1
|
Utsumi Y, Nakaguro M, Tada Y, Nagao T. High-grade salivary carcinomas: A current insight on diagnostic pathology and the key to clinical decision making. Semin Diagn Pathol 2024:S0740-2570(24)00031-5. [PMID: 38658249 DOI: 10.1053/j.semdp.2024.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
High-grade carcinomas of the salivary glands are a group of several tumor entities with highly malignant histologic appearances, and have an aggressive biological behavior accompanied by poor a prognosis. In general, they require more intensive treatment than low- or intermediate-grade carcinomas. High-grade salivary carcinomas are rare and the microscopic features often overlap between different tumor types, making an appropriate diagnosis challenging in daily practice settings. However, with recent rapid advances in molecular pathology and molecular-targeted therapy in this field, there is a growing need to properly classify tumors, rather than just diagnosing the cases as "high-grade carcinomas". This leads to specific treatment strategies. In this article, we review representative high-grade salivary gland carcinomas, including salivary duct carcinoma and its histologic subtypes, high-grade mucoepidermoid carcinoma, solid-type adenoid cystic carcinoma, and high-grade transformation of low- or intermediate-grade carcinomas, and discuss their differential diagnoses and clinical implications. Other rare entities, such as neuroendocrine carcinoma, NUT carcinoma, and metastatic carcinoma, should also be considered before diagnosing high-grade carcinoma, NOS. Of these tumors, salivary duct carcinoma has received the most attention because of its strong association with androgen deprivation and anti-HER2 therapies. Other tumor-type-specific treatments include anti-TRK therapy for high-grade transformation of secretory carcinoma, but further therapeutic options are expected to be developed in the future. It should be emphasized that detailed histological evaluation with adequate sampling, in addition to the effective use of molecular ancillary tests, is of the utmost importance for a suitable diagnosis.
Collapse
Affiliation(s)
- Yoshitaka Utsumi
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan
| | - Masato Nakaguro
- Departments of Pathology and Laboratory Medicine, Nagoya University Hospital, Nagoya, Japan
| | - Yuichiro Tada
- Head and Neck Oncology and Surgery, International University of Health and Welfare, Mita Hospital, Tokyo, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, Tokyo, Japan.
| |
Collapse
|
2
|
Desai N, Racila E, Fujioka N, Gupta A, Antonarakis ES. Case report: Salivary duct carcinoma in a patient with a germline CDH1 pathogenic variant - expanding the spectrum of hereditary cancer predisposition syndromes. Front Oncol 2024; 14:1372382. [PMID: 38651154 PMCID: PMC11034483 DOI: 10.3389/fonc.2024.1372382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 03/07/2024] [Indexed: 04/25/2024] Open
Abstract
Introduction Recently, an entity known as salivary duct carcinoma with rhabdoid features (SDC-RF) has been associated with somatic CDH1 mutations. Here we present the first known case report of conventional SDC occurring in the setting of a germline CDH1 pathogenic variant accompanied by a somatic loss of heterozygosity at the CDH1 locus. Case discussion A 67-year-old man presented with chest and back pain and was found to have osteolytic lesions in the sternum and lumbar spine. Vertebral bone biopsies were positive for metastatic carcinoma of unknown primary. A molecular profiling assay consisting of both whole-exome next-generation sequencing (NGS) as well as immunohistochemistry (IHC) for select clinically-relevant proteins performed on the bone biopsy suggested a triple-negative (ER/PR/ERBB2 negative, by IHC), androgen receptor (AR IHC) positive tumor profile. Additionally, the assay uncovered a coding mutation in the CDH1 gene (c.1792C>T, p.R598*) with genomic loss of the second CDH1 allele. Germline testing returned positive for a heterozygous CDH1 pathogenic variant. PET-CT revealed a tumor in the neck suggestive of the primary malignancy consistent with that of salivary gland origin. The patient was initially treated with carboplatin and paclitaxel, then pembrolizumab, and finally with AR-directed therapy using leuprolide and enzalutamide. These treatments were not successful, and the patient eventually succumbed to his disease. Conclusion Molecular testing revealed that our patient had bi-allelic inactivation of the CDH1 gene. We believe our patient developed a somatic mutation in addition to his preexisting germline CDH1 mutation that ultimately predisposed him to SDC. While previous studies have found somatic CDH1 pathogenic variants in SDC-RF, our patient was found to have a germline CDH1 pathogenic variant in the setting of conventional SDC, without rhabdoid features. This case provokes questions regarding tumor genetics and molecular profiling of SDC in patients with germline CDH1 pathogenic variants. Moreover, this case supports the notion that SDC may be the salivary counterpart of other malignancies associated with germline CDH1 pathogenic variants and may possibly expand the spectrum of tumors that arise in this familial cancer-predisposition syndrome.
Collapse
Affiliation(s)
- Nidhi Desai
- Division of Hematology, Oncology & Transplantation, University of Minnesota, Minneapolis, MN, United States
| | - Emilian Racila
- Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN, United States
| | - Naomi Fujioka
- Division of Hematology, Oncology & Transplantation, University of Minnesota, Minneapolis, MN, United States
| | - Arjun Gupta
- Division of Hematology, Oncology & Transplantation, University of Minnesota, Minneapolis, MN, United States
| | - Emmanuel S. Antonarakis
- Division of Hematology, Oncology & Transplantation, University of Minnesota, Minneapolis, MN, United States
| |
Collapse
|
3
|
Jain R, Sansoni ER, Angel J, Gleysteen JP, Hayes DN, Owosho AA. Salivary Duct Carcinoma with Rhabdoid Features of the Parotid Gland with No E-Cadherin Expression: A Report with Anti-HER2 Therapy and Review of the Literature. Dent J (Basel) 2023; 11:229. [PMID: 37886914 PMCID: PMC10605875 DOI: 10.3390/dj11100229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/19/2023] [Accepted: 09/21/2023] [Indexed: 10/28/2023] Open
Abstract
Salivary duct carcinoma with rhabdoid features (SDC-RF) is a rare form of salivary gland neoplasm that was recently described. We report a case of SDC-RF of the parotid gland with loss of E-cadherin and decreased β-catenin expression in a 73-year-old male who presented with right facial/neck swelling and intermittent pain. Morphologically, the tumor presented with a discohesive infiltrate of isolated and cords of pleomorphic round cells containing moderate amount of eosinophilic to fine-vacuolated cytoplasm and hyperchromatic nuclei infiltrating through fibroadipose tissue and salivary parenchyma. Immunophenotypically, the tumor was positive for Cytokeratins Oscar and 7, GATA3, GCDFP, HER2, and an androgen receptor but negative for CK20, S100, p40, Melan A, CDX2, TTF1, ER, SATB2, DOG1, synaptophysin, and chromogranin. Due to its diffuse infiltrating pattern, involvement of the parapharyngeal space, supraclavicular fat pad, dermis, and skin without a defined surgical target, the tumor was deemed unresectable. Anti-HER2 therapy (Herceptin and Pertuzumab) was utilized. At the last follow-up, the patient is alive, with complete locoregional control and brain metastases. An electronic search was performed in the following registries for papers published up to June 2023: PubMed, Embase, and Web of Science. For the database searches, the keywords searched were "salivary gland", "salivary duct carcinoma", and "salivary duct carcinoma with rhabdoid features". Our review of the literature identified 30 cases of SDC-RF that reveal there is a predilection for males (83%), parotid gland (72%), and patients older than the 6th decade of life (83%). Immunophenotypically, all SDC-RF cases except one were positive for AR and GCDFP (97%), 81% were positive for HER2, and loss or decreased expression of E-cadherin in 93% of cases. In conclusion, we described a rare case of SDF-RF of the parotid gland with no E-cadherin expression, decreased β-catenin expression, and its immunophenotypic profile.
Collapse
Affiliation(s)
- Richa Jain
- Methodist Le Bonheur Healthcare, Memphis, TN 38104, USA
| | - E. Ritter Sansoni
- Department of Otolaryngology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Jacqueline Angel
- Department of Radiology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - John P. Gleysteen
- Department of Otolaryngology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - D. Neil Hayes
- Department of Medicine, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| | - Adepitan A. Owosho
- Department of Otolaryngology, College of Medicine, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
- Department of Diagnostic Sciences, College of Dentistry, The University of Tennessee Health Science Center, Memphis, TN 38103, USA
| |
Collapse
|
4
|
Natsume H, Szczepaniak K, Yamada H, Iwashita Y, Gędek M, Šuto J, Ishino K, Kasajima R, Matsuda T, Manirakiza F, Nzitakera A, Wu Y, Xiao N, He Q, Guo W, Cai Z, Ohta T, Szekely T, Kadar Z, Sekiyama A, Oshima T, Yoshikawa T, Tsuburaya A, Kurono N, Wang Y, Miyagi Y, Gurzu S, Sugimura H. Non-CpG sites preference in G:C > A:T transition of TP53 in gastric cancer of Eastern Europe (Poland, Romania and Hungary) compared to East Asian countries (China and Japan). Genes Environ 2023; 45:1. [PMID: 36600315 DOI: 10.1186/s41021-022-00257-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/23/2022] [Indexed: 01/05/2023] Open
Abstract
AIM Mutation spectrum of TP53 in gastric cancer (GC) has been investigated world-widely, but a comparison of mutation spectrum among GCs from various regions in the world are still sparsely documented. In order to identify the difference of TP53 mutation spectrum in GCs in Eastern Europe and in East Asia, we sequenced TP53 in GCs from Eastern Europe, Lujiang (China), and Yokohama, Kanagawa (Japan) and identified the feature of TP53 mutations of GC in these regions. SUBJECTS AND METHOD In total, 689 tissue samples of GC were analyzed: 288 samples from East European populations (25 from Hungary, 71 from Poland and 192 from Romania), 268 from Yokohama, Kanagawa, Japan and 133 from Lujiang, Anhui province, China. DNA was extracted from FFPE tissue of Chinese, East European cases; and from frozen tissue of Japanese GCs. PCR products were direct-sequenced by Sanger method, and in ambiguous cases, PCR product was cloned and up to 8 clones were sequenced. We used No. NC_000017.11(hg38) as the reference sequence of TP53. Mutation patterns were categorized into nine groups: six base substitutions, insertion, deletion and deletion-insertion. Within G:C > A:T mutations the mutations in CpG and non-CpG sites were divided. The Cancer Genome Atlas data (TCGA, ver.R20, July, 2019) having somatic mutation list of GCs from Whites, Asians, and other ethnicities were used as a reference for our data. RESULTS The most frequent base substitutions were G:C > A:T transition in all the areas investigated. The G:C > A:T transition in non-CpG sites were prominent in East European GCs, compared with Asian ones. Mutation pattern from TCGA data revealed the same trend between GCs from White (TCGA category) vs Asian countries. Chinese and Japanese GCs showed higher ratio of G:C > A:T transition in CpG sites and A:T > G:C mutation was more prevalent in Asian countries. CONCLUSION The divergence in mutation spectrum of GC in different areas in the world may reflect various pathogeneses and etiologies of GC, region to region. Diversified mutation spectrum in GC in Eastern Europe may suggest GC in Europe has different carcinogenic pathway of those from Asia.
Collapse
Affiliation(s)
- Hiroko Natsume
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Kinga Szczepaniak
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Medical University of Warsaw, 1B Banacha Street, Warsaw, Poland
| | - Hidetaka Yamada
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.
| | - Yuji Iwashita
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Marta Gędek
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Medical University of Lublin, ul. Radziwiłłowska 11, wew, 5647, Lublin, Poland
| | - Jelena Šuto
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Department of Oncology, Clinical Hospital Centre Split, Split, Croatia
| | - Keiko Ishino
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Rika Kasajima
- The Center for Cancer Genome Medicine, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan.,Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan
| | - Tomonari Matsuda
- Research Center for Environmental Quality Management, Kyoto University, 1-2 Yumihama, Otsu, Shiga, 520-0811, Japan
| | - Felix Manirakiza
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Augustin Nzitakera
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Yijia Wu
- Lujiang People Hospital, 32 Wenmingzhong Road, Lujiang, Hefei, 231501, China
| | - Nong Xiao
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China
| | - Qiong He
- Department of Pathology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China
| | - Wenwen Guo
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China.,Department of Pathology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210003, China
| | - Zhenming Cai
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China.,Department of Immunology, Key Laboratory of Immune Microenvironment and Diseases, Nanjing Medical University, Nanjing, 211166, China
| | - Tsutomu Ohta
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan.,Department of Physical Therapy, Faculty of Health and Medical Sciences, Tokoha University, 1230 Miyakoda-cho, Kita-ku, Hamamatsu, Shizuoka, 431-2102, Japan
| | - Tıberiu Szekely
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania.,Department of Oncology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania
| | - Zoltan Kadar
- Department of Oncology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania
| | - Akiko Sekiyama
- Department of Clinical Laboratory, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Takashi Oshima
- Department of Gastrointestinal Surgery, Kanagawa Cancer Center, 2-3-2 Nakao, Asahi-ku, Yokohama, Kanagawa, 241-8515, Japan
| | - Takaki Yoshikawa
- Department of Gastric Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan
| | - Akira Tsuburaya
- Department of Surgery, Ozawa Hospital, 1-1-17, Honcho, Odawara, Kanagawa, 250-0012, Japan
| | - Nobuhito Kurono
- Department of Chemistry, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan
| | - Yaping Wang
- Jiangsu Key Laboratory of Molecular Medicine, Nanjing University School of Medicine, Nanjing, 210093, China.
| | - Yohei Miyagi
- Molecular Pathology and Genetics Division, Kanagawa Cancer Center Research Institute, 2-3-2 Nakao, Asahi-ku, Yokohama, 241-8515, Japan.
| | - Simona Gurzu
- Department of Pathology, George Emil Palade University of Medicine, Pharmacy, Sciences and Technology, Targu Mures, Ghe Marinescu 38 Street, 540139, Targu Mures, Romania.
| | - Haruhiko Sugimura
- Department of Tumor Pathology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higasi-ku, Hamamatsu, Shizuoka, 431-3192, Japan. .,Sasaki Foundation Sasaki Institute, 2-2, KandaSurugadai, Chiyoda-ku, Tokyo, 101-0062, Japan.
| |
Collapse
|