Does Lack of EWSR1-ATF1 Fusion Exclude Diagnosis of Salivary Gland Clear Cell Carcinoma?

Sibel Sensu, Nusret Erdogan, Kayhan Basak, Egzona Qipa, Murat Buyukdogan

Abstract


Introduction: Ewing sarcoma breakpoint region 1- activating transcription factor 1 (EWSR1-ATF1) fusion is mentioned as a diagnostic marker in favor of clear cell carcinoma in the differential diagnosis of clear cell neoplasms of salivary glands. However, in literature, its positivity is reported between 82% and 93%. In salivary glands, various benign and malignant primary tumors, as well as odontogenic neoplasms and metastatic cases, present with a varied number of clear cells. Clear cell carcinoma of the salivary gland is a rare entity with distinct histochemistry and immunohistochemistry features.

Case Presentation: We present a clear cell carcinoma of the salivary gland showing cytoplasmic Periodic acid–Schiff (PAS) (+), mucin (-) staining, cytokeratin (CK), CK7, and P63 immunoreactivity without EWSR1-ATF1 fusion.

Conclusions: We conclude that clinical, morphological, and immunohistochemical analyses should be the guide for diagnosis even though molecular analysis does not support it.


Keywords


clear cell carcinoma, ESWR1-ATF1, immunohistochemistry, salivary gland

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DOI: 10.33371/ijoc.v15i3.795

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