ETV6-NTRK3-positive parotid mammary analogue secretory carcinoma: a case report.

INTRODUCTION: Mammary analogue secretory carcinoma (MASC) is a recent discovered entity of salivary glands tumors, reported for first time in 2010. The presence of a translocation encodes the ETS variant transcription factor 6-neurotrophic tyrosine receptor kinase (ETV6-NTRK3) gene fusion differences MASC from other tumors. CASE PRESENTATION: A 68-year-old male showed a non-painful right parotid enlargement, came from dermatology service, and followed by some facial squamous cell carcinomas. A computed tomography (CT) scan showed a 1.7×1.6 cm right parotid enlargement in superficial lobe. The patient underwent a right superficial parotidectomy. The final pathology confirmed the presence of ETV6-NTRK3-positive MASC. Complete right deep parotidectomy and functional cervical emptying were performed. DISCUSSIONS AND CONCLUSIONS: It is necessary to establish an appropriated differential diagnosis between salivary gland tumors. MASC is a low-grade malignancy cancer that sometimes can evolve to a high-grade tumor that might produce local and distance dissemination. Most times, these tumors are only treated by surgical resection and evaluating by a multidisciplinary team the need of more treatments. In our case, the patient showed a primary parotid tumor, removed surgically with free edges, and being identified as MASC. We decided to underwent neck dissection and discovered a second MASC focus on cervical salivary gland; however, there was no nodal dissemination. The patient remains disease-free after 14 months from last surgery. It is important to keep studying genetic therapy targets to ETV6-NTRK3 to obtain a new therapy line to treat those cases that require.

Déficit adquirido de Factor XIII como causa de hemorragia masiva con compromiso de vía aérea superior en cirugía oncológica de cavidad oral / Acquired Factor XIII deficiency as a cause of massive hemorrhage with upper airway compromise in oncological surgery of the oral cavity

El diagnóstico etiológico de una hemorragia postoperatoria persistente en pacientes adultos sin antecedentes médicos de interés supone un reto a día de hoy. Dentro de las distintas causas encontramos el déficit adquirido del Factor XIII (F. XIII) de la coagulación. El déficit de este factor suele pasar desapercibido al no ser valorado en el estudio preoperatorio rutinario. Presentamos el caso de un varón de 70 años con déficit de F. XIII adquirido, no diagnosticado previamente, que tras ser intervenido por un carcinoma epidermoide de suelo de boca sufrió un sangrado de cavidad oral y cervical bilateral con compromiso de la vía aérea. (AU)

The etiological diagnosis of persistent postoperative bleeding in adult patients with no relevant medical history is currently a challenge. Among the different causes, we find the acquired deficiency of Factor XIII (F. XIII) of coagulation. The deficit of this factor usually goes unnoticed as it is not tested in the routine preoperative studies. We present the case of a 70-year-old man with previously undiagnosed acquired F. XIII deficiency who, after undergoing surgery for squamous cell carcinoma of the floor of the mouth, suffered oral and bilateral cervical bleeding causing airway compromise. (AU)