{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T05:05:41Z","timestamp":1780031141407,"version":"3.53.1"},"reference-count":18,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T00:00:00Z","timestamp":1780012800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Secretory carcinoma (SC) of the parotid gland is an extremely rare malignant neoplasm in childhood. Given its close clinical and imaging similarities to pleomorphic adenoma, as well as the high potential for diagnostic inaccuracies in fine-needle aspiration cytology (FNAC), preoperative diagnosis is often clinically challenging. Pediatric patients with salivary gland tumors are frequently misdiagnosed, which may lead to unfavorable clinical consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>\n                      A 12-year-old male presented with an asymptomatic left parotid mass of 6 months\u2019 duration. Preoperative fine-needle aspiration cytology was suggestive of pleomorphic adenoma. Magnetic resonance imaging (MRI) demonstrated a well-circumscribed nodule measuring 2.5\u00a0cm in maximum diameter. Intraoperative frozen section favored a low-grade malignant salivary gland tumor. The patient underwent superficial parotidectomy with functional neck dissection (levels I-III). Histopathological examination revealed the following characteristic features of the tumor: small, monomorphic epithelial cells with eosinophilic cytoplasm abundant in secretory granules; frequent microcystic or follicular architectures containing secretory material within the cystic lumina. Additionally, localized high-grade morphological features were identified, including solid areas accounting for more than 30%, nuclear enlargement with prominent nucleoli, discernible mitotic figures, and tumor giant cells. Periodic acid-Schiff (PAS) staining revealed positive secretions rich in glycogen and mucin. Immunohistochemically, the tumor cells were positive for CK19, S100, SOX10, and Mammaglobin. No perineural or lymphovascular invasion was identified. Fluorescence\n                      <jats:italic>in situ<\/jats:italic>\n                      hybridization (FISH) confirmed the presence of an\n                      <jats:italic>ETV6::NTRK3<\/jats:italic>\n                      gene fusion. Postoperative recovery was uneventful. Multidisciplinary team (MDT) discussion concluded that adjuvant therapy was unnecessary. At 29 months of follow-up, the patient remained disease-free with no evidence of recurrence, preserved facial nerve function, and no radiological signs of residual or recurrent disease.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>We reported a rare case of non-metastatic parotid SC with high-grade components in a child, which was successfully managed by surgical resection alone. Preoperative clinical manifestations, imaging findings, and FNAC collectively suggested a diagnosis of pleomorphic adenoma. Intraoperative frozen section examination indicated a pathological diagnosis of low-grade malignant salivary gland tumor. Thus, comprehensive histopathological and molecular analyses are essential, as the morphological features of this tumor may be deceptively bland.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1797821","type":"journal-article","created":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:56:21Z","timestamp":1780030581000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: A rare pediatric case of secretory carcinoma of the parotid gland with high-grade components misdiagnosed as pleomorphic adenoma"],"prefix":"10.3389","volume":"16","author":[{"given":"Li","family":"Xu","sequence":"first","affiliation":[{"name":"Department of Pathology, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huihua","family":"He","sequence":"additional","affiliation":[{"name":"Department of Pathology, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Honglin","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Pathology, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongfei","family":"Tang","sequence":"additional","affiliation":[{"name":"Department of Pathology, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingping","family":"Yuan","sequence":"additional","affiliation":[{"name":"Department of Pathology, Renmin Hospital of Wuhan University","place":["Wuhan, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,5,29]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.4317\/medoral.26983","article-title":"Epithelial salivary gland neoplasms in pediatric patients: a comprehensive review","volume":"30","author":"P\u00e9rez-de-Oliveira","year":"2025","journal-title":"Med Oral Patol Oral Cir Bucal"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1111\/jop.13151","article-title":"Clinicopathological analysis and survival outcomes of primary salivary gland tumors in pediatric patients: a systematic review","volume":"50","author":"Louredo","year":"2021","journal-title":"J Oral Pathol Med"},{"key":"B3","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1007\/s12105-025-01813-y","article-title":"Secretory carcinoma in a labial minor salivary gland of a pediatric patient","volume":"19","author":"de Melo","year":"2025","journal-title":"Head Neck Pathol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1007\/s00795-013-0051-y","article-title":"A rare Malignancy of the parotid gland in a 13-year-old Taiwanese boy: case report of a mammary analogue secretory carcinoma of the salivary gland with molecular study","volume":"47","author":"Hwang","year":"2014","journal-title":"Med Mol Morphol"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1016\/j.radcr.2020.05.035","article-title":"MR imaging findings of a rare pediatric parotid tumor: mammary analogue secretory carcinoma","volume":"15","author":"Helmy","year":"2020","journal-title":"Radiol Case Rep"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.oooo.2020.04.007","article-title":"A systematic review of secretory carcinoma of the salivary gland: where are we","volume":"132","author":"Alves","year":"2021","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1080\/15513815.2022.2116621","article-title":"A parotid gland mammary analogue secretory carcinoma in a 4-year-old boy: case report and literature review","volume":"42","author":"Meng","year":"2023","journal-title":"Fetal Pediatr Pathol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.jormas.2024.102096","article-title":"Salivary gland secretory carcinoma: a case presentation in minor salivary gland with review","volume":"126","author":"de Souza Tolentino","year":"2025","journal-title":"J Stomatol Oral Maxillofac Surg"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.07.004","article-title":"A systematic review including an additional pediatric case report: pediatric cases of mammary analogue secretory carcinoma","volume":"100","author":"Ngouajio","year":"2017","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1002\/lary.31123","article-title":"Salivary gland secretory carcinoma; review of 13\u2009years world-wide experience and meta-analysis","volume":"134","author":"Yosefof","year":"2024","journal-title":"Laryngoscope"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000002043","article-title":"Salivary gland secretory carcinoma: clinicopathologic and genetic characteristics of 215 cases and proposal for a grading system","volume":"47","author":"Ban\u011b\u010dkov\u00e1","year":"2023","journal-title":"Am J Surg Pathol"},{"key":"B12","doi-asserted-by":"publisher","first-page":"59","DOI":"10.1177\/10935266221138706","article-title":"A pediatric case of high-grade secretory carcinoma of the maxillary sinus with ETV6::NTRK3 gene fusion, therapeutic implications, and review of the literature","volume":"26","author":"Cardoni","year":"2022","journal-title":"Pediatr Dev Pathol"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1159\/000522208","article-title":"Fine-needle aspiration biopsy of pediatric salivary gland tumors: analysis of patient tolerability, sedation requirement, and procedural complication","volume":"66","author":"Wang","year":"2022","journal-title":"Acta Cytol"},{"key":"B14","doi-asserted-by":"publisher","first-page":"796","DOI":"10.1007\/s12105-021-01288-7","article-title":"Clinicopathologic and molecular characterization of four cases of pediatric salivary secretory carcinoma (SSC), one with ETV6-RET fusion","volume":"15","author":"Salgado","year":"2021","journal-title":"Head Neck Pathol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1016\/j.annpat.2024.02.005","article-title":"Tumeurs des glandes salivaires: OMS 2022 et au-del\u00e0","volume":"44","author":"Charles L\u00e9pine","year":"2024","journal-title":"Annales Pathologie"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1097\/PAS.0000000000001535","article-title":"Expanding the molecular spectrum of secretory carcinoma of salivary glands with a novel VIM-RET fusion","volume":"44","author":"Sk\u00e1lov\u00e1","year":"2020","journal-title":"Am J Surg Pathol"},{"key":"B17","doi-asserted-by":"publisher","first-page":"792","DOI":"10.1002\/hed.26971","article-title":"Prognostic factors in mammary analogue secretory carcinomas of the parotid gland: systematic review and meta-analysis","volume":"44","author":"Janik","year":"2022","journal-title":"Head Neck"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1002\/hed.27346","article-title":"Real\u2010world experience of tropomyosin receptor kinase inhibition with entrectinib in ETV6\u2010NTRK3 positive metastatic salivary secretory carcinoma: a case series","volume":"45","author":"Yokota","year":"2023","journal-title":"Head Neck"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1797821\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T04:56:46Z","timestamp":1780030606000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1797821\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,29]]},"references-count":18,"alternative-id":["10.3389\/fonc.2026.1797821"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1797821","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,29]]},"article-number":"1797821"}}