Secretory Carcinoma of the Thyroid Gland: Report of a Highly Aggressive Case Clinically Mimicking Undifferentiated Carcinoma and Review of the Literature
After being described in the salivary glands as a malignancy with features essentially identical to those of the breast, secretory carcinoma (SC) (formerly mammary analogue SC) has now been identified in other sites including the skin, lung, and thyroid gland. In the breast, SC has a relatively favorable prognosis. Likewise when arising in the salivary glands, it is generally considered to be a low to intermediate grade carcinoma; however, there is a range of clinical behavior with occasional patients dying of progressive disease. SCs of the thyroid gland are rare, and reports suggest a relatively aggressive behavior, at least relative to well differentiated carcinomas such as papillary carcinoma and minimally invasive follicular carcinoma. We present a patient with a highly aggressive thyroid gland SC that mimicked undifferentiated carcinoma clinically. The patient had widespread metastatic disease and died rapidly from airway compromise. We also review the literature for reported cases of thyroid gland SC in order to better establish the clinical features and expected clinical course of such tumors occurring at this site.
KeywordsMammary analogue secretory carcinoma Thyroid ETV6 gene rearrangement Papillary carcinoma Anaplastic carcinoma
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Conflict of interest
The authors report that there are no conflicts of interest to disclose.
- 1.Lakhani SR, Ellis IO, Schnitt SJ, WHO classification of tumours of the breast. 4th ed. Lyon: International Agency for Research on Cancer (IARC); 2012.Google Scholar
- 7.El-Naggar AK, Chan JKC, Grandis JR, Takata T, Slootweg PJ. WHO classification of head and neck tumours. 4th ed. Lyon: International Agency for Research on Cancer; 2017.Google Scholar
- 9.Skálová A, Vanecek T, Majewska H, Laco J, Grossman P, Simpson RH, et al. Mammary analogue secretory carcinoma of salivary glands with high-grade transformation: report of 3 cases with the ETV6-NTRK3 gene fusion and analysis of TP53, β-catenin, EGFR, and CCND1 genes. Am J Surg Pathol. 2014;38:23–33.CrossRefGoogle Scholar
- 13.Nguyen JK, Bridge JA, Joshi C, McKenney JK. Primary mammary analog secretory carcinoma (MASC) of the vulva with ETV6-NTRK3 fusion: a case report. Int J Gynecol Pathol. 2018.Google Scholar
- 30.Simpson RHW, Bacani J, Skalova A. (2018) United States and Canadian Academy of Pathology evening speciality conference—head, neck, & endocrine pathology. In: Evening speciality conference: challenging cases and concepts in head and neck and endocrine pathology. Vancouver, BC, Canada.Google Scholar
- 39.Skálová A, Vanecek T, Simpson RH, Laco J, Majewska H, Baneckova M, et al. Mammary analogue secretory carcinoma of salivary glands: molecular analysis of 25 ETV6 gene rearranged tumors with lack of detection of classical ETV6-NTRK3 fusion transcript by standard RT-PCR: report of 4 cases harboring ETV6-X gene fusion. Am J Surg Pathol. 2016;40:3–13.CrossRefGoogle Scholar