Microsecretory adenocarcinoma of the hard palate: A case report of a recently described entity.
Actins
/ genetics
Adenocarcinoma
/ diagnostic imaging
Adult
Biomarkers, Tumor
/ genetics
Female
Gene Fusion
Humans
MEF2 Transcription Factors
/ genetics
Magnetic Resonance Imaging
Palate, Hard
/ diagnostic imaging
Proto-Oncogene Proteins
/ genetics
Repressor Proteins
/ genetics
Salivary Gland Neoplasms
/ diagnostic imaging
Salivary Glands, Minor
/ pathology
Treatment Outcome
MEF2C
SS18
adenocarcinoma not otherwise specified
hard palate
salivary gland
Journal
Pathology international
ISSN: 1440-1827
Titre abrégé: Pathol Int
Pays: Australia
ID NLM: 9431380
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
10
05
2020
revised:
18
06
2020
accepted:
28
06
2020
pubmed:
21
7
2020
medline:
17
8
2021
entrez:
21
7
2020
Statut:
ppublish
Résumé
We report a case of microsecretory adenocarcinoma of the hard palate. The patient is a 37-year-old woman with a 15 mm submucosal tumor, which was incidentally found by her primary care dentist, in her hard palate. Preoperative magnetic resonance imaging revealed a tumor exhibiting high signal on T2-weighted image, which was gradually enhanced on dynamic study. Histologically, the tumor border was ill-defined without fibrous capsule and adjoined minor salivary gland with permeative infiltration at the tumor periphery. The tumor comprised intercalated duct-like cells with polygonal narrow eosinophilic to clear cytoplasm and small, uniform oval nuclei. These cells formed small infiltrative microcysts, tubules and fascicular cords collecting pale basophilic secretions and small vacuoles setting in an abundant fibromyxoid stroma. The tumor cells were positive for CK AE1+AE3, S-100 protein, and p63, while are completely negative for p40, alpha-SMA, and calponin. The MEF2C-SS18 fusion was identified by reverse transcriptase-polymerase chain reaction followed by Sanger sequencing. The combination of characteristic histology, immunophenotype, and presence of MEF2C-SS18 fusion indicated the diagnosis of microsecretory adenocarcinoma of the hard palate, an entity described only recently. Post-operative course was uneventful and there was no evidence of disease at 4 months after surgery.
Substances chimiques
ACTA2 protein, human
0
Actins
0
Biomarkers, Tumor
0
MEF2 Transcription Factors
0
MEF2C protein, human
0
Proto-Oncogene Proteins
0
Repressor Proteins
0
SS18 protein, human
0
Types de publication
Case Reports
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
781-785Informations de copyright
© 2020 Japanese Society of Pathology and John Wiley & Sons Australia, Ltd.
Références
Bishop JA, Weinreb I, Swanson D et al. Microsecretory adenocarcinoma: A novel salivary gland tumor characterized by a recurrent MEF2C-SS18 fusion. Am J Surg Pathol 2019; 43: 1023-32.
Crum CP, McKeon FD. p63 in epithelial survival, germ cell surveillance, and neoplasia. Annu Rev Pathol 2010; 5: 349-71.
Bishop JA, Montgomery EA, Westra WH. Use of p40 and p63 immunohistochemistry and human papillomavirus testing as ancillary tools for the recognition of head and neck sarcomatoid carcinoma and its distinction from benign and malignant mesenchymal processes. Am J Surg Pathol 2014; 38: 257-64.
Bishop JA, Teruya-Feldstein J, Westra WH, Pelosi G, Travis WD, Rekhtman N. p40 (DeltaNp63) is superior to p63 for the diagnosis of pulmonary squamous cell carcinoma. Mod Pathol 2012; 25: 405-15.
Edwards PC, Bhuiya T, Kelsch RD. Assessment of p63 expression in the salivary gland neoplasms adenoid cystic carcinoma, polymorphous low-grade adenocarcinoma, and basal cell and canalicular adenomas. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004; 97: 613-19.
Foschini MP, Gaiba A, Cocchi R, Pennesi MG, Pession A. p63 expression in salivary gland tumors: Role of DeltaNp73L in neoplastic transformation. Int J Surg Pathol 2005; 13: 329-35.
Fukushima N, Satoh T, Sueoka N et al. Clinico-pathological characteristics of p63 expression in B-cell lymphoma. Cancer Sci 2006; 97: 1050-55.
Park CK, Oh YH. Expression of p63 in reactive hyperplasias and malignant lymphomas. J Korean Med Sci 2005; 20: 752-58.
Tilson MP, Bishop JA. Utility of p40 in the differential diagnosis of small round blue cell tumors of the sinonasal tract. Head Neck Pathol 2014; 8: 141-45.
Skalova A, Vanecek T, Sima R et al. Mammary analogue secretory carcinoma of salivary glands, containing the ETV6-NTRK3 fusion gene: A hitherto undescribed salivary gland tumor entity. Am J Surg Pathol 2010; 34: 599-608.
Rooper L, Sharma R, Bishop JA. Polymorphous low grade adenocarcinoma has a consistent p63+/p40− immunophenotype that helps distinguish it from adenoid cystic carcinoma and cellular pleomorphic adenoma. Head Neck Pathol 2015; 9: 79-84.
Piscuoglio S, Fusco N, Ng CK et al. Lack of PRKD2 and PRKD3 kinase domain somatic mutations in PRKD1 wild-type classic polymorphous low-grade adenocarcinomas of the salivary gland. Histopathology 2016; 68: 1055-62.
Weinreb I, Piscuoglio S, Martelotto LG et al. Hotspot activating PRKD1 somatic mutations in polymorphous low-grade adenocarcinomas of the salivary glands. Nat Genet 2014; 46: 1166-69.
Adkins BD, Geromes A, Zhang LY et al. SOX10 and GATA3 in adenoid cystic carcinoma and polymorphous adenocarcinoma. Head Neck Pathol 2020; 14: 406-11.
Hsieh MS, Lee YH, Chang YL. SOX10-positive salivary gland tumors: A growing list, including mammary analogue secretory carcinoma of the salivary gland, sialoblastoma, low-grade salivary duct carcinoma, basal cell adenoma/adenocarcinoma, and a subgroup of mucoepidermoid carcinoma. Hum Pathol 2016; 56: 134-42.
Mino M, Pilch BZ, Faquin WC. Expression of KIT (CD117) in neoplasms of the head and neck: An ancillary marker for adenoid cystic carcinoma. Mod Pathol 2003; 16: 1224-31.
Andreadis D, Epivatianos A, Poulopoulos A et al. Detection of C-KIT (CD117) molecule in benign and malignant salivary gland tumours. Oral Oncol 2006; 42: 57-65.
Ohtomo R, Mori T, Shibata S et al. SOX10 is a novel marker of acinus and intercalated duct differentiation in salivary gland tumors: A clue to the histogenesis for tumor diagnosis. Mod Pathol 2013; 26: 1041-50.