title: Diagnostic and prognostic utility of Mastermind-like 2 (MAML2) gene rearrangement detection by fluorescent in situ hybridization (FISH) in mucoepidermoid carcinoma of the salivary glands.
abstract: OBJECTIVE
  Mucoepidermoid carcinoma (MEC) is the most common salivary gland malignancy, with a proportion harboring MAML2 rearrangement. This study evaluates the diagnostic and prognostic utility of MAML2 rearrangement in MEC.
  
  
  METHODS
  Salivary gland malignancies at a single institution (1989-2014) were reviewed to identify MECs. Histopathologic evaluation, immunohistochemistry, and fluorescent in situ hybridization (FISH) were performed.
  
  
  RESULTS
  Forty-one cases of MEC were identified, with mean age of 47 years and mean tumor size of 21 mm. Seven locoregional recurrences and five MEC-related deaths were seen over a 22-year follow-up period. Thirty-eight cases were suitable for FISH, and 31 (82%) cases were positive for MAML2 rearrangement, including the oncocytic and clear cell variants of MEC. FISH was negative in the morphologic mimics of MEC. MAML2 rearrangement was significantly associated with longer survival.
  
  
  CONCLUSIONS
  MAML2 rearrangement is common and specific for MEC, which makes it a useful diagnostic tool. MAML2 rearrangement also predicts a favorable prognosis.
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: The Sydney Head and Neck Cancer Institute, Sydney, Australia.
authors.forename: James
authors.initials: J
authors.lastname: Wykes
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: University of New South Wales, Sydney, Australia.
authors.forename: Jessica
authors.initials: J
authors.lastname: Tay
authors.affiliation: The Sydney Head and Neck Cancer Institute, Sydney, Australia.
authors.forename: Kan
authors.initials: K
authors.lastname: Gao
authors.affiliation: The Sydney Head and Neck Cancer Institute, Sydney, 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: Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney, Australia; Central Clinical School, The University of Sydney, Sydney, Australia; Chris O'Brien Lifehouse, Sydney, Australia.
authors.forename: Sandra A
authors.initials: SA
authors.lastname: O'Toole
authors.affiliation: The Sydney Head and Neck Cancer Institute, Sydney, Australia; University of New South Wales, Sydney, Australia; Central Clinical School, The University of Sydney, Sydney, Australia; 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, Sydney, Australia; Chris O'Brien Lifehouse, Sydney, Australia. Electronic address: Ruta.Gupta@sswahs.nsw.gov.au.
authors.forename: Ruta
authors.initials: R
authors.lastname: Gupta
mesh_terms: D018277:Carcinoma, Mucoepidermoid / Q000235:genetics* / Q000473:pathology; D004268:DNA-Binding Proteins / Q000235:genetics*; D005260:Female; D015321:Gene Rearrangement; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000235:genetics*; D011379:Prognosis; D012468:Salivary Gland Neoplasms / Q000235:genetics* / Q000473:pathology; D015996:Survival Rate; D015534:Trans-Activators; D014157:Transcription Factors / Q000235:genetics*
chemical_list: D004268:DNA-Binding Proteins; C471297:MAML2 protein, human; D009687:Nuclear Proteins; D015534:Trans-Activators; D014157:Transcription Factors