Case Report: A rare pediatric case of secretory carcinoma of the parotid gland with high-grade components misdiagnosed as pleomorphic adenoma

Category	Detail
Condition	High-Grade Secretory Carcinoma of the Parotid Gland
Key Mechanisms	ETV6::NTRK3 gene fusion associated with translocation t(12;15)(p13;q25)
Target Population	Pediatric patients, particularly those under 16 years of age
Care Setting	Pediatric oncology and surgical settings

Secretory carcinoma is an extremely rare malignant neoplasm in children, accounting for less than 1% of salivary gland cancers.
Preoperative diagnosis is challenging due to similarities with pleomorphic adenoma.
Intraoperative frozen section suggested a low-grade malignant tumor.
Histopathological examination revealed high-grade features and positive immunohistochemical markers.
Patient remained disease-free at 29 months follow-up after surgical resection.

Comprehensive histopathological and molecular analyses are essential for accurate diagnosis.

Surgical resection is the primary treatment; adjuvant therapy may not be necessary in localized cases.

Misdiagnosis can lead to inappropriate management and unfavorable clinical outcomes.

Children with salivary gland tumors, particularly those misdiagnosed with pleomorphic adenoma.

Surgical resection alone may be sufficient for localized high-grade secretory carcinoma.

Utilize fine-needle aspiration cytology cautiously due to potential for misdiagnosis.
Involve a multidisciplinary team for complex cases.
Consider intraoperative frozen section for real-time pathological assessment.

Clinical Scorecard: Pediatric Case Study: Misdiagnosis of High-Grade Secretory Carcinoma of the Parotid Gland as Pleomorphic Adenoma