Conclusion
The real prevalence of SC is probably underestimated given the recent
histological reclassification of salivary gland tumors, and molecular
profiling testing is generally recommended. As no clear cut
morphological signs characterizing this neoplasm have as yet been
identified, FISH analysis with the NTRK3 probe is recommended when there
are morphological signs pointing to the hypothesis of a differential
diagnosis. The FISH technique could alternatively be carried out
whenever the morphology of the lesion could be indicative of a
mucoepidermoid or an ACC carcinoma. The biological behavior of the
former can present a variety of characteristics but its high grade of
aggressiveness with respect to the latter leads us to suggest that it is
best to carry out elective treatment of the lymph nodes of the neck and
adjuvant radiotherapy in situations of greater risk.
Figure 1: Secretory carcinoma . A - At low power,
secretory carcinoma (left side) appears as a nodule with pushing and
well defined borders toward the normal salivary gland (right side)
(Hematoxylin&Eosin, 10X). B- at higher magnification, the
microhistological architecture is appreciable as numerous microcysts
bordered by plump epithelial cells with intraluminal secretion
(Hematoxylin&Eosin, 40X). C- The secretory material in the
microcyst lumen is highlighted by PAS (Periodic Acid Shift) diastase
digestion resistant staining (PAS-D, 40X)