Salivary Carcinoma Research Articles

Epidemiological and clinical characteristics of synchronous lung metastasis in major salivary gland mucoepidermoid carcinoma.

To analyze the risk factors for synchronous lung metastases (LM) in patients with major salivary gland mucoepidermoid carcinoma (MaSG-MEC). MaSG-MEC patients were extracted from the Surveillance, Epidemiology and End Results (SEER) database between 2010 and 2014. Descriptive statistics were used to examine the baseline characteristics of the patients. We examined the association between risk factors and synchronous LM using Chi-squared tests. The primary study outcomes were overall survival (OS) and cancer-specific survival (CSS). Kaplan-Meier survival curves were compared using the log-rank test. Hazard analysis was conducted using the Cox proportional hazards model. A total of 701 patients were analyzed, which including 8 patients (1.1%) with synchronous LM, and 693 patients without synchronous LM (98.9%). Lower T or N classification, and highly differentiated disease were associated with a significantly lower risk of LM and multivariate logistic regression analysis showed that lower T classification were associated with a significantly lower risk of LM (P < 0.05, respectively). Elderly Caucasian male patients with poorly differentiated disease, multiple sites of metastases and no surgical therapy to primary tumor were more likely to reduce life expectancy. By analyzing data from a large cohort, lower T or N classification and highly differentiated disease were associated with a significantly lower risk of LM. Elderly Caucasian male patients with poorly differentiated disease, multiple sites of metastases and no surgical therapy to primary tumor were more likely to reduce life expectancy. More accurate assessments of LM will be imperative for early diagnosis and treatment in patients who harbored with higher T or N classification and poorly differentiated 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.

Complete response to alectinib in ALK-fusion metastatic salivary ductal carcinoma

The advent of next-generation sequencing (NGS) has allowed for the identification of novel therapeutic targets for patients with uncommon cancers. It is well known that fusion translocations are potent driver of cancer pathogenesis and can render tumors exquisitely sensitive to matching targeted therapies. Here we describe a patient with ALK-fusion positive widely metastatic salivary ductal carcinoma, who achieved a durable complete response from alectinib, a potent and specific ALK tyrosine kinase inhibitor. This case serves as another reminder that ALK-fusions can be targeted regardless of histology and can afford patients dramatic and durable benefit. It also emphasizes the need for insurance coverage for such beneficial therapies. While ALK fusions are exceedingly rare in salivary ductal carcinoma, the presence of multiple other targetable aberrations supports the recommendation for universal NGS testing for such tumors.

Abstract 3763: microRNAs associated with metastatic potential in salivary gland mucoepidermoid carcinoma

Abstract Mucoepidermoid carcinoma (MEC) is the most common malignant tumor of the salivary glands. Metastatic spread occurs in up to 80% of high-grade tumors and it is a strong predictor of poor outcome, however, the mechanisms underlying this process are largely unknown. Large-scale microRNA expression profiling studies of human cancers have demonstrated that dysregulation of miRNA is frequently associated with many cancer types. The aim of this study was to investigate the microRNA profile in metastatic versus non-metastatic MECs. Using Real Time RT-PCR (qPCR) we have analyzed the expression of 384 miRNAs and controls in 4 non-metastatic MECs, 3 MECs with lymph node metastasis, 3 MECs with distant metastasis, and 2 non-neoplastic human salivary gland samples. The microRNA profile was able to discriminate between non-neoplastic and tumor samples and between metastatic and non-metastatic tumors. Considering non-neoplastic samples and non-metastatic MECs, 12 microRNAs were differentially expressed. The non-neoplastic versus lymph node metastasis MEC analysis demonstrated that 10 microRNAs were differentially expressed. Considering non-neoplastic versus distant metastasis MECs, 3 microRNAs were differentially expressed: 1 down-regulated and 2 up-regulated. Comparing non-metastatic MECs versus lymph node metastasis MECs we observed 17 up-regulated microRNAs. Considering non-metastatic MECs versus distant metastasis MECs, 2 microRNAs were up-regulated. One microRNA is differentially expressed between lymph node metastasis MECs and distant metastasis MECs. Our results suggest that microRNA profiles could discriminate the metastatic potential of salivary MECs and might be helpful in diagnostic and prognostic evaluation of patients. Citation Format: Maria Eduarda S. Trevizani, Katia K. Oliveira, Fabio A. Marchi, Daniela Bizinelli, Fernanda V. Mariano, Cibele P. Nagano, Felipe A. Costa, Clóvis A. Pinto, Luiz P. Kowalski, Silvia V. Lourenço, Cláudia M. Coutinho-Camillo. microRNAs associated with metastatic potential in salivary gland mucoepidermoid carcinoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3763.

Survival outcomes, prognostic factors, and effect of adjuvant radiotherapy and prophylactic neck dissection in salivary acinic cell carcinoma: A prospective multicenter REFCOR study of 187 patients

BackgroundAcinic cell carcinomas (AciCCs) are malignant tumours of the salivary glands. The aim of this work was to analyse data from the national REFCOR multicenter cohort (i) to investigate the prognostic factors influencing survival outcomes in AciCC, (ii) to assess the impact on survival of postoperative radiotherapy (RT) in patients treated for AciCC without high-grade transformation and (iii) to explore the prognostic impact of prophylactic neck dissection (ND) in patients treated for AciCC of the major salivary glands. Patients and methodsData from all the patients treated for salivary AciCC between 2009 and 2020 were extracted from the REFCOR database. Survival outcomes and prognostic factors influencing Disease-Free Survival (DFS) and Overall Survival (OS) were investigated using univariate and multivariate analyses. Propensity score matching was used to assess the impact of postoperative RT and prophylactic ND on DFS. ResultsA total of 187 patients were included. After a median follow-up of 53 months, their 5-year OS and DFS rates were 92.8% and 76.2%, respectively. In multivariate analysis, male sex, older age, higher T and N status, and high grade were independently associated with a worse DFS. In the subpopulation analysed after propensity score matching, patients with cN0 AciCC without high-grade transformation who were treated by surgery and RT did not have an improved DFS compared to patients who were treated by surgery alone (hazard ratio (HR) = 0.87, p = 0.8). Factors associated with nodal invasion were T3–T4 status and intermediate/high histological grade. After propensity score matching, prophylactic ND was associated with a trend toward a better DFS (HR = 0.46, p = 0.16). ConclusionsThese results suggest that (i) long-term follow-up (>5 years) should be considered in patients with AciCC, (ii) treatment by surgery alone could be an option in selected cN0 patients with AciCC without high-grade transformation and (iii) prophylactic ND may be considered preferentially in patients with T3–T4 status and/or intermediate/high histological grade.

Utility of Elective Neck Dissection in Clinically Node-Negative Parotid Malignancy.

We sought to investigate the utility of elective neck dissection (END) in clinically node-negative parotid malignancy through the evaluation of factors that are associated with receiving END and survival analysis of patients who received END. Retrospective cohort database study. The National Cancer Database (NCDB). The NCDB was used to extract patients with clinically node-negative parotid malignancy. END was defined as having 5or more lymph nodes examined pathologically, as previously defined in the literature. Univariate and multivariate analyses were used to compare predictors of receiving END, rates of occult metastasis, and survival. Of the 9405 included patients, 3396 (36.1%) underwent an END. END was most frequently performed for squamous cell carcinoma (SCC) and salivary duct histology. All other histologies were significantly less likely to undergo END compared to SCC (p < .05). Salivary ductal carcinoma and adenocarcinoma had the greatest rates of occult node disease (39.8% and 30.0%, respectively), followed by SCC (29.8%). Kaplan-Meier survival analysis showed a statistically significant increase in 5-year overall survival in patients who received END with poorly differentiated mucoepidermoid (56.2% vs 48.5%, p = .004) along with moderately and poorly differentiated SCC (43.2% vs 34.9%, p = .002; 48.9% vs 36.2%, p < .001, respectively). Histological classification is a benchmark for determining which patients should receive an END. We demonstrated an increase in overall survival in patients who undergo END with poorly differentiated tumors of mucoepidermoid and SCC histology. As such, histology should be considered along with clinical T-stage and rate of occult nodal metastasis to determine eligibility for END.

Histopathological Aspects of the Prognostic Factors for Salivary Gland Cancers.

Salivary gland cancers (SGCs) are diagnosed using histopathological examination, which significantly contributes to their progression, including lymph node/distant metastasis or local recurrence. In the current World Health Organization (WHO) Classification of Head and Neck Tumors: Salivary Glands (5th edition), malignant and benign epithelial tumors are classified into 21 and 15 tumor types, respectively. All malignant tumors have the potential for lymph node/distant metastasis or local recurrence. In particular, mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (AdCC), salivary duct carcinoma, salivary carcinoma, not otherwise specified (NOS, formerly known as adenocarcinoma, NOS), myoepithelial carcinoma, epithelial-myoepithelial carcinoma, and carcinoma ex pleomorphic adenoma (PA) are relatively prevalent. High-grade transformation is an important aspect of tumor progression in SGCs. MEC, AdCC, salivary carcinoma, and NOS have a distinct grading system; however, a universal histological grading system for SGCs has not yet been recommended. Conversely, PA is considered benign; nonetheless, it should be cautiously treated to avoid the development of metastasizing/recurrent PA. The aim of this review is to describe the current histopathological aspects of the prognostic factors for SGCs and discuss the genes or molecules used as diagnostic tools that might have treatment target potential in the future.

Long-Term Outcomes of Endoscopic Submucosal Dissection for Special Type of Esophageal Cancer

Background: Esophageal cancers other than two types, squamous cell carcinoma (SCC) and adenocarcinoma, are commonly referred to as special type of esophageal cancer (STEC). Studies on STECs have been limited because of its low prevalence. Therefore, we aimed to clarify the clinicopathological findings and the long-term outcomes of STECs that were managed with ESD. Methods: We reviewed 713 patients with 1,089 lesions who underwent ESD for primary esophageal cancer except Barrett’s esophageal cancer. Patients were classified into the SCC group and the STEC group, respectively. Their clinicopathological findings and long-term outcomes including disease-specific survival (DSS) were collected and examined. Results: A total of 19 consecutive patients (1.7%) were diagnosed with STEC. Nine patients were diagnosed with basaloid carcinoma, 6 with adenosquamous carcinoma, 2 with mucoepidermoid carcinoma, 2 with salivary duct-type carcinoma, and 1 with neuroendocrine cell carcinoma. There was significantly more pT1b esophageal cancer (47.4% vs. 11.0%, p < 0.01) and lymphovascular invasion (31.6% vs. 10.2%, p = 0.011) in the STEC group. Metastatic relapse and disease-specific mortality were significantly higher in the STEC group (both 15.8% vs. 1.2%, p < 0.01), and the STEC group had shorter DSS with 5-year DSS rates of 90.9%. In a subgroup analysis of patients with pT1a esophageal cancer, the 5-year DSS rate was shorter in the STEC group (p < 0.01). In the multivariate analysis, STEC (HR = 0.24) and tumor depth (HR = 12.60) were the factors associated with DSS. Conclusion: STECs are suggested to have high malignant potential and to be an independent negative prognostic factor for DSS.

Prognostic Assessment and Risk Stratification in Patients With Postoperative Major Salivary Acinar Cell Carcinoma.

To investigate the clinicopathological features and prognosis of postoperative major salivary acinar cell carcinoma (MSACC) and develop a prognostic model. Retrospective cohort analysis of a public database. Patients with MSACC were identified from the Surveillance, Epidemiology, and End Results database (1975-2019). Overall survival (OS) was evaluated using Kaplan-Meier curves and a log-rank test. Univariate and multivariate Cox analyses were performed to explore independent prognostic factors. The prognostic model was constructed using screened variables and further visualized with a nomogram and web calculator, and assessed by concordance index, the area under the curve, calibration curve, and decision-making curve analysis. An upward trend in the incidence of MSACC was observed throughout the study period. A total of 1398 patients were enrolled (training cohort: 978; validation cohort: 420), and the 5- and 10-year OS rates were 97.7% and 81.6%, respectively. Age, marital status, sex, histological grade, T stage, and lymph node status were identified as prognostic factors for OS. A novel nomogram was developed and showed excellent discrimination and clinical applicability. Additionally, a web calculator was designed to dynamically predict patient survival. Based on the nomogram-based score, a risk stratification system was constructed to distinguish patients with different risks. The OS of high-risk patients was significantly lower than that of the low-risk subgroup. Long-term survival in postoperative MSACC was influenced by 6 prognostic factors. The proposed model enables individualized survival prediction and risk stratification, prompting us to be vigilant in high-risk subgroups and consider timely adjustment of subsequent treatment.

Clinicopathological and survival profile of patients with salivary gland myoepithelial carcinoma: A systematic review.

In this systematic review, we aimed to evaluate the clinicopathological and prognosis data of patients with myoepithelial carcinoma (MC) of the salivary glands. MEDLINE/PubMed, Scopus, and Embase search was performed with the keywords "myoepithelial carcinoma", "malignant myoepithelioma", and "salivary glands". Only primary salivary glands MC that fulfilled the World Health Organization diagnostic criteria were included. The Joanna Briggs Institute tool was used to assess the risk of bias. Forty-three studies (comprising data from 71 cases) met the inclusion criteria. The patients having MC showed a mean age of 56.4 ± 19.6 years with no sex predilection. The parotid was the most affected gland (49.3%) (49.3%). Clinically, the MC presented as an asymptomatic (65.1%) mass (84%). The most common histological findings were the presence of clear tumor cells (39.7%) and multinodular growth patterns (60.7%). Multivariate analysis showed plasmacytoid cell type (p=0.010) and solid growth pattern (p=0.003) were related to decreased disease-free survival (DFS). Surgery alone was the most used treatment (53.5%). Patients with a combination of treatments (surgery, radiation therapy with/without chemotherapy) showed a longer DFS (p=0.049). The 2-year and 5-year overall survival rates were 67.5% and 46.1% respectively. Salivary gland MC is a rare salivary cancer with no sex predilection, with a higher incidence in the parotid gland. Cell type, growth pattern, and treatment type may be related to a lower DFS. Overall, salivary gland MC presented low recurrence and metastasis rates.

LAMB3 and TACSTD2, both highly expressed in salivary gland mucoepidermoid carcinoma, represent potential diagnostic biomarkers and therapeutic targets

Salivary mucoepidermoid carcinoma (MEC) is the most common malignant tumor in major and minor salivary glands. The CRTC1-MAML2 or CRTC3-MAML2 gene arrangements, which occur in up to 80% of primary salivary glands with MEC, are the major oncogenic drivers of MEC carcinogenesis. However, the molecular consequences of these fusions remain unknown. We sought to identify the key functional genes involved in MEC, then characterize biomarkers with potential therapeutic relevance. We analyzed the gene expression profiles of two primary tumors (fusion-positive HCM-MEC020T and fusion-negative HCM-MEC030T); we compared them with the profiles of the established cell line HCM-MEC010 (derived from CRTC1-MAML2 fusion-positive MEC) and fibroblast cells derived from an HCM-MEC010 patient (non-tumor control cells). Fifty-three genes were identified as commonly expressed genes among the top 500 highly expressed genes in MEC but not in fibroblasts. Among these 53 genes, we focused on LAMB3 and TACSTD2, which are not predicted to be CRTC1/CRTC3-MAML2 target genes. LAMB3 (laminin subunit beta-3) is the basement membrane protein in normal salivary glands. TACSTD2 encodes a membrane protein associated with calcium signaling. To investigate the relationship between gene expression patterns and MEC pathological grade, we performed immunohistochemical staining of 13 MEC samples. LAMB3 and TACSTD2 proteins were expressed in the tumor cells of MEC samples (LAMB3, 12/13; TACSTD2, 13/13) but not in surrounding stromal cells. Although there were no statistically significant differences in LAMB3 or TACSTD2 expression among pathological grades, further studies are needed to elucidate the value of LAMB3 and TACSTD2 in clinical applications.

Salivary gland tumor: atypical presentation of breast cancer

Breast cancer is a heterogeneous disease with various histological and molecular subtypes. Among them, salivary gland tumors are rare and can be divided into three groups: pure myoepithelial differentiation, pure epithelial differentiation and myoepithelial with mixed epithelial differentiation. In the last group, adenoid cystic carcinoma stands out, a rare entity with low malignant potential. It represents less than 0.1–3% of breast cancer cases and has the most frequent clinical presentation as a palpable mass. The diagnosis is confirmed by histology and immunohistochemistry. Classically, they are low-aggressive triple-negative tumors, with overall survival and specific cancer survival at five and ten years greater than 95%. However, there are rare reports of aggressive variants with a risk of distant metastasis and death. Treatment is based on surgical resection with margins. Lymphatic dissemination is rare, and there is no consensus regarding the indication of an axillary approach. Adjuvant radiotherapy is indicated in cases of conservative surgery and should be discussed in other cases. The benefit of chemotherapy remains uncertain, as most tumors are indolent. We report a case that required individualized decisions based on its peculiarities of presentation, diagnosed in an asymptomatic elderly patient during screening, in which mammography showed heterogeneous gross calcifications clustered covering 1.6 cm. Stereotacticguided vacuum-assisted biopsy was performed, and the area was marked with a clip. The anatomopathological examination led to a diagnosis of salivary gland-type carcinoma, triple-negative. The patient underwent segmental resection of the right breast and sentinel lymph node biopsy. The final anatomopathological result was similar to that of the biopsy, with an immunohistochemical profile of the adenoid cystic type and two sentinel lymph nodes free of neoplasia. Considering age and histological subtype, adjuvant therapy was not indicated. Follow-up for three years showed no evidence of disease.

A Case Report and Literature Review of Antibody Conjugated Drugs for Parotid Ductal Adenocarcinoma

Salivary ductal carcinoma (SDC) is a rare highly aggressive malignancy with unique pathological and clinical features, and its histological features are highly similar to that of breast ductal carcinoma. The standard treatment for SDC is surgery plus radiation therapy, but it is often detected late and has a poor prognosis. Human growth factor receptor 2 (HER2) overexpression is common in SDC, and HER2-positive SDC cases have strong aggressiveness, and the standard treatment regimen for patients with postoperative recurrence or metastasis is still controversial. Vedicitumab is an innovative antibody coupling drug independently developed in China. It targets HER2 protein on the tumor surface and can accurately identify and kill tumor cells. This case reports a case of HER2 positive SDC treated with vidiximab alone, which has a rapid onset and significant effect. It may be a promising research direction for the treatment of this disease, but the sample size control study needs to be further expanded.

Panelsequenzierung in der Kopf-Hals-Onkologie am Beispiel von sinunasalen und Speicheldrüsenmalignomen

BackgroundAs a result of the increasing implementation of innovative molecular technologies during the last two decades, the pathology of salivary gland carcinomas and sinonasal carcinomas has witnessed a tremendous revolution.AimWith the introduction of molecular tumor boards as a central opportunity exploring the possibility of actionable molecular targets in head and neck oncology, the question has been frequently raised as to which entities/patients might represent good or best candidates for OncoPanel sequencing in the context of these regularly implemented molecular tumor boards. The main aim of this review is to address this question considering recent developments and in context of the current World Health Organization (WHO) classification.Materials and methodsThis review is based on a selective literature search (PubMed) using the terms salivary gland malignancy, sinonasal carcinoma and targeted therapies as well as the authors’ own data and observations.Results and conclusionAs a result of several recent seminal studies on salivary and sinonasal carcinomas, some old concepts have been reconceptualized, some new concepts introduced, and some old, established entities became better defined molecularly. These achievements have influenced not only diagnostics (they enable a much refined, mostly molecular-based classification of many entities that were previously unclassified) but they also have a significant therapeutic impact (they enable better histology-tailored therapeutic stratification, at the same time some of them represent valuable biomarkers predicting response to targeted therapies).

Bronchial salivary gland-type intraductal carcinoma with KIAA1217::RET gene fusion composed of intercalated and oncocytic components.

Salivary gland-type intraductal carcinoma (IC) is a rare malignant salivary gland neoplasm. Primary salivary gland-type IC has never been described in the lung. Herein, we present a primary pulmonary IC in a 63-year-old woman. The tumor originated in the bronchus wall of the right middle lobe. The tumor consisted of two histological types, intercalated component and oncocytic component. The intercalated component showed tubular/cystic pattern composed of column to cube-shaped cells and scattered mucous cells. The oncocytic component showed solid nests composed of large cells with abundant eosinophilic granular cytoplasm. Immunohistochemically, both histological components were positive for cytokeratin 7 (CK7), S-100 protein, SOX10, and mammaglobin. The rimming myoepithelial cells were highlighted by p63 and smooth muscle actin (SMA). The tumor cells were negative for androgen receptor (AR), HER-2, Dog-1, TTF-1, napsin A, GCDFP-15, and GATA3. In the present case, we detected KIAA1217::RET fusion via DNA-based next-generation sequencing (NGS) and RT-PCR, which established the diagnosis of IC at a molecular level. The present case expands the categories of bronchopulmonary salivary gland-type tumors.

Clinicopathological observation of 10 cases of salivary secretory carcinoma

Objective: To investigate the clinical and pathological features of salivary secretory carcinoma (SSC). Methods: Ten cases of SSC confirmed in the Department of Pathology,Capital Medical University School of Stomatology from January 2014 to December 2021 were retrospectively included, including 5 males and 5 females, with a median age of 46.5 years. The microscopic morphology, immunophenotype, special staining and clinical follow-up of 10 cases of salivary secretory carcinoma were observed. Ten patients were tested with S-100, vimentin, mammaglobin, Dog-1, p63 and Ki-67, 9 cases with cytokeratin (CK) 8/18, 8 with CK7, 6 with calponin, 5 with smooth muscle actin (SMA) and GCDFP15, 4 with CK5/6 and 1 with SOX10. The ETV6-NTRK3 fusion gene was detected by fluorescence in situ hybridization. Results: Seven of the 10 SSC were located in the parotid gland and 3 were located in the cheeks. Histomorphology showed solid, papillary-cystic, follicular, microcystic, and macrocystic types. In 7 cases, tumor cells were dominated by single arrangement type, while certain mixed arrangements existed in some areas. The cytoplasm of the tumor cells was rich in eosinophilic, fine granular or vacuolar shapes, and clear cytoplasm was seen in 2 cases. The nuclei were mostly oval-shaped vesicular nuclei, with nucleoli in the center. Immunohistochemistry showed CK7 (8/8) positive, CK8/18 (9/9) positive, S-100 (10/10) positive, vimentin (5/10) positive, (4/10) partially positive and (1/10) less partially positive, mammaglobin (7/10) positive, (1/10) partially positive and (2/10) some individual cells positive, Dog-1 (10/10) negative, CK5/6 (4/4) negative, p63 (7/10) negative and (3/10) partially positive, SMA (5/5) negative, calponin (6/6) negative, and Ki-67 index was 5%-20%. Secretions of 5 cases showed periodic acid-Schiff (PAS) and PAS with diastase (PAS-D) staining positive. All 10 cases showed ETV6-NTRK3 fusion positive. Six cases were successfully followed up for 32-91 months, of which 2 cases recurred after 28 and 74 months and underwent surgical resection again. All cases followed up are alive and disease-free. Conclusions: The salivary secretory carcinoma is a rare low-grade malignant tumor. In certain cases, morphology is atypical and mammaglobin is immunohistochemically positive in only individual tumor cells. Therefore, the diagnosis should be supported with morphology, immunohistochemical staining, and molecular feature preferably.

Salivary papillary cystic low-grade mucoepidermoid carcinoma and cystadenoma: a comparison of clinicopathological and genetic features

Objective: To study the clinicopathologic and genetic features of papillary cystic low-grade mucoepidermoid carcinoma (LG-MEC) and cystadenoma. Methods: A retrospective review was performed on salivary gland tumor patients with papillary cystic architecture who presented to department of oral pathology, Peking University School and Hospital of Stomatology between January 2010 and June 2022. Among this cohort, there were 17 males and 17 females with a range age of 23-82 years [(55.6±14.6) years]. Diagnosis was confirmed by histological, immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) analysis. Finally, 15 papillary cystic LG-MEC and 19 cystadenoma patients were included in the present study. All patients were followed clinically and radiologically, and the duration of follow-up ranged from 1 to 141 months. Results: All neoplasms showed papillary proliferation with multilocular or giant cystic tumors. Papillary cystic LG-MEC was characterized by epidermoid cells, intermediate cell and mucous cells with multiple lining-layers. Papillary cystic LG-MEC had mild cellular atypia and a pushing infiltration. Cystadenoma was characterized by cuboidal, columnar and ciliated pseudostratified columnar lining epithelium. Squamous metaplasia, mucinous metaplasia and acidophilic degeneration could also be observed focally in cystadenoma. For IHC staining, papillary cystic LG-MEC showed diffusely and strongly positive for mucin 4 (MUC4) (15/15) and mucin 5 Subtype AC (MUC5AC) (4/15) in the epidermoid cells, intermediate cell and mucous cells. The epidermoid cells and intermediate cells were diffusely positive for p40 and p63. The Ki-67 index was about 10%-15% in LG-MEC. As a contrast, p40 (17/19) and p63 (14/15) were only detected in the basal cells of cystadenoma. Cystadenoma showed focal MUC5AC (4/19)expression and MUC4 (19/19)diffuse expression. In addition, the Ki-67 index was 5%-10% in cystadenoma. The MAML2 gene translocation was detected in 11 LG-MEC patients, but none in cystadenoma. Conclusions: The differential diagnosis points between papillary cystic LG-MEC and cystadenoma included the specific epidermoid cells, intermediate cells and mucus cells in LG-MEC, cell atypia, the pushing-infiltration pattern, diffuse expression of p40 and p63 in the lining epithelium, and a MAML2 gene rearrangement. The molecular test of MAML2 should be recommended to reduce missed LG-MEC diagnoses.

Case Report on Mucoepidermoid Carcinoma of Salivary Gland

Background: The most prevalent kind of salivary gland cancer is mucoepidermoid carcinoma. The main clinical signs of Salivary gland mucoepidermoid carcinoma region is characterized by a lump in the face, neck, discomfort in the mouth, or trouble swallowing. The initial therapy is the surgical removal of the whole tumor .and in the final stage of chemotherapy, radiation therapy is also used. A 43year old male came to the medicine unit with complaints of edema all over the right-side face below the right ear since from 1 year. loss of appetite and disturbance in sleeping patterns. As per the patient’s verbalization, he was apparently all right before a year, and after that, he started to show swelling over the right side of the face and below the right ear for 1 year, for he took treatment in the primary health care center. But after 4 months it was not relieved so again, he went to the private hospital where he has treated with anti-inflammatory medications but still got no relief. Later this swelling was associated with the loss of appetite and disturbance in sleeping patterns now after a year he came to the tertiary care hospital for management. Salivary gland cancer represents 5% of total head and neck tissue cancers. tumors. Small salivary gland tumors, which make up 10% to Approximately Malignant salivary gland neoplasms make up 15% of all cases. The second most frequent cancer type is mucoepidermoid carcinoma. tiny tumors of the salivary glands are common. (12–40 percent worldwide).

Case Report on Mucoepidermoid Carcinoma of Salivary Gland

Background: The most prevalent kind of salivary gland cancer is mucoepidermoid carcinoma. The main clinical signs of Salivary gland mucoepidermoid carcinoma region is characterized by a lump in the face, neck, discomfort in the mouth, or trouble swallowing. The initial therapy is the surgical removal of the whole tumor .and in the final stage of chemotherapy, radiation therapy is also used. A 43year old male came to the medicine unit with complaints of edema all over the right-side face below the right ear since from 1 year. loss of appetite and disturbance in sleeping patterns. As per the patient’s verbalization, he was apparently all right before a year, and after that, he started to show swelling over the right side of the face and below the right ear for 1 year, for he took treatment in the primary health care center. But after 4 months it was not relieved so again, he went to the private hospital where he has treated with anti-inflammatory medications but still got no relief. Later this swelling was associated with the loss of appetite and disturbance in sleeping patterns now after a year he came to the tertiary care hospital for management. Salivary gland cancer represents 5% of total head and neck tissue cancers. tumors. Small salivary gland tumors, which make up 10% to Approximately Malignant salivary gland neoplasms make up 15% of all cases. The second most frequent cancer type is mucoepidermoid carcinoma. tiny tumors of the salivary glands are common. (12–40 percent worldwide).

Low-grade intraductal carcinoma of accessory parotid gland: a case report.

Salivary low-grade intraductal carcinoma (LGIDC) is a rare tumor that mainly occurs in the parotid. Thus far, LGIDC originating from the accessory parotid gland has been rarely reported in domestic and foreign literature. This study reports a case of LGIDC of the accessory parotid gland and a brief summary of its clinical features, diagnostic points, and treatment by reviewing the literature, with the aim of providing a reference for clinical practice and further research.