Very rare cases of high-grade show solid growth, tumor necrosis, and multiple mitotic figures. Immunohistochemical panel of S-100, mammaglobin, and DOG1 distinguishes SC from acinic cell carcinoma [13]. SC shows a diffuse and strong expression of pancytokeratins (AE1-AE3 and CAM 5.2), CK7, CK8, CK18, CK19, epithelial membrane antigen, S-100 protein, MUC4, SOX10 and mammaglobin [13-14]. The gene discussed is KRT18; the disease is acinar cell carcinoma.