Secretory Carcinoma
Secretory carcinoma was first described in children (1), but the majority of cases have been reported in adults (2). Reports have occurred of secretory carcinoma in children prior to age 5 (3) and in a 6-year-old boy (4). There is a dearth of cases of secretory carcinoma in girls ages 10 to 15 and with rare exceptions of two men, affected males have been younger than age 10 (5). The term “secretory” is preferable to “juvenile,” an appellation used in early descriptions of the tumor. The microscopic appearance of the lesion is the same, regardless of patient age.
In most cases, the patient has a painless, circumscribed mass that may have been present for years before biopsy (2,3). Coexistence of juvenile papillomatosis and secretory carcinoma has been reported (6). Estrogen receptors were negative in the majority of tumors with only a few lesions positive for estrogen and progesterone receptors (2).
Secretory carcinoma is usually a circumscribed, firm mass that may be lobulated, but, rarely, the tumor has infiltrative margins. The tumors tend to be 3 cm or less in diameter, with larger lesions up to 12 cm found mainly in adults. The lesions are typically unicentric and only rarely multicentric (7