title: Aggressive invasive micropapillary salivary duct carcinoma of the parotid gland.
abstract: The presence of invasive micropapillary component has been reported to be associated with salivary duct carcinoma and poor outcomes. Herein is described a rare case of invasive micropapillary salivary duct carcinoma of the parotid gland in a 60-year-old man. The micropapillary component was approximately 70% of the area of the tumor. Squamous differentiation was focally seen adjacent to the micropapillary component. On immunohistochemistry the ordinary salivary duct carcinoma component was positive for gross cystic disease fluid protein-15 (GCDFP-15), androgen receptor (AR), and HER2/neu, whereas both micropapillary and squamous components were negative for GCDFP-15 and AR. Immunohistochemical staining for D2-40 highlighted the lymph vessel invasion of tumor cells. This patient developed metastases in the lymph nodes of the neck, and also in the liver, lung, and brain. The lymph nodes and liver metastases had both ordinary salivary duct carcinoma and micropapillary components. The patient died of tumor 11 months after the initial surgical operation. The results support that the presence of micropapillary component is associated with more aggressive behavior of salivary duct carcinoma. It is also important for pathologists to recognize that GCDFP-15 and AR expression can be reduced in micropapillary carcinoma in the differential diagnosis of metastatic tumor.
authors.affiliation: Department of Anatomic Pathology, Pathological Sciences, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. hidetaka@surgpath.med.kyushu-u.ac.jp <hidetaka@surgpath.med.kyushu-u.ac.jp>
authors.forename: Hidetaka
authors.initials: H
authors.lastname: Yamamoto
authors.forename: Hideoki
authors.initials: H
authors.lastname: Uryu
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Segawa
authors.forename: Masazumi
authors.initials: M
authors.lastname: Tsuneyoshi
mesh_terms: D014408:Biomarkers, Tumor / Q000032:analysis; D044584:Carcinoma, Ductal / Q000737:chemistry / Q000473:pathology* / Q000628:therapy; D002352:Carrier Proteins / Q000032:analysis; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D017809:Fatal Outcome; D019085:Fluorescent Antibody Technique, Direct; D006023:Glycoproteins / Q000032:analysis; D006801:Humans; D008297:Male; D026901:Membrane Transport Proteins; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D010307:Parotid Neoplasms / Q000737:chemistry / Q000473:pathology*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D011944:Receptors, Androgen / Q000032:analysis; D018987:Salivary Ducts / Q000737:chemistry / Q000473:pathology*; D012468:Salivary Gland Neoplasms / Q000737:chemistry / Q000473:pathology*
chemical_list: D014408:Biomarkers, Tumor; D002352:Carrier Proteins; D006023:Glycoproteins; D026901:Membrane Transport Proteins; D018719:Erb-b2 Receptor Tyrosine Kinases; D011944:Receptors, Androgen; C488892:PIP protein, human