mammary analogue secretory carcinoma

Definition: Mammary analogue secretory carcinoma of salivary gland origin (MASC) is a tumor resembling secretory carcinoma of the breast characterized by strong S-100 protein, mammaglobin, and vimentin immunoexpression. It harbors a t(12;15) (p13;q25) translocation resulting in ETV6-NTRK3 fusion product.

Images

 Mammary analogue secretory carcinoma of salivary gland origin (MASC)

• https://twitter.com/chioseasi/status/771825380416065541
• http://www.webpathology.com/image.asp?case=119&n=57

 FNA of MASC

• https://twitter.com/SteveLongMD/status/802597647085244416
• https://twitter.com/JMGardnerMD/status/837302000979230721

Mammary analog secretory carcinoma is a distinctive low-grade malignant salivary cancer that harbors a characteristic chromosomal translocation, t(12;15) (p13;q25), resulting in an ETV6-NTRK3 fusion.

Histologically, conventional MASC displays bland histomorphology and a lobulated growth pattern and is often composed of microcystic, tubular, and solid structures with abundant eosinophilic homogenous or bubbly secretions.

Colloid-like secretory material stains positively for periodic acid-Schiff with and without diastase as well as for Alcian Blue.

IHC

 Positive IHC

• Cytokeratins: CK7 KRT7 , CK8 KRT8 , CK18 KRT 18 , CK19 KTR19 , CKAE1/AE3, CAM 5.2
• S100 , STAT5a (strong, diffuse), GCDFP-15 (most cases) (Head Neck Pathol 2013;7:S30)
• Tumor cells and eosinophilic material will stain for mammaglobin
• With appropriate morphology, the positivity of both S100 and mammaglobin are strongly indicative of MASC (Head Neck Pathol 2015;9:85)
• However, these two stains alone are not entirely specific (Hum Pathol 2013;44:2501, Hum Pathol 2013;44:1982)
• Eosinophilic secretory material stains for PAS / PASD and Alcian blue

 Negative IHC

• DOG1 ; p63
• Myoepithelial markers: p63 , calponin , CK14/KRT14 , SMA and CK5/6
• ER , PR

See also

 mammary secretory carcinoma

 salivary gland tumors

Open references

 Mammary analogue secretory carcinoma: update on a new diagnosis of salivary gland malignancy. Sethi R, Kozin E, Remenschneider A, Meier J, VanderLaan P, Faquin W, Deschler D, Frankenthaler R. Laryngoscope. 2014 Jan;124(1):188-95. doi : 10.1002/lary.24254. Review PMID: 23775296 Free

Paywall References

 Mammary Analogue Secretory Carcinoma of Salivary Glands: Molecular Analysis of 25 ETV6 Gene Rearranged Tumors With Lack of Detection of Classical ETV6-NTRK3 Fusion Transcript by Standard RT-PCR: Report of 4 Cases Harboring ETV6-X Gene Fusion. Skálová A, Vanecek T, Simpson RH, Laco J, Majewska H, Baneckova M, Steiner P, Michal M. Am J Surg Pathol. 2016 Jan;40(1):3-13. doi : 10.1097/PAS.0000000000000537 PMID: 26492182

 Mammary Analogue Secretory Carcinoma of Salivary Glands: A Clinicopathologic and Molecular Study Including 2 Cases Harboring ETV6-X Fusion. Ito Y, Ishibashi K, Masaki A, Fujii K, Fujiyoshi Y, Hattori H, Kawakita D, Matsumoto M, Miyabe S, Shimozato K, Nagao T, Inagaki H. Am J Surg Pathol. 2015 Feb 3. PMID: 25651470

 Mammary Analogue Secretory Carcinoma of Salivary Glands With High-grade Transformation: Report of 3 Cases With the ETV6-NTRK3 Gene Fusion and Analysis of TP53, β-Catenin, EGFR, and CCND1 Genes. Skálová A, Vanecek T, Majewska H, Laco J, Grossmann P, Simpson RH, Hauer L, Andrle P, Hosticka L, Branžovský J, Michal M. Am J Surg Pathol. 2014 Jan;38(1):23-33. doi : 10.1097/PAS.0000000000000088 PMID: 24145651

 Mammary analogue secretory carcinoma of salivary glands is a lipid-rich tumour, and adipophilin can be valuable in its identification. Mariano FV, Dos Santos HT, Azañero WD, da Cunha IW, Coutinho-Camilo CM, de Almeida OP, Kowalski LP, Altemani A.
Histopathology. 2013 May 17. doi : 10.1111/his.12192 PMID: 23931576