Secretory carcinoma of minor salivary glands.

Secretory carcinoma is a malignant salivary gland tumor, which typically presents as an indolent painless mass within the parotid gland. Involvement of minor gland is reported but less common. Secretory carcinoma was often misclassified as other salivary gland mimics and in particular, acinic cell carcinoma prior to 2010. It was first recognized by Skalova et al. as a molecularly distinct salivary gland tumor harboring the same fusion gene as well as histological and cytogenetic features seen in juvenile breast cancer. Secretory carcinoma is generally managed as other low-grade salivary gland neoplasms and has a favorable prognosis; however, high-grade transformation requiring aggressive therapeutic interventions have been documented. Recent studies of biological agents targeting products of this fusion gene offer the promise of a novel therapeutic option for treatment of this malignancy Due to limited number of reported cases, the spectrum of clinical behavior, best practices for management and long-term treatment outcomes for secretory carcinoma remain unclear. We report a long-standing secretory carcinoma involving minor salivary glands of the mucobuccal fold, which was detected years after it was first noted by the patient. This case brings to light the importance of a thorough clinical exam during dental visits and reviews diagnostic differentiation of this malignancy from other mimics and discusses decision making for its management.