Salivary glands
Primary salivary gland neoplasms
Secretory carcinoma

Topic Completed: 1 September 2015

Minor changes: 10 July 2020

Copyright: 2002-2020,, Inc.

PubMed Search: Secretory carcinoma salivary

Jeffrey Krane, M.D., Ph.D.
Page views in 2019: 9,540
Page views in 2020 to date: 9,116
Cite this page: Guilmette J, Gologan O, Krane J. Secretory carcinoma. website. Accessed October 25th, 2020.
Definition / general
  • Recently described, rare salivary gland tumor that relates the morphology and genetics of an equally rare malignancy of the breast, secretory carcinoma (SC)
  • Previously classified as acinic cell carcinoma ("zymogen poor", intercalated cell predominant variant), mucoepidermoid carcinoma and adenocarcinoma, NOS
  • Harbors specific cytogenetic characteristic: t(12; 15)(q13;q25): ETV6-NTRK3 translocation, demonstrated by either FISH or PCR (Am J Surg Pathol 2010;34:599)
  • Parotid gland (up to 70%); lips, hard palate, submandibular glands
  • More frequent in nonparotid sites compared to acinic cell carcinoma (AciCC) (Am J Surg Pathol 2013;37:1053)
Clinical features
Prognostic factors
  • Broad range of clinical behaviors, from indolent to aggressive
  • Currently there is no way to predict which tumors will behave aggressively
  • Higher incidence of regional lymph node involvement than acinic cell carcinomas (Histopathology 2012;61:387)
Case reports
Gross description
  • Most frequently solitary, well circumscribed, nonencapsulated or multinodular mass
  • Brown or gray in color and rubbery in texture
  • Variable sizes, from 0.2 cm to 5.5 cm (Virchows Arch 2015;466:245)
Microscopic (histologic) description
  • Prominent "bubbly" low power aspect
  • Cystic, tubular, solid or papillary architecture
  • Intermediate size cells with eosinophilic / amphophilic vacuolated cytoplasm; absence of zymogen granules
  • Low grade, bland and pale nuclei, some with prominent nucleoli
  • Intraluminal or intracellular colloid-like material with a "bubbly" appearance
  • May have mucinous differentiation (Am J Surg Pathol 2012;36:27)
  • May have perineural invasion
  • No extensive necrosis and very low mitotic activity
  • Unusual feature: foci of high grade / dedifferentiation with large nests and comedonecrosis (Virchows Arch 2015;466:245)
Microscopic (histologic) images

Case #382


Contributed by Julie Guilmette, M.D., Olguta Gologan, M.D. and Jeffrey Krane, M.D., Ph.D.
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Prominent "bubbly" colloid-like material on low power

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Various histological patterns

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Intermediate sized cells

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Cytology description
  • Cellular smears; background of eosinophilic, filamentous matrix and mucin
  • Sheets and clusters of bland polygonal epithelial cells with patterns ranging from acinar-like structures, papillae and tubuloglandular (Head Neck Pathol 2013;7:S30)
  • Most tumor cells have abundant small cytoplasmic vacuoles, some containing mucin; others will have a finely eosinophilic granular cytoplasm
  • Dispersed, isolated cells with a "histiocyte-like" appearance
  • Nuclei are uniform, small, round, eccentrically located, with small nucleoli
  • Cellular smear with 2 different architectural patterns (Cancer Cytopathol 2013;121:228)
    • Papillary or sheet-like fragments
    • Dispersed or dissociated single cells
  • Polygonal tumor cells with abundant finely granular cytoplasm, occasional to prominent cytoplasmic vacuoles and rare eosinophilic secretory globules and intracytoplasmic mucin (Cancer Cytopathol 2013;121:234)
  • Mild to moderate nuclear atypia with distinct nucleoli and occasional multinucleation
Cytology images

Contributed by Jeffrey Krane, M.D., Ph.D.
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Sheets and clusters cells

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Nuclei are uniform

Contributed by Jen-Fan Hang, M.D.

Papillary pattern

Vacuolated cytoplasm

Papillary and secretory

Positive stains
Negative stains
Molecular / cytogenetics description
  • t(12;15)(q13;q25) translocation, a fusion of the ETV6 and NTRK3 gene (also identified in secretory breast carcinoma, infantile fibrosarcoma and acute myelogenous leukaemias)
  • Other ETV6 translocation partner (ETV6-X fusion) (Am J Surg Pathol 2015;39:602)
Additional references
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