A clinicopathologic study of secretory carcinoma of minor salivary gland: a series of 4 cases and diagnostic considerations

Clinicopathologic characterization of secretory carcinoma of salivary gland

BACKGROUND

To investigate the clinicopathologic characteristics, therapeutic methods, and prognosis of secretory carcinoma of salivary gland (SCSG).

METHODS

The clinicopathologic data of 13 patients with SCSG admitted to Shanxi Cancer Hospital from January 2018 to June 2023 were retrospectively analyzed, and a literature review was performed.

RESULTS

A total of eight males and five females aged 22-78 years old were enrolled, and they commonly presented with painless masses in the parotid or submandibular gland. They all underwent surgical treatment, accompanied by typical pathological examinations postoperatively. Fluorescence in situ hybridization (FISH) was conducted in seven cases, the results were all positive, and no gene fusion other than ETV6-NTRK3 was found. Two patients developed local relapse during follow-up, both of which were in the surgical area. By the end of the follow-up, 12 patients survived and one patient died.

CONCLUSIONS

SCSG is a rare low-grade malignancy with a good prognosis. Pathological and immunohistochemical characteristics are the key to secretory carcinoma (SC) diagnosis, and surgical excision is the major treatment means for SCSG. Whether to perform simultaneous cervical lymph node dissection and other adjuvant therapies should be determined based on the pathological stage and the presence or absence of high-risk factors.

Salivary gland secretory carcinoma: A case presentation in minor salivary gland with review

INTRODUCTION AND IMPORTANCE

Salivary gland secretory carcinoma (SGSC) represents a rare malignant tumor of the salivary glands. Despite being regarded as low-grade tumors, they may manifest with metastases and a high-grade aggressive clinical behaviour. The literature on this subject is limited, and there is currently no standardized approach to treatment.

CASE REPORT

We report a rare case of SGSC in the palate of a 14-year-old female patient. The patient underwent excision, bilateral tonsillectomy and adjuvant radiotherapy.

CLINICAL DISCUSSION

A critical review of the literature was conducted with the objective of analysing the cases of intraoral SGSC that have been previously reported. A total of 23 articles, published between 2010 and 2024, were identified as being directly pertinent to the review, resulting in a total of 58 patients being included.

CONCLUSION

SGSC on the hard palate in a 14-year-old child is an exceedingly rare occurrence. These tumors can mimic other pathologies of the salivary glands clinically and microscopically, which can result in misdiagnosis and a delay in treatment.

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

OBJECTIVES

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.

DATA SOURCES

Pubmed, Google Scholar, and Web of Science databases.

REVIEW METHODS

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.

RESULTS

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%).

CONCLUSIONS

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.

LEVEL OF EVIDENCE

NA Laryngoscope, 134:1716-1724, 2024.

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

Objectives

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.

Methods

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.

Results

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).

Conclusions

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.