Purpose

This retrospective study aimed to investigate the radiological features of head and neck mammary analogue secretory carcinoma (MASC) and systematically review previous publications and 11 new cases.

Methods

We included patients with pathologically proven MASCs with preoperative CT or MRI images, including 11 patients from our hospital and 29 patients from 28 publications extracted after screening 645 abstracts. Two board-certified radiologists reviewed and evaluated all radiological images. The frequency of metastasis during the follow-up period in tumors with well- and ill-defined margins was compared using a Fisher’s exact test.

Results

The median age at diagnosis was 52.5 years (range, 7–78 years; 20 males). Of the 40 patients, those in their 50 s were the most common (10/40, 25.0%), and the main tumor site was the parotid gland (27/40, 42.5%). Characteristic radiological features included high intensity on T1WI in the cystic components and tumors frequently showed “papillary and cystic,” which showed a projection into the cystic components, or “non-papillary and cystic” morphology, which did not show projection of the solid components. Tumor metastasis was found in 10/35 patients (28.6%) during the follow-up period, with a significant difference in frequency between the tumors with well- and ill-defined margin (well-defined (4/26) vs. ill-defined (6/9); P = 0.0074).

Conclusion

MASCs are newly recognized malignant tumors. Characteristic T1WI high intensity on MRI and predominant cystic morphology may reflect its unique histological profile. Ill-defined tumor margin status was related to frequent metastasis. Awareness of these characteristic radiological features can assist radiologists in better detection of this novel entity.

中文翻译：

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头颈部乳腺类似物分泌性癌的放射学特征：11 例新病例，对 28 篇出版物报道的 29 例病例进行系统评价

目的

这项回顾性研究旨在调查头颈部乳腺类似物分泌性癌 (MASC) 的放射学特征，并系统地回顾以前的出版物和 11 例新病例。

方法

我们纳入了术前 CT 或 MRI 图像经病理证实 MASC 的患者，其中包括来自我们医院的 11 名患者和来自 645 篇摘要筛选后提取的 28 篇出版物中的 29 名患者。两名获得委员会认证的放射科医师审查并评估了所有放射影像。使用Fisher精确检验比较具有明确和不明确边缘的肿瘤在随访期间的转移频率。

结果

诊断时的中位年龄为 52.5 岁（范围，7-78 岁；20 名男性）。40例患者中，以50多岁最常见（10/40，25.0%），主要肿瘤部位为腮腺（27/40，42.5%）。特征性影像学特征包括囊性成分的 T1WI 高强度，肿瘤常表现为“乳头状和囊性”，显示向囊性成分的投射，或“非乳头状和囊性”形态，不显示实性成分的投射. 在随访期间，10/35 患者 (28.6%) 发现肿瘤转移，边缘明确和边缘不明确（明确 (4/26) 与不明确）的肿瘤之间的频率存在显着差异。定义 (6/9)；P  = 0.0074)。

结论

MASCs是新发现的恶性肿瘤。MRI 上特征性的 T1WI 高强度和主要的囊性形态可能反映了其独特的组织学特征。不明确的肿瘤边缘状态与频繁转移有关。了解这些特征性放射学特征可以帮助放射科医生更好地检测这种新实体。