Page 45 - AAOMP Meeting 2019

POSTER ABSTRACTS - TUESDAY, JUNE 11, 2019

#41 SECRETORY CARCINOMA OF THE MINOR SALIVARY GLAND IN A 9-YEAR-OLD: REPORT OF
A CASE
Dr. Jennie Ison (Zucker School of Medicine at Hofstra/Northwell), Dr. John Fantasia (Zucker School
of Medicine at Hofstra/Northwell) J. Ison, J. Fantasia, Zucker School of Medicine at Hofstra/Northwell -
New Hyde Park, NY
Introduction: Secretory carcinoma (SC), previously known as mammary analog secretory carcinoma of
the salivary glands, is a recent addition to the WHO Classification of Head and Neck Tumors and is a distinct
salivary gland malignancy characterized by a morphological resemblance to mammary secretory
carcinoma of the breast and an ETV6-NTRK3 gene fusion. SC typically presents in adults (mean patient
age of 46.5 years, range: 10-86 years) as a painless, slow growing mass, with an equal sex distribution.
The most common site of occurrence is the parotid gland, followed by the minor salivary glands, and
submandibular gland. Case Report: A firm movable nodule adjacent to the first molar was noted in the
left mandibular buccal vestibule of a nine-year-old male. The clinical differential diagnosis included
mucocele, mucous retention cyst and salivary gland tumor. Microscopic examination revealed a non-
encapsulated tumor composed of medium-sized, round-to-polygonal cells with moderate amounts of pale,
eosinophilic, bubbly cytoplasm arranged in solid, microcystic, macrocystic, tubular, and focally papillary
growth patterns. S-100, mammaglobin, and SOX-10 stains were positive, supporting a diagnosis of SC.
Conclusions: The histological differential diagnosis of SC includes acinic cell carcinoma, low-grade
cribriform salivary duct carcinoma, and mucoepidermoid carcinoma. Acinic cell carcinoma is negative for
S-100 and mammaglobin. Low-grade cribriform salivary duct carcinoma, like SC, is positive for S-100 and
mammoglobin, but is an intraductal tumor. Mucoepidermoid carcinoma contains epidermoid and mucous
cells, but is S-100 negative and positive for MECT1/3-MAML2. All entities on the histological differential,
other than SC, are negative for ETV6-NTRK gene fusion. This case highlights SC occurring in a pediatric
patient.

#42 PLASMACYTOID MYOEPITHELIOMA OF THE HARD PALATE: TWO CASES
Ms. Rachelle Wolk (New York University College of Dentistry), Ms. Sara Sternbach (New York
University College of Dentistry), Dr. Sonal Shah (New York University College of Dentistry), Dr. Arthi
Kumar (New York University College of Dentistry), Dr. Denise Trochesset (New York University
College of Dentistry)
Background: Myoepitheliomas are benign salivary gland tumors that comprise approximately 1-1.5% of all
salivary gland tumors. These tumors commonly involve the parotid glands or the minor salivary glands of the
palate. There are no known age or gender predilections noted with myoepitheliomas and the risk factors are
poorly understood. Over the past twenty years, the Diagnostic Pathology Laboratory at New York University
College of Dentistry (NYUCD) has signed out 27,416 cases, with 28 cases of benign salivary gland tumors and
45 cases of malignant salivary gland tumors. Two cases of myoepitheliomas were identified, a localized
prevalence of 2.73% of all salivary gland tumors at NYUCD.
Cases: The first case of plasmacytoid myoepithelioma from 2015 was in a 79-year-old African-American male,
and the second case from 2018 was in a 63-year-old African-American female. The tumor locations for both
cases were on the hard palate, with the 2015 case being left of the midline and the 2018 case being right of the
midline. Both myoepitheliomas were of the plasmacytoid subtype, a rare form. The microscopic features
shared for both tumors included collections of plasmacytoid myoepithelial cells supported with a markedly
myxoid stroma and adipose tissue. The microscopic description from the 2015 case noted a localized area of
salivary gland ductal structures (less than 5% is acceptable for the diagnosis of myoepithelioma). The
description from the 2018 case noted no ductal structures and focal atypia including enlarged nuclei and
pleomorphism. The tumors were excised in both patients and there has been no report of recurrence throughout
their follow-up.
Conclusion: It is important for clinicians to be aware of the myoepithelioma as a variant of a benign salivary
gland tumor. Due to their rarity, additional investigation is required to document their clinical, histological
and immunological features.