Mammary Analogue Research Articles

Pilomatrix-like breast carcinoma: A mammary analog of pilomatrix-like high-grade endometrioid carcinoma (PiMHEC).

To describe what is, to our knowledge, the first recognized case of a triple-negative breast carcinoma (TNBC) with a PiMHEC-like phenotype.Pilomatrix-like high-grade endometrioid carcinoma (PiMHEC) is a high-grade carcinoma with divergent differentiation resembling cutaneous pilomatrix carcinoma that was recently described in the endometrium and ovary. For reference, pertinent features of PiMHEC include (1)high-grade basaloid to squamoidmorphology withthe presence of ghost cells; (2) only focal p63 and/or p40 expression despite a squamoid appearance; (3) CTNNB1 mutation, accompanied by diffusely aberrant β-catenin expression and LEF1 and/or CDX2 expression; and (4) loss of site-specific markers (ie, PAX8, ER). Here we report the histologic, immunophenotypic and molecular genetic features ofa case of a triple-negative breast carcinoma (TNBC) with a PiMHEC-like phenotype. The tumor developed immediately adjacent to a HER2+, androgen receptor (AR)+, GATA3+ conventional grade 3 invasive ductal carcinoma (IDC) with only membranous β-catenin expression. The PiMHEC-like component had all of the above-noted morphologic and immunophenotypic features of endometrial PiMHEC but with loss of GATA3 and AR rather than PAX8 and ER.Molecular analysis performed on both tumor components demonstrated a shared TP53 point mutation and an exon 3 CTNNB1 mutation restricted to the PiMHEC-like component, implying a clonal relationship with secondary acquisition of CTNNB1. Following neoadjuvant chemotherapy, the HER2+ conventional component had completely resolved, but the PiMHEC-like component had very little response. This case demonstrates that a PiMHEC-like phenotype may be seen as a form of TNBC that can develop from conventional IDC, with loss of site-specific biomarkers, acquisition of CTNNB1 mutation, and resistance to conventional chemotherapy.

Mammary analogue secretory carcinoma involving submandibular gland: Diagnostic pitfall with review of literature

ABSTRACT Mammary analogue secretory carcinoma (MASC) is a recently defined entity among salivary gland tumors. MASC bores a striking resemblance to secretory carcinoma of breast along with the characteristics of ETV6–NTRK3 translocation. Hence, the entity was designated as MASC and was formally included in the 4th edition of World Health Organization classification of head and neck tumors in 2017. To the best of our knowledge, around 12 cases of MASC have been described in the Indian literature. MASC commonly involves parotid gland (70%). Involvement of submandibular gland is still rarer (7%). Prognosis of MASC is comparable to other low grade salivary gland malignancies; however, aggressive behavior has also been reported in few cases. This case is one of the very few reported cases describing MASC with detailed clinical, cytology, and microscopy findings along with special stains and immunohistochemistry.

Non Indigenous Mammary Secretory Carcinoma of Parotid Gland - An Unusual Presentation.

Mammary analog secretory carcinoma (MASC) is a relatively rare, low-grade tumor affecting the salivary glands. We report a 62-year-old female who was diagnosed with MASC of the left parotid gland and underwent left Total conservative parotidectomy with condylectomy and reconstruction with right anterolateral free flap and left facial nerve (frontal branch) reconstruction with a cable graft. As there is no standard treatment protocol developed for the management of MASC, this report focuses on the various management options that have been followed to date.

Mammary Analogue Secretory Carcinoma Of The Parotid: An Arduous Maze To Solve

Mammary analogue secretory carcinoma (MASC) is an unusual and rare salivary gland malignancy that recapitulates the genetic and microscopic features of secretory carcinoma of the breast (SCB) which is an equally rare entity. MASC and SCB express S-100 protein, vimentin, mammaglobin, and harbor a t (12; 15) (p13; q25) translocation which leads to ETV6-NTRK3 fusion product. The morphology of MASC is not specific and can overlap with many salivary gland tumors. S100 and mammaglobin’s strong positivity confirm the diagnosis of MASC. The morphology along with immunohistochemical findings provides important clues for diagnosis. Recent advances in molecular pathology help in investigating both differential diagnosis and prognosis in salivary gland oncology. Molecular testing is recommended to arrive at a diagnosis of MASC. We report a case of MASC of the parotid gland in a 47-year-old male patient with his immunohistochemical profile.t.

Mammary Analog Secretory Carcinoma (MASC) of the oral mucosa with proven ETV6- NTRK3 fusion gene as the gold standard for diagnosis – A case series and literature review

Abstract Introduction/Objective Mammary Analog Secretory Carcinoma (MASC) is a rare type of cancer that occurs in the salivary glands. It is named after its similarity in appearance and behavior to secretory carcinoma of the breast. The incidence of MASC is estimated at 0.3%, with less tha 500 cases reported. The diagnosis of MASC is based on a combination of clinical, radiographic, and histopathologic features. Prognosis is generally good, with a low risk of recurrence and metastasis; its differential diagnosis includes: acinic cell carcinoma, adenocarcinoma (primary or metastatic), mucoepidermoid carcinoma, and low-grade cribriform cystadenocarcinoma. MASC is characterized by ETV6-NTRK3 fusion gene, a translocation between the ETV6 gene on chromosome 12 and the NTRK3 gene on chromosome 15, leading to the fusion of these two genes and the production of a chimeric protein. FISH testing can detect the presence of the ETV6-NTRK3 fusion gene. The detection of the ETV6-NTRK3 fusion gene is highly specific for MASC and can aid in the diagnosis and management of this tumor. In addition, the presence of this gene fusion can have implications for targeted therapy, as drugs that target the NTRK3 gene may be effective in the treatment of MASC. Methods/Case Report This review aims to compare the characteristics of MASC in cases we diagnosed since 2015. Results (if a Case Study enter NA) Cases Case 1 (2015) 68yo Female Right Lower Lip, Biopsy Positive: S100, PAS with and without diastase and mammaglobin Negative: Mucicarmine ETV6 + Case 2 (2016) 54yo Female Right Buccal Mucosa, Biopsy Positive: S100, Mammaglobin Weakly positive: p63 ETV6 + Case 3 (2016) 42yo Male Right Buccal Mucosa, Biopsy Positive: S100, Ck7, Ck5/6, Vimentin Weakly positive: GFAP, p63 Negative: SMA, MSA, Calponin ETV6 + Case 4 (2018) 60yo Female Left Soft Palate, Biopsy Positive: CK7 Weakly positive: GATA-3 Negative: CK20, TTF-1, CDX-2, Napsin A ETV6 + Case 5 (2019) 57yo Female Right Palatal Mucosa, Biopsy Positive: S100, Ck7, Ck5/6, Vimentin Negative: p63, GFAP, Calponin, SMA ETV6 + Conclusion MASC is a very rare salivary gland tumor and the gold standard for its diagnosis is FISH for ETV6 gene rearrangement. All our cases showed ETV6- NTRK3 fusion gene, while 80% (4/5) of the patients were females. S100, mammaglobin and PAS were positive in all tested cases, consistent with previous reports. The histopathological diagnosis of MASC on a biopsy can be challenging; although immunohistochemical stains and morphology may be helpful hints, FISH testing should be considered when MASC is suspected.

Salivary Gland Secretory Carcinoma; Review of 13 Years World-Wide Experience and Meta-Analysis.

Secretory Carcinoma is a malignant salivary gland tumor, initially described in 2010. This rare tumor is associated with the translocation t(12;15) (p13;q25), resulting in the fusion gene ETV6-NTRK3. Since this tumor is quite rare, most publications describe only small cohorts of patients. We aimed to investigate the clinical, pathological, and prognostic features of this newly defined malignant entity. Pubmed, Google Scholar, and Web of Science databases. All published articles between 2010 and 2023 were reviewed. Search terms included the terms "Mammary Analogue Secretory Carcinoma" and "Secretory Carcinoma". All articles published in English reporting on Secretory Carcinoma of salivary glands were retrieved. One-hundred and 12 retrospective articles reporting a total of 674 patients were included, with 52% males and a mean age of 44.9 ± 18.9. The event rate for patients with advanced-stage disease (Stage 3/4) at presentation was 24.1% (95% CI 17.6%-31.9%, I2 = 9.2%), 14.6% for regional metastases (95% CI 10.5%-20%, I2 = 12%), and the event rate of distant metastasis was 8.4% (95% CI 5.5%-12.7%, I2 = 4.2%). Adjuvant radiotherapy was administered for 30.3% of patients (95% CI 24.1%-37.2%, I2 = 21.5%). The recurrence rate was 19% (95% CI 15.1%-23.8%, I2 = 5%). Survival outcomes showed a 17.2% death of disease rate for Secretory Carcinoma patients (95% CI 13.5%-21.8%, I2 = 7.3%). Secretory Carcinoma is a rare and relatively newly defined entity arising in the parotid gland most commonly. Characterized as a low-grade tumor, the majority of patients are diagnosed at an early stage, without regional or distant disease, and the prognosis is relatively good. NA Laryngoscope, 134:1716-1724, 2024.

Secretory carcinoma of salivary gland: A rare tumor masquerading as acinic cell carcinoma on cytology.

Secretory carcinoma (SC) was originally described as mammary analogue secretory carcinoma (MASC). We present here a case of 33 years old male who came to ENT outpatient department with a complaint of swelling over the left side of his neck for 8 months. On Fine-needle aspiration cytology, an impression of cytomorphological features suggestive of acinic cell carcinoma (Milan category V) was given. Left functional endoscopic sinus surgery was done. On histopathology, a final impression of Secretory carcinoma, the left submandibular gland was given with pathological stage classification as pT2N0Mx. SC of the salivary gland is a rare entity that may pose diagnostic challenges. Awareness of its cytologic features is paramount to achieve an accurate diagnosis. Morphologic interpretation must be supported by an immunohistochemical profile and molecular studies to confirm a diagnosis of SC.

The Role of Novel Immunohistochemical Markers for Special Types of Breast Carcinoma.

Some histologic special types of breast carcinoma harbor specific recurrent genetic alterations that are not seen in other types of breast carcinoma (no special type), namely adenoid cystic carcinoma, secretory carcinoma, and tall cell carcinoma with reversed polarity. These tumors have unique morphologic features, are triple-negative, that is, do not express hormone receptors or HER2, and are generally associated with a favorable prognosis. Adenoid cystic carcinoma, like its counterpart in other organs, shows a MYB-NFIB fusion gene that is the result of a recurrent t(6;9)(q22-23;p23-24) translocation. Other MYB alterations have been described that result in overexpression of MYB . Secretory carcinoma is characterized by an ETV6-NTRK3 gene fusion that is the result of recurrent (12;15);(p13;q25) translocation, which is also seen in mammary analog secretory carcinoma of the salivary gland. Tall cell carcinoma with reversed polarity shows IDH2 p.Arg172 hotspot mutations. Immunohistochemical antibodies have emerged that identify the underlying genetic alterations in these tumors and serve as useful diagnostic tools. This review will provide an update on the molecular features and diagnostic immunohistochemical markers that have become increasingly popular to aid in diagnosing these uncommon triple-negative breast tumors.

Mammary analogue secretory carcinoma (MASC) of parotid gland- A case report

Mammary analogue secretory carcinoma is a rare salivary gland carcinoma which shares morphologic and immunohistochemical features with the secretory carcinoma of breast and was first proposed by Skalova in 2010 with translocation of (q13; q25), t (12; 15), subsequently giving ETV6-NTRK3 gene rearrangement. Usually, it is a benign tumor that affects the parotid gland, with slight predilection for males. The present article report a case of secretory carcinoma of right parotid gland with special emphasis on histological feature and immunohistochemistry for diagnostic purpose and its management. Differential diagnosis includes AciCC, ADC-NOS and MEC. In a review by Chiosa et al (2012) in 337 cases of salivary gland malignancy included AciCC, ADC-NOS, MEC, LGCC, non-ITAC, signet ring adenocarcinoma, PLGA and most common malignancy reclassified as MASC were AciCC (11/89), ADC-NOS (14/37), MEC (1/165). Management for MASC includes surgical excision of the lesion (either superficial or total parotidectomy) for local, less aggressive disease like for low-grade malignant salivary gland neoplasms. For more invasive, metastatic disease and positive margins- neck dissection, radiotherapy and chemotherapy are reserved. There is no standard multidisciplinary treatment protocol established due to scarcity of this disease.

Salivary Gland Secretory Carcinoma: Clinicopathologic and Genetic Characteristics of 215 Cases and Proposal for a Grading System.

Salivary gland secretory carcinoma (SC), previously mammary analog SC, is a low-grade malignancy characterized by well-defined morphology and an immunohistochemical and genetic profile identical to SC of the breast. Translocation t(12;15)(p13;q25) resulting in the ETV6::NTRK3 gene fusion is a characteristic feature of SC along with S100 protein and mammaglobin immunopositivity. The spectrum of genetic alterations for SC continues to evolve. The aim of this retrospective study was to collect data of salivary gland SCs and to correlate their histologic, immunohistochemical, and molecular genetic data with clinical behavior and long-term follow-up. In this large retrospective study, we aimed to establish a histologic grading scheme and scoring system. A total of 215 cases of salivary gland SCs diagnosed between 1994 and 2021 were obtained from the tumor registries of the authors. Eighty cases were originally diagnosed as something other than SC, most frequently acinic cell carcinoma. Lymph node metastases were identified in 17.1% (20/117 cases with available data), with distant metastasis in 5.1% (6/117). Disease recurrence was seen in 15% (n=17/113 cases with available data). The molecular genetic profile showed ETV6::NTRK3 gene fusion in 95.4%, including 1 case with a dual fusion of ETV6::NTRK3 and MYB::SMR3B. Less frequent fusion transcripts included ETV6::RET (n=12) and VIM::RET (n=1). A 3-tiered grading scheme using 6 pathologic parameters (prevailing architecture, pleomorphism, tumor necrosis, perineural invasion (PNI), lymphovascular invasion (LVI), and mitotic count and/or Ki-67 labeling index) was applied. Grade 1 histology was observed in 44.7% (n=96), grade 2 in 41.9% (n=90), and grade 3 in 13.5% (n=29) of cases. Compared with low-grade and intermediate-grade SC, high-grade tumors were associated with a solid architecture, more prominent hyalinization, infiltrative tumor borders, nuclear pleomorphism, presence of PNI and/or LVI, and Ki-67 proliferative index >30%. High-grade transformation, a subset of grade 2 or 3 tumors, seen in 8.8% (n=19), was defined as an abrupt transformation of conventional SC into high-grade morphology, sheet-like growth, and a tumor lacking distinctive features of SC. Both overall survival and disease-free survival (5 and 10y) were negatively affected by tumor grade, stage, and TNM status (each P<0.0001). SC is a low-grade malignancy with predominantly solid-microcystic growth patterns, driven by a gene fusion, most commonly ETV6::NTRK3. There is a low risk for local recurrence and a good overall long-term survival, with a low risk for distant metastasis but a higher risk for locoregional lymph node metastasis. The presence of tumor necrosis, hyalinization, PNI and/or LVI, and positive resection margins correlate with higher tumor grade, less favorable prognosis, and increased mortality. The statistical results allowed us to design a 3-tiered grading system for salivary SC.

Secretory Carcinoma of Salivary Glands: A Case Series and Review of Literature.

Mammary analogue of secretory carcinoma is a recently described entity in WHO 2017 classification of head and neck tumours. It resembles secretory carcinoma of breast. It usually affects the salivary glands and has an indolent behaviour. We reviewed five cases of Mammary analogue of secretory carcinoma in our institute and compared our results with existing literature. All the patients underwent surgical resections and appropriate adjuvant treatment. Immunohistochemistry is an alternative cost effective tool as compared to genetic testing to differentiate secretory carcinoma from its mimickers. Surgery with adequate margins followed by adjuvant therapy is the treatment of choice.

Mire and Pelage-Mucoepidermoid Carcinoma Salivary Gland

Mucoepidermoid carcinoma of salivary gland is a frequently encountered, malignant neoplasm arising from salivary gland epithelium constituted of mucous cells, intermediate cells and epidermoid cells. Tumefaction is associated with specific chromosomal translocation t(11;19)(q14-21;p12-13) and CRTC1(MECT1)-MAML2 genetic fusion. Median age of disease emergence is 49 years and a mild female preponderance is observed. Neoplasm predominantly incriminates major salivary glands as the parotid gland. Tumefaction depicts a solid, cystic or dual configuration and is composed of neoplastic epidermoid cells demonstrating solid nests, sheets or cellular cords along with varying proportion of epidermoid cells, intermediate cells or mucocytes. Tumour cells appear immune reactive to pan-cytokeratin, CK5/6, p63, p40, epithelial membrane antigen(EMA), CK7 or CK14. Membrane bound mucins appear immune reactive to MUC1, MUC2, MUC4, MUC5AC and MUC5B. Mucoepidermoid carcinoma requires segregation from neoplasms such as pleomorphic adenoma with squamous cell and mucinous cell metaplasia, necrotizing sialometaplasia, Warthin tumour with squamous metaplasia, acinic cell carcinoma, mammary analogue secretory carcinoma (MASC), primary or secondary squamous cell carcinoma or salivary duct carcinoma. Preoperative assessment with ultrasonography or fine needle aspiration cytology may be beneficially employed. Tumefaction may be subjected to comprehensive surgical eradication with excision of broad perimeter of uninvolved, circumscribing soft tissue.

Defining the clinical characteristics of mammary analog secretory carcinoma of the salivary gland: Analysis of the National Cancer Database.

Mammary analog secretory carcinoma (MASC) is a classification of salivary gland tumors, recently included within the term secretory carcinoma. Previous descriptions of this diagnosis have largely consisted of case reports and case series with few studies investigating its clinical characteristics as compared to non-MASC tumors. Our objective was to use a large patient database to compare the clinical characteristics of mammary analog secretory carcinoma vs. non-mammary analog secretory carcinoma salivary gland tumors. The National Cancer Database was queried between September and October 2022 for histological diagnosis of mammary analog secretory carcinoma and non-MASC salivary tumors. Patients diagnosed with mammary analog secretory carcinoma and non-mammary analog secretory carcinoma salivary tumors between the period of 2004 through 2019 were included in this analysis. Various demographic and clinical variables were abstracted from the database and compared using Wilcoxon rank sum and chi-square tests. Survival was compared between cohorts using Cox proportional hazards regression. Overall, compared to non-mammary analog secretory carcinoma diagnoses (n = 47668), mammary analog secretory carcinoma tumors (n = 384) affected younger individuals, displayed favorable pathologic staging and tumor grade, and were less likely to invade surrounding tissues. Patients with mammary analog secretory carcinoma tumors also received treatment more quickly following diagnosis compared to patients with non-mammary analog secretory carcinoma tumors. The risk of death was 4.3 times greater for non-mammary analog secretory carcinoma diagnoses when adjusted for patient variables (hazard ratio = 4.3, 95% confidence interval [2.37-7.71], p < 0.001). Clinically, mammary analog secretory carcinoma salivary tumors have a more indolent course compared to other salivary cancers. Additional studies are needed to determine the natural history of this tumor type.

176. Secretory Cell Carcinoma: A case report of a rare salivary neoplasm

Secretory cell carcinoma of the salivary gland is a rare malignant neoplasm, described as a new entity in the 2017 WHO classification of head and neck tumours. It was previously synonymous with ‘mammary analogue secretory carcinoma’ due to the morphological, genetic and histological similarities to breast secretory carcinoma. Despite the risk of local recurrence and distant metastases it is reported to have a favourable prognosis.

A rare case of mammary analogue secretory carcinoma of the parotid gland; A diagnostic and management challenge

Mammary Analogue Secretory Carcinomas (MASCs) are rare slow growing salivary gland tumors that mimic the histological and genetic features of secretory carcinoma, a rare tumor of the breast. In this article, we present the case of a 24-year-old woman diagnosed as a case of mammary analogue secretory carcinoma. The patient underwent left superficial parotidectomy to excise the parotid mass. A multilobulated solid cum cystic mass of around 60 x 50 mm was excised with clear margins with preservation of the facial nerve. The lesion demonstrated an infiltrative pattern extending beyond the capsule of the tumor and immunohistochemical stains were positive for Cytokeratin AE1/AE3, Cytokeratin 7, SOX-10, and Mammaglobin. Due to vague clinical presentation and lack of certain imaging, MASC is a challenging definitive diagnosis to make, and less than 100 cases of MASCs have been reported in existing literature and management guidelines for the tumor are not yet clearly defined. We aim to help improve upon the existing knowledge base by reporting this rare case and lay down future groundwork for larger studies involving MASCs

Mammary Analogue Secretory Carcinoma of Parotid - a Pathological Mystery.

Salivary gland neoplasms account for 3-6% of head and neck tumours. 70-80% of parotid tumours are benign in histopathology. FNAC has an overall accuracy of 95% in diagnosis of parotid neoplasms. However, the remaining 5% still pose a histopathological mystery which may require a surgical excision of the parotid. We report a case of a 42 year-old-man with a history of parotid swelling and a FNAC report which showed a possibility of a low-grade mucoepidermoid carcinoma or a ductal adenocarcinoma. Final histopathological diagnosis after surgical excision revealed a new pathological entity in mammary analogue secretory carcinoma of parotid.

A Parotid Gland Mammary Analogue Secretory Carcinoma in a 4-Year-Old Boy: Case Report and Literature Review

Background: Mammary analogue secretory carcinoma (MASC) is characterized by similar histologic, immunohistochemical, and molecular features with breast secretory carcinoma. MASC usually occurs in adults. Case report: A 4-year-old boy presented with a right infra-auricular mass. Features of the tumor include solid, tubular, and papillary growth patterns, with homogenous eosinophilic secretions inside microcystic structures. Immunohistochemical stains showed strong, diffuse staining for CK7, S100, pan-TRK protein. P63 was positive in a peripheral pattern. Fluorescence in situ hybridization (FISH) analysis showed the characteristic ETV6-NTRK3 gene fusion. Conclusion: Typical histological, immunohistochemical, and molecular features are present in MASC occurring early in childhood.

Mammary analog secretory carcinoma in adults: A systematic review.

e18076 Background: Mammary analog secretory carcinoma (MASC) is a rare malignant salivary gland tumor of the head and neck region that was first described by Skálová et al. in 2010. It histologically mimics breast secretory carcinoma and parotid acinic cell carcinoma, and characterized by ETV6-NTRK3 fusion gene. This review aims to investigate the clinicopathologic features, treatment, and outcomes of MASC in adults. Methods: PubMed search for MASC adults (18+ years) from data inception through 2021, pooled with a case from our institution. Kaplan-Meier analysis was used to plot survival curves. Results: Of the 254 included cases, female:male ratio 1.02:1 with a mean age at diagnosis (±SD, range) of 50.1 (±16.7, 18–86) years. In terms of location, 143 (56.3%) occurred in the parotid gland, 21 (8.3%) in the submandibular gland, 21 (8.3%) in the lip, 15 (5.9%) in the thyroid gland–all (100%) had a component of classical type papillary carcinoma, 15 (5.9%) were cutaneous, 13 (5.1%) in the buccal mucosa, 12 (4.7%) split between hard and soft palate, 4 (1.6%) in the nasal mucosa, 2 (0.8%) in the lung, and remaining 8 (3.1%) each in the conjunctiva, tongue, minor salivary gland, submaxillary gland, maxillary sinus, ethmoid sinus, upper esophagus, and mandible. Patients mostly presented with swelling or growing mass in 95.4% (out of which, 93.3% were painless), followed by a painful ulcer in 1.8%. Median tumor size was 1.9 cm (range 0.3cm–8.5cm). Median duration of symptoms at time of presentation was 12 (range 1-360) months. Tumors were T1 (49.7%), T2 (23.9%), T3 (20.3%), and T4 (6.1%), N0 (81.9%), N1 (10.7%), N2 (7.4%), M0 (97.4%), and M1 (2.6%). Most patients (70.7%) presented as early stage (I or II) which was associated with a high survival probability based on a log-rank test (p-value: 0.0007). All patients had surgical resection, mostly combined with neck dissection (ND) in11.4%, radiation (RT) in 7.8%, ND+RT in 4.7%, ND with platinum-based chemoradiation in 1.0%, and one case reported use of Crizotinib followed by Entrectinib with disease progression at 4.5 and 7 months, respectively. Among patients with reported outcomes, 92.2% were alive with a median follow-up of 26 (range 1-228) months, and 7.8% deceased with a median time-to-death of 29 (range 1-107) months. Eleven (4.3%) reported a high-grade MASC and 18.5% of patients lived for over five years after their diagnosis. Conclusions: Early stage was a notable predictor of higher survival probability in MASC patients. Its rarity, heterogeneity of clinical behaviors, and variable outcomes make it even more challenging. This review serves as real-world evidence to further our understanding of this rare entity and shed light on prospective clinical trial design.

Mammary analogue secretory carcinoma of parotid gland: Literature review and experience of a dedicated cancer institution in Pakistan.

Mammary Analogue Secretory Carcinoma (MASC) is a rare pathology of the salivary gland, most commonly involving the parotid gland. The objective of this study was to identify the characteristic features of MASC and its treatment outcomes. A retrospective review of 12 patients with histological diagnosis of MASC, who were managed between 2010 to 2019, was carried out at the Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore. Their mean age was 34±16 years. There were 9 (75%) male and 3 (25%) female patients. Painless slow growing swelling was the most common presenting symptom. All the patients had undergone surgical excision with or without neck dissection, followed by adjuvant treatment. Of these, six patients had T2 tumours, while four had cervical lymph node metastasis. The mean follow-up period was 23±21 months. Local recurrence was seen in one patient. MASC is considered a low-grade tumour with good prognosis which can be treated with curative intent of surgery followed by radiotherapy effectively.

Mammary analogue secretory carcinoma presenting with cervical lymphadenopathy: A rare case report with review of the literature.

IntroductionMammary analogue secretory carcinoma is a rare malignant tumor of the salivary glands that typically involves the major glands. The aim of the current study is to report a rare case of mammary analogue secretory carcinoma that presented with left cervical lymphadenopathy.Case reportA 59-year-old lady presented with left cervical lymphadenopathy. Tissue biopsy and immunohistochemistry revealed metastatic carcinoma, favoring ovarian origin. Staging workup was performed and, ultimately, the patient was treated as having a carcinoma of unknown primary. After showing partial response to therapy, left side neck dissection was performed. Based on better assessment of the histologic picture and a broader panel of immunohistochemistry performed on the excision specimen, the final diagnosis was that of mammary analogue secretory carcinoma.DiscussionMammary analogue secretory carcinoma is usually an indolent salivary gland carcinoma, with the majority of patients presenting with a slow-growing, painless mass measuring approximately 2 cm in size, and a reported duration ranging from 2 months to several years. In certain cases, pain and facial paralysis have been reported. It could also be found incidentally during radiologic assessment for thyroid illness or routine dental screening.ConclusionDiagnosing mammary analogue secretory carcinoma is challenging, and this should be in the differential diagnosis list of metastatic carcinomas to cervical lymph nodes.