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Mammary analogue secretory carcinoma (MASC) is a recently described salivary gland tumor, with a limited number of published reports. Less than three hundred cases have been reported in the literature and only 18 of these cases have been reported in minor palatal salivary glands, though publication bias is likely a factor. We present a case of a 57-year-old male who was diagnosed with MASC tumor presenting in a minor salivary gland and briefly review the current literature. MASC has a variety of histological features and different range of clinical behaviors. The histopathological diagnosis of MASC can be difficult, and the immunohistochemical profile of MASC is still being updated. The gold standard for MASC diagnosis is cytogenetics, with the majority having a translocation t(12;15)(p133;q25). Presently, there is no conclusive evidence that MASC should be treated differently than any other low-grade malignant salivary gland tumors, though high-grade transformation has been described.

A 59-year-old woman presented with a 1-month history of an ulcerated left nipple. This was associated with an intermittent bloody discharge. The surrounding areola was thickened and indurated. There was no nipple inversion ( Fig. 1).On examination the nipple was slightly erythematous. A 0.5 cm ulcer was located over the lower third of the nipple. A hemoserous discharge was present. There were no palpable breast masses and no associated adenopathy.The lesion was clinically suspicious of Paget's disease of the nipple. The patient had a mammogram that revealed no abnormality and then had a biopsy of the ulcerated area.The biopsy revealed a proliferation of glandular structures suggestive of a benign adenomatous process. The patient then had local curative excision of the lesion. Histology confirmed a proliferation of glandular tissues, all of which were invested by a myoepithelial cell layer (Fig. 2). Figure 2. Double layer of myoepithelial cells investing a proliferation of glandular tissue. Florid intraductal epithelial hyperplasia is also present. (Hematoxylin and eosin; magnification ×40.)Figure 1. Preoperative picture of the ulcerated nipple.

Semuloparin commenced postoperatively did not demonstrate noninferiority to enoxaparin initiated preoperatively for thromboprophylaxis after major abdominal surgery. Study registered with clinicaltrials.gov: NCT00679588.