title: Salivary duct carcinoma: Clinicopathologic features, morphologic spectrum, and somatic mutations.
abstract: Accurate diagnosis of salivary duct carcinoma requires a high index of suspicion and clinicopathologic correlation. Hallmark genetic changes that may provide novel therapeutic options are being explored.
  
  
  
  One hundred ninety salivary gland malignancies at Royal Prince Alfred Hospital (from 1989-2014) were reviewed. Human epidermal growth factor receptor 2 (HER2) and androgen receptor status were determined along with multigene profiling.
  
  
  
  Twenty-three salivary duct carcinomas were identified, predominantly in men in their fifth to ninth decades of life. Facial nerve palsy (12%) and cervical lymph node metastases (82%) were present, and 96% received postoperative adjuvant therapy. Histologically, the tumors resembled high-grade invasive and in situ ductal carcinoma of the breast. Micropapillary, papillary, sarcomatoid, oncocytic, and mucinous variants were seen. The tumors showed androgen receptor (70%), HER2 amplification (30%), and HRAS, AKT1, PIK3CA, and NRAS mutations (22%; cumulative). The 5-year disease-free survival was 36%.
  
  
  
  Salivary duct carcinoma demonstrates a wide histopathologic spectrum. Treatment strategies need to take androgen receptor, HER2 amplification, and PIK3CA mutation into account. © 2015 Wiley Periodicals, Inc. Head Neck 38: E1838-E1847, 2016.
authors.affiliation: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Peter P
authors.initials: PP
authors.lastname: Luk
authors.affiliation: Westmead Hospital, Sydney, Australia.
authors.forename: Jared D
authors.initials: JD
authors.lastname: Weston
authors.affiliation: Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney, Australia.|Central Clinical School, The University of Sydney, Australia.
authors.forename: Bing
authors.initials: B
authors.lastname: Yu
authors.affiliation: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Christina I
authors.initials: CI
authors.lastname: Selinger
authors.affiliation: University of New South Wales, Sydney, Australia.
authors.forename: Rafael
authors.initials: R
authors.lastname: Ekmejian
authors.affiliation: The Sydney Head and Neck Cancer Institute, Australia.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Eviston
authors.affiliation: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.
authors.forename: Trina
authors.initials: T
authors.lastname: Lum
authors.affiliation: The Sydney Head and Neck Cancer Institute, Australia.
authors.forename: Kan
authors.initials: K
authors.lastname: Gao
authors.affiliation: Central Clinical School, The University of Sydney, Australia.|The Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia.
authors.forename: Michael
authors.initials: M
authors.lastname: Boyer
authors.affiliation: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.|Department of Medical Genomics, Royal Prince Alfred Hospital, Sydney, Australia.|Central Clinical School, The University of Sydney, Australia.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: O'Toole
authors.affiliation: Central Clinical School, The University of Sydney, Australia.|The Sydney Head and Neck Cancer Institute, Australia.|The Department of Medical Oncology, Chris O'Brien Lifehouse, Sydney, Australia.
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Clark
authors.affiliation: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia.|Central Clinical School, The University of Sydney, Australia.
authors.forename: Ruta
authors.initials: R
authors.lastname: Gupta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D058534:Class I Phosphatidylinositol 3-Kinases / Q000235:genetics; D005154:Facial Nerve / Q000503:physiopathology; D005260:Female; D020558:GTP Phosphohydrolases / Q000235:genetics; D006801:Humans; D007150:Immunohistochemistry; D008207:Lymphatic Metastasis; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D009154:Mutation; D051057:Proto-Oncogene Proteins c-akt / Q000235:genetics; D016283:Proto-Oncogene Proteins p21(ras) / Q000235:genetics; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D011944:Receptors, Androgen / Q000235:genetics; D018987:Salivary Ducts / Q000473:pathology*; D012468:Salivary Gland Neoplasms / Q000175:diagnosis* / Q000235:genetics* / Q000473:pathology
chemical_list: D058534:Class I Phosphatidylinositol 3-Kinases; D020558:GTP Phosphohydrolases; D008565:Membrane Proteins; D051057:Proto-Oncogene Proteins c-akt; D016283:Proto-Oncogene Proteins p21(ras); D018719:Erb-b2 Receptor Tyrosine Kinases; D011944:Receptors, Androgen; C484760:PIK3CA protein, human; C508053:ERBB2 protein, human; C494918:AKT1 protein, human; C579846:NRAS protein, human; C501009:HRAS protein, human
keywords: androgen receptor; human epidermal growth factor receptor 2 (HER2) amplification; salivary duct carcinoma; somatic mutations; survival