/macrocystic structures. Characteristic "colloid-like" eosinophilic secretory material was present within intraluminal spaces. Immunohistochemically, the tumor cells were positive for mammaglobin, S-100, STAT5a, vimentin, GCDFP-15, AE1/AE3, EMA, and CK7 and were negative for DOG-1, CK5/6, and SMA. A dual color break-apart fluorescence in situ hybridization probe identified rearrangement of the ETV6 gene locus on chromosome 12. The patient had no history of breast or salivary gland tumor. The tumor was completely excised, and the patient has no evidence of recurrent disease or metastasis after 1-year follow-up. A diagnosis of primary MASC was rendered. MASC has never been reported occurring in ocular region. This type of secretory carcinoma probably originates from sweat glands or accessory lacrimal glands, Wolfring and Krause. This unique case expands the clinicopathologic landscape of MASCs for better characterization of this rare entity.
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Affiliation(s)
| | - Jiang Li
- Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Synchronous Parotid (Mammary Analog) Secretory Carcinoma and Acinic Cell Carcinoma: Report of a Case. Head Neck Pathol 2018; 13:686-691. [PMID: 29876739 PMCID: PMC6854153 DOI: 10.1007/s12105-018-0935-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 05/21/2018] [Indexed: 01/16/2023]
Abstract
Mammary analogue secretory carcinoma (MASC) is a recently described low-grade salivary gland malignancy with histologic, immunohistochemical and molecular similarities to secretory carcinoma of the breast, including a specific t(12;15)(p13;q25) resulting in an ETV6-NTRK3 gene fusion. Ultrasound and magnetic resonance imaging frequently document a macrocystic structure. The main differential diagnosis of secretory carcinoma is with low grade acinic cell carcinoma (AciCC). The two can be differentiated with immunohistochemical stains for S100, mammaglobin, carbonic anhydrase VI and DOG-1; the identification of the specific translocation can help to characterize non-typical cases. We report a unique case of synchronous MASC and AciCC presenting in a parotid gland and discuss the implications of the correct identification of the two tumors.
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