Difference between revisions of "Secretory carcinoma of the salivary gland"

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'''Mammary analogue secretory carcinoma''', abbreviation '''MASC''', is a newly described [[malignant]] [[salivary gland]] tumour.<ref name=pmid22127547>{{Cite journal  | last1 = Lei | first1 = Y. | last2 = Chiosea | first2 = SI. | title = Re-evaluating historic cohort of salivary acinic cell carcinoma with new diagnostic tools. | journal = Head Neck Pathol | volume = 6 | issue = 2 | pages = 166-70 | month = Jun | year = 2012 | doi = 10.1007/s12105-011-0312-9 | PMID = 22127547 }}</ref>
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Mammary analogue secretory carcinoma (H&E, medium power).jpg
| Width      =
| Caption    = Secretory carcinoma of the salivary gland. [[H&E stain]]. (WC/NormanDy)
| Synonyms  = Mammary analogue secretory carcinoma (previous name)
| Micro      = large cells with abundant cytoplasm, small nuclei, +/-lymphocytic infiltrate, solid and microcystic growth pattern
| Subtypes  =
| LMDDx      = [[acinic cell carcinoma]], [[mucoepidermoid carcinoma]]
| Stains    = [[PAS stain|PAS]] +ve
| IHC        = S-100 +ve, mammaglobin +ve, vimentin +ve
| EM        =
| Molecular  = ETV6-[[NTRK3]] fusion gene
| IF        =
| Gross      =
| Grossing  =
| Site      = [[salivary gland]] - usually parotid
| Assdx      =
| Syndromes  =
| Clinicalhx =
| Signs      =
| Symptoms  =
| Prevalence = rare
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  =
| Other      =
| ClinDDx    = other [[salivary gland]] tumours
| Tx        = excision
}}
'''Secretory carcinoma of the salivary gland''' is an uncommon [[malignant]] [[salivary gland]] tumour that was first described in 2010.<ref name=pmid22127547>{{Cite journal  | last1 = Lei | first1 = Y. | last2 = Chiosea | first2 = SI. | title = Re-evaluating historic cohort of salivary acinic cell carcinoma with new diagnostic tools. | journal = Head Neck Pathol | volume = 6 | issue = 2 | pages = 166-70 | month = Jun | year = 2012 | doi = 10.1007/s12105-011-0312-9 | PMID = 22127547 }}</ref>
 
It was previously known as '''mammary analogue secretory carcinoma''', abbreviated '''MASC'''.<ref name=pmid31007960>{{cite journal |authors=Montalvo N, Galarza D, Redrobán L |title=Secretory Carcinoma of the Parotid: Making the Correct Diagnosis of a Rare Salivary Gland Carcinoma When Molecular Biology Testing Is Not Available |journal=Case Rep Pathol |volume=2019 |issue= |pages=5103496 |date=2019 |pmid=31007960 |pmc=6441535 |doi=10.1155/2019/5103496 |url=}}</ref>


==General==
==General==
*Described in pediatric patient.<ref>{{Cite journal  | last1 = Rastatter | first1 = JC. | last2 = Jatana | first2 = KR. | last3 = Jennings | first3 = LJ. | last4 = Melin-Aldana | first4 = H. | title = Mammary analogue secretory carcinoma of the parotid gland in a pediatric patient. | journal = Otolaryngol Head Neck Surg | volume = 146 | issue = 3 | pages = 514-5 | month = Mar | year = 2012 | doi = 10.1177/0194599811419044 | PMID = 21873597 }}</ref>
*Microscopic appearance similar to [[secretory breast carcinoma]].<ref name=pmid20410810>{{Cite journal  | last1 = Skálová | first1 = A. | last2 = Vanecek | first2 = T. | last3 = Sima | first3 = R. | last4 = Laco | first4 = J. | last5 = Weinreb | first5 = I. | last6 = Perez-Ordonez | first6 = B. | last7 = Starek | first7 = I. | last8 = Geierova | first8 = M. | last9 = Simpson | first9 = RH. | title = Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity. | journal = Am J Surg Pathol | volume = 34 | issue = 5 | pages = 599-608 | month = May | year = 2010 | doi = 10.1097/PAS.0b013e3181d9efcc | PMID = 20410810 }}</ref>
*Rare - 21 cases in the world literature as of 2012.<ref name=pmid22127547/>
*Original paper described it only in adults.<ref name=pmid20410810/>
**Has been described in a pediatric patient.<ref name=pmid21873597>{{Cite journal  | last1 = Rastatter | first1 = JC. | last2 = Jatana | first2 = KR. | last3 = Jennings | first3 = LJ. | last4 = Melin-Aldana | first4 = H. | title = Mammary analogue secretory carcinoma of the parotid gland in a pediatric patient. | journal = Otolaryngol Head Neck Surg | volume = 146 | issue = 3 | pages = 514-5 | month = Mar | year = 2012 | doi = 10.1177/0194599811419044 | PMID = 21873597 }}</ref>


==Gross==
*Usually parotid gland.<ref name=pmid20410810/>
*Well-circumscribed.{{fact}}


==Microscopic==
==Microscopic==
Features:
Features:
*Serous cells. (???)
*Large cells with abundant cytoplasm.
*Small nuclei.
*+/-Lymphocytic infiltrate.
*Solid and microcystic growth pattern.
*+/-Cystic changes lined by hobnail cells - useful feature.


DDx:
DDx:
*[[Acinic cell carcinoma]] - very closely mimics.
*[[Acinic cell carcinoma]] - very closely mimics.
**Abundant basophilic granular cytoplasm.<ref name=pmid22127547/>
*[[Mucoepidermoid carcinoma]].
*[[Mucoepidermoid carcinoma]].


===Images===
===Images===
====Case 1====
<gallery>
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_low_power).jpg | SC - low. (WC/NormanDy)
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_medium_power).jpg | SC - med. (WC/NormanDy)
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_high_power).jpg | SC - high. (WC/NormanDy)
Image:Mammary_analogue_secretory_carcinoma_(H%26E,_high_power),_solid.jpg | SC - high solid. (WC/NormanDy)
</gallery>
====Case 2====
<gallery>
Image: Secretory carcinoma of salivary gland -- low mag.jpg | SCSG - low mag. (WC)
Image: Secretory carcinoma of salivary gland -- intermed mag.jpg | SCSG - intermed. mag. (WC)
Image: Secretory carcinoma of salivary gland -- high mag.jpg | SCSG - high mag. (WC)
Image: Secretory carcinoma of salivary gland - alt -- high mag.jpg | SCSG - high mag. (WC)
</gallery>
====www====
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370021/figure/Fig2/ MASC (nih.gov)].<ref name=pmid22127547/>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370021/figure/Fig2/ MASC (nih.gov)].<ref name=pmid22127547/>
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370021/figure/Fig1/ AcCC - the main DDx of MASC (nih.gov)].<ref name=pmid22127547/>
==Stains==
Features:<ref name=pmid20410810/>
*[[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:<ref name=pmid20410810/>
*[[S-100]] +ve.<ref name=pmid22127547/>
*Mammaglobin +ve.
*Vimentin +ve.
Others:
*[[p63]] -ve.
**Unusual in mucoepidermoid carcinoma.
*HMWCK -ve.
*[[GATA3]] +ve.
Panel:
*S-100, mammaglobin, p63, HMWCK.
===Images===
<gallery>
Image:Mammary_analogue_secretory_carcinoma_(mammaglobin_immunohistochemstry,_medium_power).jpg | MASC - mammaglobin. (WC/NormanDy)
Image:Mammary_analogue_secretory_carcinoma_(S100immunohistochemstry,_low_power).jpg | MASC - S-100. (WC/NormanDy)
</gallery>


==Molecular==
==Molecular==
*t(12;15)(p13;q25)  
*t(12;15)(p13;q25).
**Fusion of the genes ''ETV6'' and ''NTRK3''.<ref name=pmid22127547/>
**Fusion of the genes ''ETV6'' and ''[[NTRK3]]''.<ref name=pmid22127547/>


Note:
Note:
*The translocation seen in [[congenital-infantile fibrosarcoma]].
*The translocation seen in [[secretory breast carcinoma]], [[congenital-infantile fibrosarcoma]] and [[mesoblastic nephroma]].
 
==Sign out==
<pre>
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.
</pre>
 
===Micro===
The sections show a cohesive tumor with moderate amphophilic cytoplasm and vacuolation. The vacuolation is focally prominent. Nucleoli are inconspicuous. Poorly formed glands are present. Keratinization is absent.


==See also==
==See also==
*[[Salivary gland]].
*[[Salivary gland]].
*[[Secretory breast carcinoma]].
*[[Secretory carcinoma]].


==References==
==References==

Latest revision as of 20:53, 2 November 2021

Secretory carcinoma of the salivary gland
Diagnosis in short

Secretory carcinoma of the salivary gland. H&E stain. (WC/NormanDy)
Synonyms Mammary analogue secretory carcinoma (previous name)
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
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

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:

Images

Case 1

  • SC - low. (WC/NormanDy)

  • SC - med. (WC/NormanDy)

  • SC - high. (WC/NormanDy)

  • SC - high solid. (WC/NormanDy)

Case 2

  • SCSG - low mag. (WC)

  • SCSG - intermed. mag. (WC)

  • SCSG - high mag. (WC)

  • SCSG - high mag. (WC)

www

Stains

Features:[3]

IHC

Features:[3]

  • S-100 +ve.[1]
  • Mammaglobin +ve.
  • Vimentin +ve.

Others:

  • p63 -ve.
    • Unusual in mucoepidermoid carcinoma.
  • HMWCK -ve.
  • GATA3 +ve.

Panel:

  • S-100, mammaglobin, p63, HMWCK.

Images

  • MASC - mammaglobin. (WC/NormanDy)

  • MASC - S-100. (WC/NormanDy)

Molecular

  • t(12;15)(p13;q25).

Note:

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.

Micro

The sections show a cohesive tumor with moderate amphophilic cytoplasm and vacuolation. The vacuolation is focally prominent. Nucleoli are inconspicuous. Poorly formed glands are present. Keratinization is absent.

See also

References

  1. ↑ 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.
  2. ↑ 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. ↑ 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.
  4. ↑ 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.
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