Mammary Analogue Secretory Carcinoma (MASC) of salivary gland in four Mexican patients.

Abstract

The Clinco-pathological, immunohistochemical and molecular findings of four cases of Mammary Analogue Secretory Carcinoma (MASC) of salivary glands found in Mexico are described. The cases were extracted from 253 salivary gland tumors from a single institution in Mexico City. The 85 candidates for initial selection were: low grade mucoepidermoid carcinoma (MEC) (N=70 ), acinic cell cancinoma (AciCC) (N=14), papillary cystadenocarcinoma (N=1), and adenocarcinoma NOS (N=0). Tumors with some histological features consistent with MASC (N= 17, 6.7%) were studied by immunohistochemistry for mammaglobin, STAT5, and S-100 protein and four cases were positive (1.5%), thus the diagnosis of MASC was established, and these were submitted for molecular studies for ETV6-NTRK3. Fusion gene was demonstrated in three cases, two had been erroneously diagnosed as poorly granulated AciCC, and one as low grade MEC with microcystic pattern. Female gender predominated (3:1); one occurred in the parotid, two in minor salivary glands and one in the submaxillary gland; infiltrating borders, atypical mitosis and lymph node metastases were seen in the parotideal tumor. Two patients with major salivary gland tumors are alive and well at 10 and 20 months respectively, the two patients with minor salivary gland tumors are lost. It can be concluded that is important to think in MASC in poorly granulated AciCC and low grade MEC with microcystic pattern. Immunohistochemisty studies confirm the diagnosis, preferentially supported by molecular studies. MASC may follow aggressive behavior or transform into a high grade neoplasm. Key words:Acinic cell carcinoma, ETV6-NTRK3, Mammary Analogue Secretory Carcinoma, secretory breast carcinoma.

Secretory carcinoma of the major salivary gland: Provincial population‐based analysis of clinical behavior and outcomes

“…SC is also known to occur in the lip, buccal mucosa, soft palate, and thyroid. 1,5,32,35,[38][39][40][41][42][43][44] Similar to previous studies, 1,2,6,37 cases of SC show a slight male preponderance and occur at an earlier age than reported populations of acinic cell carcinoma or other mimics of SC. 38 Although the majority of cases of SC follow an indolent course and present with a slowly enlarging painless mass, pain was a feature in a quarter of SC cases and one case demonstrated aggressive growth and facial palsy.…”

“…All of the cases of SC in this study occurred in the parotid gland, which may relate to the search strategy in which only tumors of the major salivary glands were reviewed. SC is also known to occur in the lip, buccal mucosa, soft palate, and thyroid …”

“…In addition, we reviewed all published cases of SC in which follow‐up data of 6 months or greater were available by conducting a PubMed search using the terms “mammary analog secretory carcinoma,” “mammary analogue secretory carcinoma,” “secretory carcinoma,” and “MASC.” SC‐like tumors of nonsalivary gland origin were excluded. We identified 26 case reports and series totaling 170 patients with reported outcome data as shown in Table . Patient data from all publications were combined in order to assess recurrence rate and pattern.…”

“…We identified 26 case reports and series totaling 170 patients with reported outcome data as shown in Table 1. [1][2][3]6,7,9,10,[17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] Patient data from all publications were combined in order to assess recurrence rate and pattern. Patients were not doublecounted if appearing in more than one publication and due to variable follow-up reporting, actuarial survival analysis was not attempted.…”

Mammary Analogue Secretory Carcinoma of the Parotid Gland: A Rare and Unique Entity

“…Immunocytochemistry of MASC is positive for mammoglobin and S100. Diagnosis of MASC is confirmed with the detection of chromosomal translocation (12;15) (p13;q25) leading to the fusion gene ETV6-NTRK3 [4,[6][7][8]. As a result of this translocation, the tyrosine kinase is constitutively active.…”