Salivary glands
Primary salivary gland neoplasms - malignant
Secretory carcinoma


Topic Completed: 1 September 2015

Revised: 30 April 2019

Copyright: 2002-2019, PathologyOutlines.com, Inc.

PubMed Search: Secretory carcinoma salivary

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Cite this page: Guilmette J, Gologan O, Krane J. Secretory carcinoma. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/salivaryglandsmammary.html. Accessed October 19th, 2019.
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)
Epidemiology
Sites
  • 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
Treatment
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 of the Week #382

Mammaglobin



Images hosted on other servers:

Images contributed by 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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S100+

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Mammaglobin+

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CK7+

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PASD

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DOG1-

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p63-

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
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

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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