Salivary duct carcinoma: clinicopathologic features, morphologic spectrum, and somatic mutations

Peter P. Luk, Jared D. Weston, Bing Yu, Christina I. Selinger, Rafael Ekmejian, Timothy J. Eviston, Trina Lum, Kan Gao, Michael Boyer, Sandra A. O'Toole, Jonathan R. Clark, Ruta Gupta*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

50 Citations (Scopus)

Abstract

Background 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. Methods 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. Results 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%. Conclusion Salivary duct carcinoma demonstrates a wide histopathologic spectrum. Treatment strategies need to take androgen receptor, HER2 amplification, and PIK3CA mutation into account.

Original languageEnglish
Pages (from-to)E1838-E1847
Number of pages10
JournalHead and Neck
Volume38
Issue numberS1
DOIs
Publication statusPublished - 1 Apr 2016
Externally publishedYes

Keywords

  • androgen receptor
  • human epidermal growth factor receptor 2 (HER2) amplification
  • salivary duct carcinoma
  • somatic mutations
  • survival

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