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Vital AGB, de Carvalho MCM, Maia CR, Galvão HC, de Souza LB, de Andrade Santos PP. Relationship between tumor thickness and GATA3 immunoexpression in lip and tongue squamous cell carcinomas. Oral Maxillofac Surg 2024; 28:1259-1266. [PMID: 38600414 DOI: 10.1007/s10006-024-01251-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 04/09/2024] [Indexed: 04/12/2024]
Abstract
PURPOSE Lower lip squamous cell carcinomas (LLSCCs) exhibit lower levels of aggressiveness, low relations with metastases and better prognosis when compared with intraoral squamous cell carcinomas. Differently from the oral tongue squamous cell carcinomas (OTSCCs) have a high tendency towards local invasion and lymph nodal dissemination. Our aim was to evaluate tumor thickness in cases of oral squamous cell carcinoma and correlate it with histological grade of malignancy and GATA3 immunoreactivity. METHODS Sixty specimens (30 LLSCCs and 30 OTSCCs) were scanned and digitized for the subsequent measurement of tumor thickness, histopathological examination, and quantitative analysis of GATA3 in the parenchyma and stroma of the tumors. RESULTS Tumor thickness was lower in LLSCC compared to OTSCCs. Immunohistochemical analysis of GATA3 in parenchyma, stroma and both compartments showed higher immunoreactivity in LLSCCs compared to OTSCCs. We observed a negative correlation between tumor thickness and GATA3 expression in parenchyma, stroma, and both compartments. Our results revealed the presence of GATA3 in all cases both in the parenchyma and in the stroma. Higher expression was more related to LLSCCs, which are known to be less aggressive tumors than OTSCCs. CONCLUSIONS A greater tumor thickness was found in OTSCCs, which was correlated with lower expression of GATA3, suggesting that this protein is involved in the inhibition of proliferative, migratory, and invasive capacity.
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Affiliation(s)
| | | | - Caio Rodrigues Maia
- Postgraduate Program in Dental Sciences, Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Hébel Cavalcanti Galvão
- Department of Pathology, Health Sciences Center at Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Lélia Batista de Souza
- Department of Pathology, Health Sciences Center at Federal University of Rio Grande do Norte (UFRN), Natal, RN, Brazil
| | - Pedro Paulo de Andrade Santos
- Department of Morphology, Biosciences Center, Federal University of Rio Grande do Norte (UFRN), Campus Universitário Lagoa Nova, Centro de Biociências, Natal, RN, Brazil.
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Yorita K, Miyazaki K, Urano M, Nagao T, Nakaguro M, Tahara K, Takeda T, Nakatani K. Macrocystic and non-necrotic salivary duct carcinoma of the submandibular gland: A case report. Radiol Case Rep 2024; 19:3049-3055. [PMID: 38756951 PMCID: PMC11096982 DOI: 10.1016/j.radcr.2024.04.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Revised: 04/03/2024] [Accepted: 04/08/2024] [Indexed: 05/18/2024] Open
Abstract
Salivary duct carcinoma (SDC) is a major malignant salivary gland tumor that usually forms a solid tumor. Non-necrotic macrocystic SDCs have rarely been reported among salivary gland tumors. A 78-year-old Japanese man with a submandibular gland tumor was evaluated radiologically, pathologically, and immunohistochemically. A multilocular lesion with a maximum size of 6 cm was radiologically observed in the left submandibular region. It had been noticed 20 years earlier. Malignant cytological result was obtained, and surgical resection was performed. Pathological examination revealed a non-necrotic, macrocystic submandibular gland tumor lined with glandular, cribriform, or papillary forms of atypical cuboidal cells. Frankly invasive components were observed in intercystic areas. Intraductal, mucoepidermoid, and secretory carcinomas were identified as pathological differential diagnoses because of their macrocystic morphology. We diagnosed SDC because there was no intraductal growth based on the lack of myoepithelial markers, diffuse immunoreactivity to gross cystic disease fluid protein15, androgen receptor, and mammaglobin and immunonegativity to S100 and p63. Postoperative positron emission tomography revealed the absence of lymph node and distant metastases. The patient was disease-free 9 months after surgery. Salivary duct carcinoma can be included in the differential diagnoses of cystic salivary gland tumors.
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Affiliation(s)
- Kenji Yorita
- Department of Diagnostic Pathology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Katsushi Miyazaki
- Department of Otorhinolaryngology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Makoto Urano
- Department of Diagnostic Pathology, Fujita Health University Bantane Hospital, Nagoya-shi, 3-6-10 Otobashi, Nakagawa-ku, Nagoya-shi, Aichi 454-8509, Japan
| | - Toshitaka Nagao
- Department of Anatomic Pathology, Tokyo Medical University, 6-1-1 Shinjuku, Shinjuku-ku, Tokyo 160-8402, Japan
| | - Masato Nakaguro
- Department of Pathology and Laboratory Medicine, Nagoya University Hospital, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8560, Japan
| | - Kazuhiko Tahara
- Department of Otorhinolaryngology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Takashi Takeda
- Department of Otorhinolaryngology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
| | - Kimiko Nakatani
- Department of Radiology, Japanese Red Cross Kochi Hospital, 1-4-63-11 Hadaminamimachi, Kochi-shi, Kochi 780-8562, Japan
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3
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Serrano-Meneses GJ, Brenes Guzmán S, Serrano-Meneses MA, Delgado-Porras A. Insights Into Pediatric Secretory Carcinoma of the Salivary Gland: A Case Report. Cureus 2024; 16:e60355. [PMID: 38883019 PMCID: PMC11178125 DOI: 10.7759/cureus.60355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/15/2024] [Indexed: 06/18/2024] Open
Abstract
Secretory carcinoma of the salivary gland (SCSG) is a rare head and neck tumor in adults and exceptional at the pediatric age. Its varied histological subtypes and distinct clinical presentation pose diagnostic and therapeutic challenges. Therefore, standardized guidelines are of utmost importance for the care of these patients, especially in children. Here we present an 11-year-old male presented with a left cheek mass initially diagnosed as lipoma. A wide resection was performed and SCSG was revealed in the histopathologic and immunohistochemistry analysis. The presentation of this case provides valuable information on the diagnostic and therapeutic complexities of SCSG. It emphasizes the need for standardized guidelines and further research to optimize pediatric patient outcomes. Overall, this case report is a crucial resource for clinicians and researchers, highlighting the importance of interdisciplinary collaboration and early intervention in managing SCSG.
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Affiliation(s)
| | - Sofia Brenes Guzmán
- Pediatric Surgical Oncology, Hospital Infantil Privado, Star Médica, Mexico City, MEX
| | | | - Alberto Delgado-Porras
- Pediatric and Neonatal Surgery, Hospital Infantil Privado, Star Médica, Mexico City, MEX
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4
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Mokhles P, Sadeghipour A, Babaheidarian P, Mohebbi S, Keshtpour Amlashi Z, Gharib MH, Ahmadi MS, Khastkhodaei Z. Salivary gland secretory carcinoma presenting as a cervical soft tissue mass: a case report. J Med Case Rep 2024; 18:78. [PMID: 38311786 PMCID: PMC10840246 DOI: 10.1186/s13256-024-04364-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 01/05/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Secretory carcinoma (SC) has been described as a distinct salivary gland tumor in the fourth edition of the World Health Organization (WHO) classification of head and neck tumors. SC is generally considered as a slow-growing low-grade malignant tumor, while several cases have been reported with high-grade features, and even metastases in the literature up until now. In this article, a soft tissue SC case is discussed with high-grade microscopic features and neural invasion. A review of the salivary gland SC cases with aggressive behavior is also debated. CASE PRESENTATION A 65-year-old Caucasian man presented with a left neck mass for the past six months. The imaging studies demonstrated a very large cystic cervical mass (46 × 23 mm) with papillary projections in the anterolateral aspect of the left neck zone Vb. He underwent left radical neck dissection (level I-V) and was followed up for 12 months with the diagnosis of Secretory carcinoma. CONCLUSION Although SC generally has a good outcome, multiple recurrences and unusual metastases may occur, which should be considered by either the pathologists or clinicians.
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Affiliation(s)
- Parisa Mokhles
- Faculty of Medicine, School of Medicine, Iran University of Medical Sciences, Hemmat Highway, Tehran, Iran.
| | - Alireza Sadeghipour
- Faculty of Medicine, School of Medicine, Iran University of Medical Sciences, Hemmat Highway, Tehran, Iran
| | - Pegah Babaheidarian
- Faculty of Medicine, School of Medicine, Iran University of Medical Sciences, Hemmat Highway, Tehran, Iran
| | - Saleh Mohebbi
- Skull Base Research Center, School of Medicine, The Five Senses Health Institute, Iran University of Medical Sciences, Tehran, Iran
| | | | | | | | - Zeinab Khastkhodaei
- Institute of Physiology, University Medicine of the Johannes Gutenberg, Mainz, Germany
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5
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Wang Y, Sun J, Sun B, Zhang C, Tian Z, Wang L, Li J. The genetic and immune features of salivary gland secretory carcinoma with high-grade transformation. Oral Dis 2024. [PMID: 38263601 DOI: 10.1111/odi.14876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 12/26/2023] [Accepted: 01/11/2024] [Indexed: 01/25/2024]
Abstract
OBJECTIVES To compare the clinicopathological, molecular, and immune features of conventional and high-grade transformation (HGT) secretory carcinoma (SC) in salivary glands. MATERIALS AND METHODS The clinicopathological data of 88 cases including 74 conventional SCs and 14 SCs with HGT were reviewed. Targeted next-generation sequencing was performed in 11 SCs with HGT and 7 conventional SCs. The level of PD-L1 and CD8+ TILs was determined by immunohistochemistry. RESULTS Compared with the conventional group, the rates of nodal metastasis, local recurrence, distant metastasis and mortality were significantly higher in the HGT cohort. Mutations of ARID1A/B, KMT2A, HOXD13, NRG1 and ETV6 genes were identified in HGT SCs. A recurrent E307G mutation in GATA6 gene was also observed in two cases. Two deceased HGT patients with distant metastasis harboured NOTCH3 mutations. ETV6-RET translocation was prone to occur in the HGT SCs. Additionally, PD-L1 expression was low, and CD8+ TILs were sparse in most HGT cases. CONCLUSION Our findings reveal novel gene alterations involved in the progression of HGT in SCs. Most HGT SCs patients cannot benefit from PD-L1 blocking and may be approached with a distinct treatment strategy including the lymph node dissection and application of molecular target drugs in precision oncology.
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Affiliation(s)
- Yu Wang
- Shanghai Key Laboratory of Stomatology, Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Sun
- Shanghai Key Laboratory of Stomatology, Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bao Sun
- Shanghai Key Laboratory of Stomatology, Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chunye Zhang
- Shanghai Key Laboratory of Stomatology, Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen Tian
- Shanghai Key Laboratory of Stomatology, Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lizhen Wang
- Shanghai Key Laboratory of Stomatology, Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiang Li
- Shanghai Key Laboratory of Stomatology, Department of Oral Pathology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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6
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Wang T, Yang X, Yao L, Wan Z, Zhao H, Zheng Z, Tang Y, Chen Y, Han Q. Clinicopathological analysis of 18 cases of secretory carcinoma of the salivary glands. J Dent Sci 2024; 19:109-117. [PMID: 38303791 PMCID: PMC10829629 DOI: 10.1016/j.jds.2023.05.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 05/18/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose Secretory carcinoma (SC) is a rare salivary gland tumor that featured by ETV6::NTRK3 gene fusion, and was included in the WHO Classification of Head and Neck Tumors since 2017. Nevertheless, the description of SCs by WHO is still vague. This study examined 18 SC cases by using both histomorphology and molecular pathology for diagnostic determination, especially immunohistochemical features of SCs. Materials and methods Based on WHO characteristics, 18 patients with SC admitted between 2001 and 2022 were included in this study. Main histomorphological patterns, FISH analyses of the ETV6::NTRK3 gene fusion, and immunohistochemical analyses of S100, mammaglobin, DOG1, ADFP, CA6 and Ki-67 were performed. Results Among the 18 SC patients, the median age of onset was 39.22 years. Grossly, the average tumor size in 2.96 cm with various texture from soft to tough. The majority patients were positive for S100, mammaglobin, and negative for DOG1, except for one patient negative for S100 (Case 18). All patients were positive for ADFP, and the majority patients were negative for CA6, except for Case 9. Two cases were found recurrence, and the tumor were found both in parotid gland with local invasion. Conclusion Combined with the results of previous studies, we proposed that the combination of all five markers, S100, mammaglobin, DOG1, ADFP and CA6, could contribute more to differential diagnosis of SCs with other salivary carcinomas, especially with AciCC. The prognosis of SCs is optimistic in most cases, but larger patient cohort and long-term follow-up are still needed.
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Affiliation(s)
- Tianyi Wang
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xiuxiu Yang
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Stomatology, The First People's Hospital of Ziyang, Ziyang, Sichuan, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Lihong Yao
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Zixin Wan
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Haowei Zhao
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Faculty of Dentistry, University of Toronto, Toronto, Ontario, Canada
| | - Zhijian Zheng
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yaling Tang
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Yu Chen
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Qi Han
- State Key Laboratory of Oral Disease and National Clinical Research Center for Oral Disease, West China Hospital of Stomatology, Sichuan University, Chengdu, China
- Department of Oral Pathology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
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7
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Verghese G, Lennerz JK, Ruta D, Ng W, Thavaraj S, Siziopikou KP, Naidoo T, Rane S, Salgado R, Pinder SE, Grigoriadis A. Computational pathology in cancer diagnosis, prognosis, and prediction - present day and prospects. J Pathol 2023; 260:551-563. [PMID: 37580849 PMCID: PMC10785705 DOI: 10.1002/path.6163] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/12/2023] [Accepted: 06/17/2023] [Indexed: 08/16/2023]
Abstract
Computational pathology refers to applying deep learning techniques and algorithms to analyse and interpret histopathology images. Advances in artificial intelligence (AI) have led to an explosion in innovation in computational pathology, ranging from the prospect of automation of routine diagnostic tasks to the discovery of new prognostic and predictive biomarkers from tissue morphology. Despite the promising potential of computational pathology, its integration in clinical settings has been limited by a range of obstacles including operational, technical, regulatory, ethical, financial, and cultural challenges. Here, we focus on the pathologists' perspective of computational pathology: we map its current translational research landscape, evaluate its clinical utility, and address the more common challenges slowing clinical adoption and implementation. We conclude by describing contemporary approaches to drive forward these techniques. © 2023 The Authors. The Journal of Pathology published by John Wiley & Sons Ltd on behalf of The Pathological Society of Great Britain and Ireland.
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Affiliation(s)
- Gregory Verghese
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- The Breast Cancer Now Research Unit, School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
| | - Jochen K Lennerz
- Center for Integrated Diagnostics, Department of PathologyMassachusetts General Hospital/Harvard Medical SchoolBostonMAUSA
| | - Danny Ruta
- Guy's CancerGuy's and St Thomas’ NHS Foundation TrustLondonUK
| | - Wen Ng
- Department of Cellular PathologyGuy's and St Thomas NHS Foundation TrustLondonUK
| | - Selvam Thavaraj
- Head & Neck PathologyGuy's and St Thomas NHS Foundation TrustLondonUK
- Centre for Clinical, Oral & Translational Science, Faculty of Dentistry, Oral & Craniofacial SciencesKing's College LondonLondonUK
| | - Kalliopi P Siziopikou
- Department of Pathology, Section of Breast PathologyNorthwestern University Feinberg School of MedicineChicagoILUSA
| | - Threnesan Naidoo
- Department of Laboratory Medicine and Pathology, Walter Sisulu University, Mthatha, Eastern CapeSouth Africa and Africa Health Research InstituteDurbanSouth Africa
| | - Swapnil Rane
- Department of PathologyTata Memorial Centre – ACTRECHBNINavi MumbaiIndia
- Computational Pathology, AI & Imaging LaboratoryTata Memorial Centre – ACTREC, HBNINavi MumbaiIndia
| | - Roberto Salgado
- Department of PathologyGZA–ZNA ZiekenhuizenAntwerpBelgium
- Division of ResearchPeter MacCallum Cancer CentreMelbourneVictoriaAustralia
| | - Sarah E Pinder
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- Department of Cellular PathologyGuy's and St Thomas NHS Foundation TrustLondonUK
| | - Anita Grigoriadis
- School of Cancer & Pharmaceutical Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
- The Breast Cancer Now Research Unit, School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and MedicineKing's College LondonLondonUK
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8
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Peterson V, Kokkinos V, Ferrante E, Walton A, Merk T, Hadanny A, Saravanan V, Sisterson N, Zaher N, Urban A, Richardson RM. Deep net detection and onset prediction of electrographic seizure patterns in responsive neurostimulation. Epilepsia 2023; 64:2056-2069. [PMID: 37243362 DOI: 10.1111/epi.17666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 05/21/2023] [Accepted: 05/22/2023] [Indexed: 05/28/2023]
Abstract
OBJECTIVE Managing the progress of drug-resistant epilepsy patients implanted with the Responsive Neurostimulation (RNS) System requires the manual evaluation of hundreds of hours of intracranial recordings. The generation of these large amounts of data and the scarcity of experts' time for evaluation necessitate the development of automatic tools to detect intracranial electroencephalographic (iEEG) seizure patterns (iESPs) with expert-level accuracy. We developed an intelligent system for identifying the presence and onset time of iESPs in iEEG recordings from the RNS device. METHODS An iEEG dataset from 24 patients (36 293 recordings) recorded by the RNS System was used for training and evaluating a neural network model (iESPnet). The model was trained to identify the probability of seizure onset at each sample point of the iEEG. The reliability of the net was assessed and compared to baseline methods, including detections made by the device. iESPnet performance was measured using balanced accuracy and the F1 score for iESP detection. The prediction time was assessed via both the error and the mean absolute error. The model was evaluated following a hold-one-out strategy, and then validated in a separate cohort of 26 patients from a different medical center. RESULTS iESPnet detected the presence of an iESP with a mean accuracy value of 90% and an onset time prediction error of approximately 3.4 s. There was no relationship between electrode location and prediction outcome. Model outputs were well calibrated and unbiased by the RNS detections. Validation on a separate cohort further supported iESPnet applicability in real clinical scenarios. Importantly, RNS device detections were found to be less accurate and delayed in nonresponders; therefore, tools to improve the accuracy of seizure detection are critical for increasing therapeutic efficacy. SIGNIFICANCE iESPnet is a reliable and accurate tool with the potential to alleviate the time-consuming manual inspection of iESPs and facilitate the evaluation of therapeutic response in RNS-implanted patients.
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Affiliation(s)
- Victoria Peterson
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Instituto de Matemática Aplicada del Litoral, UNL-CONICET, Santa Fe, Argentina
| | - Vasileios Kokkinos
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Enzo Ferrante
- Research Institute for Signals, Systems, and Computational Intelligence, UNL-CONICET, Santa Fe, Argentina
| | - Ashley Walton
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Boston, Massachusetts, USA
| | - Timon Merk
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Amir Hadanny
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Varun Saravanan
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Boston, Massachusetts, USA
| | - Nathaniel Sisterson
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Naoir Zaher
- Department of Neurology, Epilepsy Center at Orlando Health, Orlando, Florida, USA
| | - Alexandra Urban
- University of Pittsburgh Comprehensive Epilepsy Center, Pittsburgh, Pennsylvania, USA
| | - R Mark Richardson
- Department of Neurosurgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
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9
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Sharma P, Sivakumar N, Pandiar D. Diagnostic accuracy of pan-TRK immunohistochemistry in differentiating secretory carcinoma from acinic cell carcinoma of salivary gland-A systematic review. J Oral Pathol Med 2023; 52:255-262. [PMID: 36207812 DOI: 10.1111/jop.13373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 09/18/2022] [Accepted: 09/29/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Secretory carcinoma (SC) is a well-established salivary gland malignancy that has earned its popularity for its unique clinicopathological behavior. Although it is an indolent malignancy, few of them have been reported with high grade transformation making it mandatory to differentiate it from its prime histological mimicker, acinic cell carcinoma (AciCC). Recently, many studies have been directed toward validating the sensitivity and specificity of pan-TRK IHC for confirming ETV6::NTRK3 gene fusion in SCs involving salivary gland. AIM The aim of the present systematic review was to establish the diagnostic utility of pan-TRK immunostaining in histological differentiation of SC from AciCC. MATERIAL AND METHODS An electronic search was carried out using MEDLINE by PubMed, Scopus, Google scholar, Trip, Cochrane library and EMBASE databases. Articles in which SC assessed with pan-TRK immunohistochemical expressions were included for systematic review and their staining pattern (cytoplasmic, nuclear and/or combined), sensitivity, specificity, positive as well as negative predictive were gathered. Risk of bias was analyzed for each study using QUADAS-2 tool. RESULTS Thirteen eligible articles were included for the quantitative analysis, which revealed positive immunostaining of pan-TRK by nearly all the ETV6::NTRK3 fusion prevalent SCs alongside negative expression in almost all the cases of AciCC with 100% of sensitivity as well as specificity. CONCLUSION The evidence from the included studies supports that pan-TRK immunostaining could be used as a reliable preliminary screening tool for discerning SC from AciCC. PROSPERO No: CRD42022308913.
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Affiliation(s)
- Pooja Sharma
- Department of Oral Pathology, King George's Medical University, Lucknow, India
| | - N Sivakumar
- Department of Oral Pathology, King George's Medical University, Lucknow, India
| | - Deepak Pandiar
- Department of Oral Pathology and Microbiology, Saveetha Dental College and Hospitals, Chennai, India
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10
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Mahendru R, Kakkar A, Cipriani NA, Sarma C, Ghosh V, Kaur K, Gupta S, Mohan A. Pleural metastasis from parotid secretory carcinoma: First report of morphology on effusion cytology, and role of pan-TRK immunohistochemistry. Diagn Cytopathol 2023; 51:E28-E37. [PMID: 36148935 DOI: 10.1002/dc.25057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 09/03/2022] [Accepted: 09/14/2022] [Indexed: 12/13/2022]
Abstract
Distant metastasis from salivary gland secretory carcinoma (SC) is rare, with lung and pleura being the most frequent site. While cytological features of SC on fine needle aspirates are well documented, its morphology in serous effusions has not been described. We describe the cytomorphological features on effusion cytology of two patients with ETV6::NTRK3 fusion-positive SC, who subsequently developed pleural metastases. Cytospin preparations of pleural fluid showed tightly cohesive, irregularly shaped and ball-like clusters of large tumor cells with scant to abundant uni- and multi-vacuolated cytoplasm. Nuclei were eccentrically placed, round to oval, vesicular, with finely granular chromatin, irregular nuclear membranes and conspicuous to prominent nucleoli. With these features, the tumors resembled an adenocarcinoma, indistinguishable from a lung primary. Cell blocks from both cases showed tumor fragments, some of which had the hollow appearance of transversely sectioned cell spheres as seen in lung and breast adenocarcinomas. Immunohistochemistry on cell blocks revealed nuclear pan-TRK positivity in both cases. Case 1 also showed focal mammaglobin staining, and TTF1 negativity. Pleural metastases from SC may mimic other adenocarcinomas. As targeted therapy, that is, selective TRK inhibitors are available for treatment of metastatic disease, NTRK3 fusion status is not only diagnostic, but also required to plan treatment. Pan-TRK immunohistochemistry serves as a viable cost-effective, easy to apply surrogate marker for NTRK3 fusion, particularly in diagnostic laboratories lacking easy access to molecular testing on cytological material.
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Affiliation(s)
- Ria Mahendru
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Aanchal Kakkar
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Nicole Anne Cipriani
- Department of Pathology, The University of Chicago Medicine, Chicago, Illinois, USA
| | - Chetna Sarma
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Vivek Ghosh
- Department of Radiation Oncology, BRA IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Kavneet Kaur
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Subhash Gupta
- Department of Radiation Oncology, BRA IRCH, All India Institute of Medical Sciences, New Delhi, India
| | - Anant Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India
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Xu B, Viswanathan K, Umrau K, Al-Ameri TAD, Dogan S, Magliocca K, Ghossein RA, Cipriani NA, Katabi N. Secretory carcinoma of the salivary gland: a multi-institutional clinicopathologic study of 90 cases with emphasis on grading and prognostic factors. Histopathology 2022; 81:670-679. [PMID: 35974431 PMCID: PMC9580072 DOI: 10.1111/his.14772] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/08/2022] [Accepted: 08/12/2022] [Indexed: 11/29/2022]
Abstract
Secretory carcinoma (SC) is a rare form of salivary carcinoma that was first described in 2010 and is characterized by ETV6::NTRK3 fusion in most cases. In this large retrospective study, we aimed to identify adverse clinicopathologic factors and propose a prognostically relevant grading scheme for SC. METHODS A detailed clinicopathologic review was conducted on 90 SCs from the major and minor salivary glands. RESULTS The median age at presentation was 50 years (range: 7-93). Sixty-nine (77%) tumours originated from major salivary glands, whereas the remaining 21 involved minor salivary glands.Six cases (7%) had cervical nodal metastasis. Only lymphovascular invasion (LVI) was associated with a risk of nodal metastasis (P < 0.05). The 5-year disease-specific survival and disease-free survival (DFS) were 98% and 87%, respectively. On univariate survival analysis, adverse prognostic factors associated with decreased DFS included minor salivary gland origin, atypical mitosis, high mitotic index, high-grade transformation (HGT), necrosis, nuclear pleomorphism, infiltrative tumour border, fibrosis at the invasive front, LVI, positive margin, and advanced pT stage (P < 0.05). When adjusted for pT stage and margin status, mitotic index, LVI, nuclear pleomorphism, and HGT remained as independent prognostic factors. CONCLUSION We therefore propose a two-tiered grading system for SC. The low-grade SC is defined as those with <5 mitoses /10 high-power fields and no tumour necrosis, and high-grade SC as those with ≥5 mitoses /10 high-power fields and/or necrosis. This proposed grading system can be useful to risk stratify patients with SC for appropriate clinical management.
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Affiliation(s)
- Bin Xu
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Kartik Viswanathan
- Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, US
| | - Kavita Umrau
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | | | - Snjezana Dogan
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Kelly Magliocca
- Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA, US
| | - Ronald A. Ghossein
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, US
| | - Nicole A. Cipriani
- Department of Pathology, The University of Chicago Medicine & Biological Sciences, Chicago, IL, US
| | - Nora Katabi
- Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, US
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12
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Secretory carcinoma of the minor salivary gland in the lip with ETV6-NTRK3 fusion: case report and literature review. JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY, MEDICINE, AND PATHOLOGY 2022. [DOI: 10.1016/j.ajoms.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
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13
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Rack S, Feeney L, Hapuarachi B, Adderley H, Woodhouse L, Betts G, Burghel GJ, Harrington KJ, Metcalf R. Evaluation of the Clinical Utility of Genomic Profiling to Inform Selection of Clinical Trial Therapy in Salivary Gland Cancer. Cancers (Basel) 2022; 14:1133. [PMID: 35267442 PMCID: PMC8909363 DOI: 10.3390/cancers14051133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/27/2022] Open
Abstract
For most patients with salivary gland cancer, there are no effective standard systemic therapies. Although clinical trials of biomarker-led drug therapies have delivered significant recent advances, there remains a need to understand the clinical utility of genomic profiling of cancer as a means to match patients with recurrent or metastatic salivary gland cancer to clinical trial therapies. In total, 209 patients with salivary gland cancers were profiled with 24 gene (n = 209)) and >325 gene (n = 32) DNA-based next-generation sequencing panels. A retrospective systematic evaluation was performed to identify the frequency of available matched drug therapies within clinical trials based on the results. The matches were then stratified based upon the level of evidence supporting the drug−biomarker combination being investigated using the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT) to determine the strength of the clinical rationale for each gene−drug match identified. DNA-based next generation sequencing (NGS) analysis was successful in 175/209 (84%) patients with salivary gland cancer. Using the 24-gene NGS panel, actionable alterations were identified in 27% (48/175) patients. Alterations were most frequent in salivary duct carcinoma (88%) characterized by TP53 and/or PIK3CA mutations, with matched trials available for 63% (10/16). In ACC, biomarker-matched trials were available for 7% (8/115), and no genomic alterations were found in 96/115 (83%) of ACC patients. TP53 was the most frequently altered gene across all subtypes; however, there were no trials recruiting based on TP53 status. In 32 ACC patients with no genomic alterations using the 24-gene panel, a broader (>325 gene) panel identified alterations in 87% (27/32) of cases with biomarker-matched trials available in 40% (13/32) cases. This study identified that genomic profiling using focused (24-gene) NGS panels has potential utility in matching to trial therapies for most patients with non-ACC salivary gland cancer. For patients with ACC, broader genomic profiling has demonstrated added clinical utility. We describe the application of an approach to classification of levels of evidence which may be helpful to inform the clinician and patient decision making around the selection of clinical trial therapies.
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Affiliation(s)
- Samuel Rack
- Department of Medical Oncology, The Christie Hospital NHS Foundation Trust, Manchester M20 4BX, UK; (S.R.); (H.A.); (L.W.)
| | - Laura Feeney
- The Northern Ireland Cancer Centre, Belfast City Hospital, Lisburn Road, Belfast BT9 7AB, UK;
| | - Brindley Hapuarachi
- Sheffield Teaching Hospitals NHS Foundation Trust, Glossop Road, Broomhall, Sheffield S10 2JF, UK;
| | - Helen Adderley
- Department of Medical Oncology, The Christie Hospital NHS Foundation Trust, Manchester M20 4BX, UK; (S.R.); (H.A.); (L.W.)
| | - Laura Woodhouse
- Department of Medical Oncology, The Christie Hospital NHS Foundation Trust, Manchester M20 4BX, UK; (S.R.); (H.A.); (L.W.)
| | - Guy Betts
- Department of Adult Histopathology, Manchester University NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK;
| | - George J. Burghel
- North West Genomic Laboratory Hub, Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust, Oxford Road Rd, Manchester M13 9WL, UK;
| | | | - Robert Metcalf
- Department of Medical Oncology, The Christie Hospital NHS Foundation Trust, Manchester M20 4BX, UK; (S.R.); (H.A.); (L.W.)
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