Abstract
Purpose
Mammary analogue secretory carcinoma (SC) of the parotid gland is a relatively uncommon cancer associated with the ETV6–NTRK3 fusion product similar to breast cancer. The clinical characteristics and outcome of treatment were reviewed for patients with this tumor at our hospital.
Methods
In this retrospective case series, 24 patients with a diagnosis of acinic cell carcinoma (AcCC) of the parotid gland were classified as having either SC or AcCC based on analysis of the ETV6–NTRK3 fusion gene. These two groups were compared with respect to their clinical and imaging characteristics (MRI/US), cytologic findings, accuracy of fine-needle aspiration cytology and frozen section, treatment outcomes, and immunohistochemical findings.
Results
Based on re-classification by ETV6–NTRK3 fusion gene analysis, the diagnosis was SC in 14 patients and AcCC in 10 patients. The SC group had a significantly higher proportion of male patients and was also significantly younger than the AcCC group. Imaging studies revealed that SC was significantly more likely to show internal heterogeneity. Correct grading of both tumors was comparable by fine needle aspiration, with the rate being 60% for AcCC and 50% for SC. Diagnosis by frozen section biopsy diagnosis obtained the correct grade in 90% of the AcCC group and 93% of the SC group.
Conclusions
In 24 patients previously diagnosed with AcCC, re-analysis of the ETV6–NTRK3 fusion product indicated that 14 patients actually had SC. Although AcCC and SC show similarities of their biological aggressiveness and prognosis, patients with SC were significantly more likely to be male and younger.
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References
El-Naggar AK, Chan JK, Grandis JR et al (2017) World Health Organization classification of tumors. Chapter 7, tumors of salivary glands. IARC press, Lyon, pp 160–202
Skalova A, Vanecek T, Sima R et al (2010) Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: a hitherto undescribed salivary gland tumor entity. Am J Surg Pathol 34:599–608
Boon E, Valstar MH, van der Graaf WTA et al (2018) Clinicopathological characteristics and outcome of 31 patients with ETV6-NTRK3 fusion gene confirmed (mammary analogue) secretory carcinoma of salivary glands. Oral Oncol 82:29–33
Khalele BA (2017) Systematic review of mammary analog secretory carcinoma of salivary glands at 7 years after description. Head Neck 39(6):1243–1248
Kuwabara H, Yamamoto K, Terada T, Kawata R, Nagao T, Hirose Y (2018) Hemorrhage of MRI and immunohistochemical panels distinguish secretory carcinoma from acinic cell carcinoma. Laryngoscope Investig Otolaryngol 3(4):268–274
Bourgeois JM, Knezevich SR, Mathers JA, Sorensen PH (2000) Molecular detection of the ETV6-NTRK3 gene fusion differentiates congenital fibrosarcoma from other childhood spindle cell tumors. Am J Surg Pathol 24:937–946
Nishikado A, Kawata R, Haginomori SI, Terada T, Higashino M, Kurisu Y et al (2018) A clinicopathological study of parotid carcinoma: 18-year review of 171 patients at a single institution. Int J Clin Oncol 23(4):615–624
Chiosea SI, Griffith C, Assaad A, Seethala RR (2012) Clinicopathological characterization of mammary analogue secretory carcinoma of salivary glands. Histopathology 61(3):387–394
Shah AA, Wenig BM, LeGallo RD, Mills SE, Stelow EB (2015) Morphology in conjunction with immunohistochemistry is sufficient for the diagnosis of mammary analogue secretory carcinoma. Head Neck Pathol 9(1):85–95
Skálová A, Vanecek T, Simpson RH et al (2016) 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 40(1):3–13
Bishop JA, Yonescu R, Batista D, Eisele DW, Westra WH (2013) Most nonparotid "acinic cell carcinomas" represent mammary analog secretory carcinomas. Am J Surg Pathol 37(7):1053–1057
Sethi R, Kozin E, Remenschneider A et al (2014) Mammary analogue secretory carcinoma: update on a new diagnosis of salivary gland malignancy. Laryngoscope 124(1):188–195
Scherl C, Kato MG, Erkul E et al (2018) Outcomes and prognostic factors for parotid acinic cell Carcinoma: a National Cancer Database study of 2362 cases. Oral Oncol 82:53–60
Kim YA, Joung JW, Lee SJ, Oh HK, Cho CH, Sung WJ (2019) Cytopathologic features of secretory carcinoma of salivary gland: report of two cases. J Pathol Transl Med 53(1):70–74
Oza N, Sanghvi K, Shet T et al (2016) Mammary analogue secretory carcinoma of parotid: is preoperative cytological diagnosis possible? Diagn Cytopathol 44(6):519–525
Hoffman HT, Karnell LH, Robinson RA, Pinkston JA, Menck HR (1999) National Cancer Data Base report on cancer of the head and neck: acinic cell carcinoma. Head Neck 21(4):297–309
Chong GC, Beahrs OH, Woolner LB (1974) Surgical management of acinic cell carcinoma of the parotid gland. Surg Gynecol Obstet 138(1):65–68
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Terada, T., Kawata, R., Noro, K. et al. Clinical characteristics of acinic cell carcinoma and secretory carcinoma of the parotid gland. Eur Arch Otorhinolaryngol 276, 3461–3466 (2019). https://doi.org/10.1007/s00405-019-05604-4
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DOI: https://doi.org/10.1007/s00405-019-05604-4