2021 Volume 60 Issue 6 Pages 317-323
Background : Secretory carcinomas are low-grade tumors that account for 10% of all salivary gland tumors.
Case : A man in his 40s presented to us with a swelling in the region anterior to his right ear that he had first noticed approximately three years ago. Magnetic resonance imaging (MRI) revealed a multilocular mass measuring approximately 4 cm in diameter. Fine-needle aspiration cytology revealed tumor cells arranged in a microfollicular papillary pattern or in flat sheets, and mucin, hemorrhage, and hemosiderin-laden foamy histiocytes in the background. The nuclei were medium-sized and eccentric, containing prominent nucleoli and slightly increased chromatin. Metachromatic secretory material was observed in the cytoplasm of some tumor cells. Histologically, the tumor, contained within a cyst, showed small circular ducts and an alveolar, papillary architecture of the tumor cells. Immunohistochemically, the tumor cells were positive for Vimentin, GATA3, S-100, Mammaglobin, and CK7 ; based on the findings, the tumor was diagnosed as a secretory carcinoma. The ETV6-NTRK3 fusion gene was detected in the tumor cells by direct sequence analysis using the Sanger method.
Conclusion : In patients with salivary gland tumors in whom cytology specimens reveal tumor cells arranged in a papillary and/or microfollicular pattern, secretory carcinoma should be considered as the most a highly likely diagnosis.
