Salivary Gland Secretory Carcinoma With High-Grade Transformation, CDKN2A/B Loss, Distant Metastasis, and Lack of Sustained Response to Crizotinib

2017 ◽  
Vol 25 (7) ◽  
pp. 613-618 ◽  
Author(s):  
Nicole A. Cipriani ◽  
Elizabeth A. Blair ◽  
Joshua Finkle ◽  
Jennifer L. Kraninger ◽  
Christopher M. Straus ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Molecular Genetic ◽  
Low Grade ◽  
High Grade ◽  
Secretory Carcinoma ◽  
Parotid Duct ◽  
Pleural Metastases ◽  
High Grade Transformation ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Background. Salivary gland secretory carcinoma is usually a low-grade neoplasm. However, high-grade transformation can occur and has important implications for clinical outcome. Methods. A patient presented with an enlarging buccal mass. Magnetic resonance imaging (MRI) showed a tumor with a biphasic appearance along the right parotid duct. Local excision and histopathologic examination confirmed the diagnosis of secretory carcinoma with high-grade transformation. ETV6-NTRK3 translocation and loss of CDKN2A/B were identified. Results. The patient subsequently presented with cough and dyspnea and was found to have pleural metastases. Carboplatin and paclitaxel exacerbated the symptoms. Crizotinib resulted in initial symptomatic and radiographic improvement; however, the patient soon succumbed to progressive intrathoracic disease. Conclusions. High-grade salivary gland secretory carcinoma can have a biphasic appearance on MRI. Diagnosis is confirmed by the histologic appearance and associated ETV6-NTRK3 fusion. Additional molecular genetic events leading to transformation are unknown; however, loss of CDKN2A/B may have contributed. Treatment with multimodal chemotherapy was of limited benefit.

scholarly journals Secretory Carcinoma of Salivary Gland with High-Grade Histology Arising in Hard Palate: A Case Report

Reports ◽  
2020 ◽  
Vol 3 (2) ◽  
pp. 6
Author(s):  
Kiyofumi Takabatake ◽  
Keisuke Nakano ◽  
Hotaka Kawai ◽  
Saori Yoshida ◽  
Haruka Omori ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Hard Palate ◽  
Relevant Literature ◽  
Salivary Gland Tumor ◽  
World Health ◽  
Fusion Product ◽  
Low Grade ◽  
High Grade ◽  
Secretory Carcinoma ◽  
High Grade Transformation

Secretory carcinoma (SC) is a recently described salivary gland tumor reported in the fourth edition of World Health Organization classification of head and neck tumors. SC is characterized by strong S-100 protein, mammaglobin, and vimentin immunoexpression, and harbors a t(12;15)(p13;q25) translocation which leads to ETV6-NTRK3 fusion product. Histologically, SC displays a lobulated growth pattern and is often composed of microcystic, tubular, and solid structures with abundant eosinophilic homogenous or bubbly secretion. SC is generally recognized as low-grade malignancy with low-grade histopathologic features, and metastasis is relatively uncommon. In this case, we described a SC of hard palate that underwent high grade transformation and metastasis to the cervical lymph node in a 54-year-old patient. In addition, this case showed different histological findings between primary lesion and metastasis lesion. Therefore, the diagnosis was confirmed by the presence of ETV6 translocation. Here, we report a case that occurred SC with high-grade transformation in the palate, and a review of the relevant literature is also presented.

scholarly journals Current Concepts on Dedifferentiation/High-Grade Transformation in Salivary Gland Tumors

2011 ◽  
Vol 2011 ◽  
pp. 1-9 ◽  
Author(s):  
Ana Flávia Costa ◽  
Albina Altemani ◽  
Mario Hermsen
Keyword(s):  
Salivary Gland ◽  
Tp53 Gene ◽  
Salivary Gland Tumors ◽  
Low Grade ◽  
High Grade ◽  
Ki 67 ◽  
Histopathological Classification ◽  
Morphological Criteria ◽  
Salivary Gland Carcinomas ◽  
High Grade Transformation

The concept of dedifferentiation had previously been used in salivary gland carcinomas. Recently, the term “high-grade transformation” was introduced for adenoid cystic carcinoma, acinic cell carcinoma, epithelial-myoepithelial carcinoma, and polymorphous low-grade adenocarcinoma and may better reflect this phenomenon, although transformation into moderately differentiated adenocarcinoma (i.e., not “high grade”) has also been described. Among the immunohistochemical markers, Ki-67 seems to be the only one that can help distinguish between the conventional and transformed components; however, the combination of morphological criteria is still sovereign. The overexpression of p53 was observed in the transformed component in all tumor types studied, despite few cases having been demonstrated to carry mutations or deletions in TP53 gene. Genetic studies in salivary gland tumors with dedifferentiation/high-grade transformation are rare and deserve further investigation. This paper aims at providing an overview on the recent concepts in histopathological classification of salivary gland tumors, complemented by immunohistochemical and genetic findings.

scholarly journals Clinicopathological investigation of secretory carcinoma cases including a successful treatment outcome using entrectinib for high-grade transformation: a case report

2022 ◽  
Vol 15 (1) ◽  
Author(s):  
Kensuke Suzuki ◽  
Hiroshi Harada ◽  
Masayuki Takeda ◽  
Chisato Ohe ◽  
Yoshiko Uemura ◽  
...  
Keyword(s):  
Head And Neck ◽  
Genetic Study ◽  
Locoregional Recurrence ◽  
Molecular Genetic ◽  
Labeling Index ◽  
Low Grade ◽  
High Grade ◽  
Secretory Carcinoma ◽  
Molecular Genetic Study ◽  
Ki 67

Abstract Background Secretory carcinoma (SC) of the salivary gland is a recently described malignant tumor harboring characteristic ETV6-NTRK3 gene fusion. SC generally has a favorable clinical course, and is currently regarded as a low-grade carcinoma. However, a small subset of SCs demonstrates aggressive clinical features with histologically high-grade transformed morphology, the molecular pathogenesis of which has not yet been elucidated. In this study, we performed a clinicopathological and molecular genetic study of patients with SC of the head and neck displaying various clinical characteristics to investigate the differences of pathological and molecular genetics between low-grade and high-grade components of SC. Case presentation Three cases with SC of the head and neck, including a conventional low-grade SC and two high-grade transformed SCs are described. High-grade transformed SCs with histological features such as nuclear polymorphism, distinctive nucleoli and increased mitotic activity developed locoregional recurrence and distant metastasis. Immunohistochemical analysis revealed that low- and high-grade components showed different expression patterns for S-100 protein and mammaglobin, whereas all examined components were positive for p-STAT5. p53-positive cell population was markedly higher in one case with high-grade transformed SC. The proliferative activity of high-grade components was markedly increased, with the Ki-67 labeling index ranging up to 30–32%. A fluorescence in situ hybridization study with an ETV6 (12p13) break apart probe revealed split signals in the nuclei in all 3 cases. A targeted next-generation sequencing-based fusion assay demonstrated that all 6 clinical samples from the 3 patients showed the presence of the ETV6-NTRK3 fusion transcripts. One patient with high-grade transformed SC showed a dramatic clinical response to the pan-TRK inhibitor, entrectinib, for the treatment of locoregional recurrence and pulmonary metastasis. Conclusions High-grade transformed SC showed aggressive clinical and pathological features with increased Ki-67 labeling index. Molecular genetic study of gene rearrangement appears to be beneficial treatment as the presence of ETV6-NTRK3 translocation may represent a therapeutic target in SC, particularly the high-grade transformed type.

scholarly journals Dedifferentiated Acinic Cell Carcinoma of the Parotid Gland With Myoepithelial Features

2002 ◽  
Vol 126 (9) ◽  
pp. 1104-1105 ◽  
Author(s):  
Simonetta Piana ◽  
Alberto Cavazza ◽  
Corrado Pedroni ◽  
Rosa Scotti ◽  
Luigi Serra ◽  
...  
Keyword(s):  
Salivary Gland ◽  
Parotid Gland ◽  
Cell Carcinoma ◽  
Clinical Course ◽  
Acinic Cell Carcinoma ◽  
Low Grade ◽  
High Grade ◽  
Epithelial Proliferation ◽  
Acinic Cell

Abstract Dedifferentiated acinic cell carcinoma of the salivary gland is an uncommon variant of acinic cell carcinoma, characterized by the coexistence of both an usual low-grade acinic cell carcinoma and a high-grade dedifferentiated component, as well as by an accelerated clinical course. We describe a case of acinic cell carcinoma of the parotid gland in a 67-year-old woman, which recurred 4 times after surgery and radiotherapy. The recurrences consisted of residual foci of acinic cell carcinoma intermingled with a high-grade epithelial proliferation; the latter was focally constituted by cells with morphologic and immunohistochemical features of myoepithelium.

scholarly journals Mammary analogue secretory carcinoma: a rare salivary gland tumor

2020 ◽  
Vol 6 (5) ◽  
pp. 998
Author(s):  
Shashikant Anil Pol ◽  
Surinder K. Singhal ◽  
Nitin Gupta ◽  
Himanshu Bayad
Keyword(s):  
Salivary Gland ◽  
Salivary Gland Tumor ◽  
Needle Aspiration ◽  
Good Prognosis ◽  
Low Grade ◽  
Secretory Carcinoma ◽  
Mammary Analogue Secretory Carcinoma ◽  
Grade Malignancy ◽  
Enhanced Computed Tomography ◽  
Slow Growing

<p>Mammary analogue secretary carcinoma are salivary gland tumors similar to secretary carcinoma of breast histologically. It usually affects adults with mean age group of 45 years. Clinically it is usually slow growing, low grade malignancy with favorable prognosis. We are reporting a case of 47 years old female presented with complaints of swelling behind left ear for last 7 years. It was slow growing, painless and persistent. On examination, 4 x 3 cm swelling was present just below left ear lobule. It was nontender, firm, irregular in shape with smooth surface with slight mobility and overlying skin pinchable. Fine needle aspiration cytology suggested benign tumor with cystic change. On contrast enhanced computed tomography scan, there was a lobulated hypodense lesion measuring 24×35×32 mm with internal septations and enhancement of wall in expected location of superficial as well as deep lobe of left parotid gland. Patient underwent left total conservative parotidectomy and histopathology came out to be secretory analogue mammary carcinoma. Subsequently she received post-operative radiotherapy. Patient is on regular follow up and disease free till date. Usually mammary analogue secretory carcinoma is a low-grade malignancy with good prognosis. Immunohistochemistry is confirmatory which shows positivity for S-100 protein and mammaglobin.</p>

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