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

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Secretory carcinoma of the salivary gland (view source)

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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==
*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==
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.<ref name=pmid22127547/>
*[[Mucoepidermoid carcinoma]].
 
===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/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==
*t(12;15)(p13;q25).
**Fusion of the genes ''ETV6'' and ''[[NTRK3]]''.<ref name=pmid22127547/>
 
Note:
*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==
{{Reflist|1}}
{{Reflist|2}}


[[Category:Diagnosis]]
[[Category:Diagnosis]]
[[Category:Salivary gland]]
[[Category:Salivary gland]]
Michael
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