High-Grade Transformation of Acinic Cell Carcinoma: An Inadequately Treated Entity?

Abstract Objective Acinic cell carcinoma (AcCC) is an uncommon salivary gland malignancy. We aim to characterize the clinical and pathologic characteristics of AcCC with/without high-grade transformation (HGT). Importantly, cases of mammary analogue secretory carcinoma (MASC), a recently described h...

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Published in:Oral surgery, oral medicine, oral pathology and oral radiology oral medicine, oral pathology and oral radiology, 2016-05, Vol.121 (5), p.542-549.e1
Main Authors: Chintakuntlawar, Ashish V., MBBS, PhD, Shon, Wonwoo, DO, Erickson-Johnson, Michele, PhD, Bilodeau, Elizabeth, DMD, MD, Jenkins, Sarah M, Davidson, Jennifer A., PA, Keeney, Michael G., MD, Rivera, Michael, MD, Price, Daniel L., MD, Moore, Eric J., MD, Olsen, Kerry D., MD, Kasperbauer, Jan L., MD, Foote, Robert L., MD, Price, Katharine A., MD, García, Joaquín J., MD
Format: Article
Language:English
Subjects:
Adolescent
Adult
Aged
Aged, 80 and over
Carcinoma, Acinar Cell - genetics
Carcinoma, Acinar Cell - pathology
Carcinoma, Acinar Cell - surgery
Dentistry
Female
Gene Rearrangement
Humans
In Situ Hybridization, Fluorescence
Male
Middle Aged
Neoplasm Grading
Prognosis
Reverse Transcriptase Polymerase Chain Reaction
Salivary Gland Neoplasms - genetics
Salivary Gland Neoplasms - pathology
Salivary Gland Neoplasms - surgery
Surgery
Survival Rate
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Summary:Abstract Objective Acinic cell carcinoma (AcCC) is an uncommon salivary gland malignancy. We aim to characterize the clinical and pathologic characteristics of AcCC with/without high-grade transformation (HGT). Importantly, cases of mammary analogue secretory carcinoma (MASC), a recently described histologic mimic of AcCC, have been excluded using cytogenetics and molecular studies. Materials and Methods Archival surgical pathology material was obtained for patients diagnosed with AcCC at Mayo Clinic Rochester between 1990 and 2010. Tumors harboring the ETV6-NTRK3 fusion transcript were excluded from analysis using cytogenetics and molecular studies. Tumors with HGT were characterized by areas with an infiltrative growth pattern, nuclear anaplasia, prominent nucleoli, brisk mitotic activity, geographic necrosis, and stromal desmoplasia. Demographic and clinical data was extracted from medical record. Results AcCC with HGT was seen in 8 of 48 cases (17%). Patients with AcCC with HGT were significantly older than patients without HGT (median 69 vs. 54 years, p=0.04). Angiolymphatic invasion was more common in AcCC with HGT (P=0.02). Relapse-free survival (RFS) and overall-survival (OS) were significantly worse for cases of AcCC with HGT (hazard ratio 10.4 and 9.3, respectively; P
ISSN:2212-4403
2212-4411
DOI:10.1016/j.oooo.2016.01.011