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. 2022 Jun:95:107132.
doi: 10.1016/j.ijscr.2022.107132. Epub 2022 Apr 29.

Mammary analogue secretory carcinoma presenting with cervical lymphadenopathy: A rare case report with review of the literature

Sami S Omar  1 , Emily C Daugherty  2 , Kakil I Rasul  3 , Fahmi M Salih  4 , Hawro T Hamza  5 , Fahmi H Kakamad  6 , Abdulwahid M Salih  7
Affiliations

Mammary analogue secretory carcinoma presenting with cervical lymphadenopathy: A rare case report with review of the literature

Sami S Omar et al. Int J Surg Case Rep. 2022 Jun.

Abstract

Introduction: Mammary analogue secretory carcinoma is a rare malignant tumor of the salivary glands that typically involves the major glands. The aim of the current study is to report a rare case of mammary analogue secretory carcinoma that presented with left cervical lymphadenopathy.

Case report: A 59-year-old lady presented with left cervical lymphadenopathy. Tissue biopsy and immunohistochemistry revealed metastatic carcinoma, favoring ovarian origin. Staging workup was performed and, ultimately, the patient was treated as having a carcinoma of unknown primary. After showing partial response to therapy, left side neck dissection was performed. Based on better assessment of the histologic picture and a broader panel of immunohistochemistry performed on the excision specimen, the final diagnosis was that of mammary analogue secretory carcinoma.

Discussion: Mammary analogue secretory carcinoma is usually an indolent salivary gland carcinoma, with the majority of patients presenting with a slow-growing, painless mass measuring approximately 2 cm in size, and a reported duration ranging from 2 months to several years. In certain cases, pain and facial paralysis have been reported. It could also be found incidentally during radiologic assessment for thyroid illness or routine dental screening.

Conclusion: Diagnosing mammary analogue secretory carcinoma is challenging, and this should be in the differential diagnosis list of metastatic carcinomas to cervical lymph nodes.

Keywords: Mammary analogue secretory carcinoma; NTRK fusion gene; Parotid gland tumor; Salivary gland.

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Conflict of interest statement

None to be declared.

Figures

Fig. 1
Fig. 1
Biopsy specimen of left neck lymph nodes showing infiltration by nests of malignant cells.
Fig. 2
Fig. 2
Immunohistochemistry showing positive staining for CK7 (left) and CA-125 (right).
Fig. 3
Fig. 3
Two malignant foci, each measuring 1 mm in greatest dimension, in the left parotid gland specimen.
Fig. 4
Fig. 4
A 9-mm focus of malignancy in the left parotid gland specimen.
Fig. 5
Fig. 5
Immunohistochemistry showing positive staining for S100 (left), GATA3 (middle), and mammaglobin (right).
See this image and copyright information in PMC

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