Abstract: Objective: To discuss the clinical manifestations, imaging features, pathological features, differential diagnoses, treatment methods, and prognosis of secretory carcinoma of salivary gland (SCSG). Methods: A total of 14 SCSG patients admitted to the Department of Oral and Maxillofacial Surgery, Henan Provincial People’s Hospital from February 2018 to August 2024 were enrolled. Clinical data were retrospectively analyzed, and a comprehensive analysis and discussion were carried out. Results: Fourteen patients were included (12 males and 2 females), aged 15-64 years (mean age 48.4 years). The disease duration ranged from 2 months to 26 years. Tumor locations included the parotid gland (10 cases), submandibular gland (1 case), hard palate (1 case), and lip (2 cases). Tumor diameters ranged from 1.5 to 7.8 cm. All patients underwent surgical resection. Immunohistochemical analysis revealed strong diffuse positivity for Cytokeratin 7 (CK7), S-100 protein (S-100), and GATA binding protein 3 (GATA3) in all cases. The Ki67 proliferation index ranged from 5% to 30%, and Ets variant 6 (ETV6) rearrangements were detected in 6 cases. Lymph node metastasis was observed in 2 cases (14.3%). Postoperative interventions included radiotherapy/chemotherapy (1 case), radiotherapy alone (1 case), and radioactive particle implantation (3 cases). During follow-up until December 2024, recurrence was observed in 1 case. Conclusion: SCSG is a rare low-grade malignant salivary gland tumor with a favorable prognosis. The clinical manifestations and imaging features are not specific. Diagnosis mainly depends on characteristic histopathology, immunohistochemistry, and molecular detection. Prophylactic cervical lymph node dissection is unnecessary in the absence of confirmed metastasis. Targeted therapy against ETV6 rearrangements may represent a novel therapeutic avenue.

Key words: secretory carcinoma of salivary gland, mammary analogue secretary carcinoma of salivary gland, immunohistochemistry, ETV6