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'''Salivary duct carcinoma''', abbreviated '''SDC''', is a rare [[salivary gland]] tumour that typically has an aggressive course. | |||
==General== | |||
*Malignant counterpart of ''salivary duct adenoma''. | |||
*Male:female ~= 4:1. | |||
*Dismal prognosis.<ref name=pmid21393874>{{Cite journal | last1 = Rajesh | first1 = NG. | last2 = Prayaga | first2 = AK. | last3 = Sundaram | first3 = C. | title = Salivary duct carcinoma: correlation of morphologic features by fine needle aspiration cytology and histopathology. | journal = Indian J Pathol Microbiol | volume = 54 | issue = 1 | pages = 37-41 | month = | year = | doi = 10.4103/0377-4929.77321 | PMID = 21393874 | url = http://www.ijpmonline.org/text.asp?2011/54/1/37/77321 }}</ref> | |||
*Typically >50 years old. | |||
*Mostly in the parotid. | |||
==Microscopic== | |||
Features - resembles ductal breast carcinoma:<ref name=pmid21393874/> | |||
*Architecture: sheets, nests, cords, cribriform, micropapillary. | |||
*Neoplastic cells line-up around cystic spaces "Roman bridges". | |||
*Nuclear atypia (variation in size, shape, staining). | |||
*Apocrine snouts - pseudopod-like/lollipop-like undulations of the cell membrane. | |||
*Decapitation secretions - apocrine snouts (membrane bound blobs of cytoplasm) that have separated from its mother cell. | |||
Notes: | |||
*Similar to ductal breast carcinoma - '''key to remember'''. | |||
DDx: | |||
*[[Carcinoma ex pleomorphic adenoma]] with SDC component. | |||
===Images=== | |||
<gallery> | |||
Image:Salivary duct carcinoma - very low mag.jpg | SDC - very low mag. (WC/Nephron) | |||
Image:Salivary_duct_carcinoma_-_low_mag.jpg | SDC - low mag. (WC/Nephron) | |||
Image:Salivary duct carcinoma - intermed mag.jpg | SDC - intermed. mag. (WC/Nephron) | |||
Image:Salivary_duct_carcinoma_-_high_mag.jpg | SDC - high mag. (WC/Nephron) | |||
Image:Salivary duct carcinoma - very high mag.jpg | SDC - very high mag. (WC/Nephron) | |||
</gallery> | |||
<gallery> | |||
Image:Salivary_duct_carcinoma_-a-_low_mag.jpg | SDC - low mag. (WC/Nephron) | |||
Image:Salivary duct carcinoma -a- intermed mag.jpg | SDC - intermed. mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://www.webpathology.com/image.asp?case=122&n=2 Salivary duct carcinoma (webpathology.com)]. | |||
===Subtypes=== | |||
*Conventional. | |||
*Mucinous - worse prognosis; opposite of what would one expect from the outcomes in [[breast cancer]]. | |||
*Micropapillary - assoc. with a poor prognosis. | |||
*Sarcomatoid/spindle cell. | |||
==IHC== | |||
*LMWK, EMA, CK7, CK19 +ve. | |||
*p63 -ve. | |||
*Androgen receptor +ve. | |||
*BRST2 (GCDFP-15) +ve. | |||
*HER2 +ve ~21%; use of [[trastuzumab]] (Herceptin) not systematically studied. | |||
Curiosity: | |||
*PSA +/-. | |||
*PSAP +/-. | |||
*ER-beta +ve.<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2011/MajorSalGlands_11protocol.pdf]. Accessed on: 3 April 2012.</ref> | |||
*ER-alpha -ve (the common ''ER'' stain). | |||
==See also== | |||
*[[Salivary glands]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Salivary gland]] |
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