Advertisement

Head and Neck Pathology

, Volume 13, Issue 4, pp 686–691 | Cite as

Synchronous Parotid (Mammary Analog) Secretory Carcinoma and Acinic Cell Carcinoma: Report of a Case

  • C. MossinelliEmail author
  • C. Pigni
  • F. Sovardi
  • A. Occhini
  • L. Preda
  • M. Benazzo
  • P. Morbini
  • F. Pagella
Case Report

Abstract

Mammary analogue secretory carcinoma (MASC) is a recently described low-grade salivary gland malignancy with histologic, immunohistochemical and molecular similarities to secretory carcinoma of the breast, including a specific t(12;15)(p13;q25) resulting in an ETV6–NTRK3 gene fusion. Ultrasound and magnetic resonance imaging frequently document a macrocystic structure. The main differential diagnosis of secretory carcinoma is with low grade acinic cell carcinoma (AciCC). The two can be differentiated with immunohistochemical stains for S100, mammaglobin, carbonic anhydrase VI and DOG-1; the identification of the specific translocation can help to characterize non-typical cases. We report a unique case of synchronous MASC and AciCC presenting in a parotid gland and discuss the implications of the correct identification of the two tumors.

Keywords

MASC Salivary gland tumor Cystic carcinoma Parotid Acinic cell carcinoma 

References

  1. 1.
    Skálová A, Vanecek T, Sima R, et al. Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity. Am J Surg Pathol. 2010.  https://doi.org/10.1097/pas.0b013e3181d9efcc.CrossRefPubMedGoogle Scholar
  2. 2.
    Seethala R. Update from the 4th edition of the World Health Organization classification of head and neck tumours: preface. Head Neck Pathol. 2017;11(1):1–2.  https://doi.org/10.1007/s12105-017-0785-2.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Chiosea S, Griffith C, Assaad A, Seethala R. Clinicopathological characterization of mammary analogue secretory carcinoma of salivary glands. Histopathology 2012;61(3):387–94.  https://doi.org/10.1111/j.1365-2559.2012.04232.x.CrossRefPubMedGoogle Scholar
  4. 4.
    Bishop J, Unmasking MASC: bringing to light the unique morphologic, immunohistochemical and genetic features of the newly recognized mammary analogue secretory carcinoma of salivary glands. Head Neck Pathol. 2013;7(1):35–9.  https://doi.org/10.1007/s12105-013-0429-0.CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Stevens T, Parekh V. Mammary analogue secretory carcinoma. Arch Pathol Lab Med. 2016;140(9):997–1001.  https://doi.org/10.5858/arpa.2015-0075-rs.CrossRefPubMedGoogle Scholar
  6. 6.
    Skalova A. Mammary analogue secretory carcinoma of salivary gland origin: an update and expanded morphologic and immunohistochemical spectrum of recently described entity. Head Neck Pathol. 2013;7(S1):30–6.  https://doi.org/10.1007/s12105-013-0455-y.CrossRefPubMedCentralGoogle Scholar
  7. 7.
    Skálová A, Vanecek T, Simpson R, et al. Mammary analogue secretory carcinoma of salivary glands. Am J Surg Pathol. 2016;40(1):3–13.  https://doi.org/10.1097/pas.0000000000000537.CrossRefPubMedGoogle Scholar
  8. 8.
    Skalova A, Vanecek T, Martinek P, et al. Molecular profiling of mammary analog secretory carcinoma revealed a subset of tumors harboring a novel ETV6-RET translocation. Am J Surg Pathol. 2018;42(2):234–46.  https://doi.org/10.1097/pas.0000000000000972.CrossRefPubMedGoogle Scholar
  9. 9.
    Cantisani V, David E, Sidhu P, et al. Parotid gland lesions: multiparametric ultrasound and MRI features. Ultraschall Med. 2016;37(05):454–71.  https://doi.org/10.1055/s-0042-109171.CrossRefPubMedGoogle Scholar
  10. 10.
    Tyagi R, Dey P. Diagnostic problems of salivary gland tumors. Diagn Cytopathol. 2015;43(6):495–509.  https://doi.org/10.1002/dc.23255.CrossRefPubMedGoogle Scholar
  11. 11.
    Oza N, Sanghvi K, Shet T, et al. Mammary analogue secretory carcinoma of parotid: is preoperative cytological diagnosis possible? Diagn Cytopathol. 2016;44(6):519–25.  https://doi.org/10.1002/dc.23459.CrossRefPubMedGoogle Scholar
  12. 12.
    Evrard S, Meilleroux J, Daniel G, et al. Use of fluorescent in-situ hybridisation in salivary gland cytology: a powerful diagnostic tool. Cytopathology 2017;28(4):312–20.  https://doi.org/10.1111/cyt.12427.CrossRefPubMedGoogle Scholar
  13. 13.
    Said-Al-Naief N, Carlos R, Vance G, Miller C, Edwards P. Combined DOG1 and mammaglobin immunohistochemistry is comparable to ETV6-breakapart analysis for differentiating between papillary cystic variants of acinic cell carcinoma and mammary analogue secretory carcinoma. Int J Surg Pathol. 2016;25(2):127–40.  https://doi.org/10.1177/1066896916670005.CrossRefPubMedGoogle Scholar
  14. 14.
    Shah A, Wenig B, LeGallo R, Mills S, Stelow E. Morphology in conjunction with immunohistochemistry is sufficient for the diagnosis of mammary analogue secretory carcinoma. Head Neck Pathol. 2014;9(1):85–95.  https://doi.org/10.1007/s12105-014-0557-1.CrossRefPubMedPubMedCentralGoogle Scholar
  15. 15.
    Hsieh M, Jeng Y, Jhuang Y, Chou Y, Lin C. Carbonic anhydrase VI: a novel marker for salivary serous acinar differentiation and its application to discriminate acinic cell carcinoma from mammary analogue secretory carcinoma of the salivary gland. Histopathology 2016;68(5):641–7.  https://doi.org/10.1111/his.12792.CrossRefPubMedGoogle Scholar
  16. 16.
    Guilmette J, Nielsen G, Faquin W, et al. Ultrastructural characterization of mammary analogue secretory carcinoma of the salivary glands: a distinct entity from acinic cell carcinoma? Head Neck Pathol. 2017;11(4):419–26.  https://doi.org/10.1007/s12105-017-0784-3.CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Baghai F, Yazdani F, Etebarian A, Garajei A, Skalova A. Clinicopathologic and molecular characterization of mammary analogue secretory carcinoma of salivary gland origin. Pathol Res Pract. 2017;213(9):1112–8.  https://doi.org/10.1016/j.prp.2017.07.017.CrossRefPubMedGoogle Scholar
  18. 18.
    Tanaka S, Tabuchi K, Oikawa K, et al. Synchronous unilateral parotid gland neoplasms of three different histological types. Auris Nasus Larynx. 2007;34(2):263–6.  https://doi.org/10.1016/j.anl.2006.07.001.CrossRefPubMedGoogle Scholar
  19. 19.
    Gnepp D, Schroeder W, Heffner D. Synchronous tumors arising in a single major salivary gland. Cancer 1989;63(6):1219–1224.  https://doi.org/10.1002/1097-0142(19890315)63:6%3C1219::aid-cncr2820630631%3E3.0.co;2-y.CrossRefPubMedGoogle Scholar
  20. 20.
    Ochal-Choińska A, Bruzgielewicz A, Osuch-Wójcikiewicz E. Synchronous multiple unilateral parotid gland tumors of benign and malignant histological types: case report and literature review. Braz J Otorhinolaryngol. 2016.  https://doi.org/10.1016/j.bjorl.2016.03.002.CrossRefPubMedGoogle Scholar
  21. 21.
    Terada T. Hyperplastic intraparotid lymph nodes with incipient Warthin’s tumor presenting as a parotid tumor. Pathol Res Pract. 2008;204(11):863–6.  https://doi.org/10.1016/j.prp.2008.04.012.CrossRefPubMedGoogle Scholar
  22. 22.
    Faras F, Abo-Alhassan F, Bastaki J, Al-Sihan M. Primary mucoepidermoid carcinoma arising from ectopic salivary tissue within an intraparotid lymph node. Case Rep Otolaryngol. 2015;2015:1–3.  https://doi.org/10.1155/2015/879137.CrossRefGoogle Scholar
  23. 23.
    Gupta S, Loh K, Petersson F. Lymphoepithelial carcinoma of the parotid gland arising in an intraglandular lymph node: report of a rare case mimicking metastasis. Ann Diagn Pathol. 2012;16(5):416–21.  https://doi.org/10.1016/j.anndiagpath.2011.03.007.CrossRefPubMedGoogle Scholar
  24. 24.
    Lidang Jensen M, Kiær H. Acinic cell carcinoma with primary presentation in an intraparotid lymph node. Pathol Res Pract. 1992;188(1–2):226–31.  https://doi.org/10.1016/s0344-0338(11)81187-8.CrossRefPubMedGoogle Scholar
  25. 25.
    Md A, Winkler B, Perzin K, Wazen J, Blitzer A. Mucoepidermoid carcinoma arising in an intraparotid lymph node. Cancer. 1985;55(2):400–403.  https://doi.org/10.1002/1097-0142(19850115)55:2%3C400::aid-cncr2820550218%3E3.0.co;2-4.CrossRefGoogle Scholar
  26. 26.
    Weinreb I. Intraductal carcinoma of salivary gland (so-called low-grade cribriform cystadenocarcinoma) arising in an intraparotid lymph node. Head Neck Pathol. 2011;5(3):321–5.  https://doi.org/10.1007/s12105-011-0256-0.CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Minić A. Acinic cell carcinoma arising in a parotid lymph node. Int J Oral Maxillofac Surg. 1993;22(5):289–91.  https://doi.org/10.1016/s0901-5027(05)80518-1.CrossRefPubMedGoogle Scholar
  28. 28.
    Perzin K, Livolsi V. Acinic cell carcinoma arising in ectopic salivary gland tissue. Cancer 1980;45(5):967–72.  https://doi.org/10.1002/1097-0142(19800301)45:5%3C967::aid-cncr2820450522%3E3.0.co;2-a.CrossRefPubMedGoogle Scholar
  29. 29.
    Seethala R. Salivary gland tumors. Surg Pathol Clin. 2017;10(1):155–76.  https://doi.org/10.1016/j.path.2016.11.004.CrossRefPubMedGoogle Scholar
  30. 30.
    Sethi R, Kozin E, Remenschneider A, et al. Mammary analogue secretory carcinoma: update on a new diagnosis of salivary gland malignancy. Laryngoscope 2013;124(1):188–95.  https://doi.org/10.1002/lary.24254.CrossRefPubMedPubMedCentralGoogle Scholar
  31. 31.
    Damjanov I, Skenderi F, Vranic S. Mammary analogue secretory carcinoma (MASC) of the salivary gland: a new tumor entity. Bosn J Basic Med Sci. 2016.  https://doi.org/10.17305/bjbms.2016.1321.CrossRefPubMedPubMedCentralGoogle Scholar
  32. 32.
    Petersson F, Michal M, Kazakov D, Grossmann P, Michal M. A new hitherto unreported histopathologic manifestation of mammary analogue secretory carcinoma. Appl Immunohistochem Mol Morphol. 2016;24(9):e80–5.  https://doi.org/10.1097/pai.0000000000000320.CrossRefGoogle Scholar
  33. 33.
    Walz C, Erben P, Ritter M, et al. Response of ETV6-FLT3-positive myeloid/lymphoid neoplasm with eosinophilia to inhibitors of FMS-like tyrosine kinase 3. Blood 2011;118(8):2239–42.  https://doi.org/10.1182/blood-2011-03-343426.CrossRefPubMedGoogle Scholar
  34. 34.
    Tognon C, Somasiri A, Evdokimova V, et al. ETV6-NTRK3-mediated breast epithelial cell transformation is blocked by targeting the IGF1R signaling pathway. Cancer Res. 2010;71(3):1060–70.  https://doi.org/10.1158/0008-5472.can-10-3096.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of OtolaryngologyUniversity of Pavia and Fondazione IRCCS Policlinico San MatteoPaviaItaly
  2. 2.Department of Clinical, Surgical, Diagnostic and Paediatric SciencesUniversity of PaviaPaviaItaly
  3. 3.Department of Molecular Medicine - Unit of PathologyUniversity of Pavia and Fondazione IRCCS Policlinico San MatteoPaviaItaly

Personalised recommendations