Low grade mucoepidermoid carcinoma in left parotid of 51 year old woman. Herein we report the morphological features of myoepithelial carcinoma in a 74yearold female clinically presenting with a parotid mass. An immunohistochemical panel for reliable differentiation. Tumor shows blue squamoud differentiation with cystic dilatation. Clinical characteristics, therapy and prognosis of parotid acinar cell. With prompt diagnosis and adequate treatment, the prognosis is generally improved. Tests that examine the head, neck, and the inside of the mouth are. More than half of these cases involve the major salivary glands, primarily the parotid glands. Squamous cell carcinoma adenocarcinoma undifferentiated carcinoma high grade mucoepidermoid carcinoma salivary duct carcinoma 18.
Mucoepidermoid carcinoma mec is a malignant epithelial neoplasm composed of varying proportions of mucous, epidermoid, intermediate, columnar, and clear cells and often demonstrates prominent cystic growth. Mucoepidermoid carcinoma is the most common malignant tumor of salivary gland. The aim of this report is to present a case of mucoepidermoid carcinoma of the. Objective to determine clinical and histopathologic features of mucoepidermoid carcinoma of the parotid gland, specifically, the relation of tumor stage and grade and treatment type with clinical outcome. The purpose of this study was to examine how patient demographics and tumor characteristics affect overall survival. Epithelial myoepithelial carcinoma of parotid gland. Clinical and radiological findings often mimic a benign tumor. The deep and diffuse distribution of salivary glands in the soft tissue of the head and neck region is one common limitation to the early diagnosis of pleomorphic adenoma pa from those glands. Mucoepidermoid carcinoma is a tumor that usually occurs in the salivary glands.
Squamous cell carcinoma scc originating in the parotid gland is a rare, often aggressive malignancy which makes up 0. Parotid tumor metastasis to the spleen is extremely rare. Because of rarity of emc a standard treatment guideline is not yet known. Among the major salivary glands, the parotid gland is most commonly involved. These nodules appear to arise within the parotid but are discrete from salivary tissue. It can mimic most other tumors of the glands, and therefore is often considered in the differential. Squamous component with round to spindled cancer cells. A 21 year old female presented in our hospital with a painless swelling in the left parotid region simulating a parotid gland tumor.
Approximately 66% of these tumors occur in a part of the salivary gland, known as the parotid gland. Mucoepidermoid carcinoma can also be found in other organs, such as bronchi, lacrimal sac, and thyroid gland. Complete excision superficial or total parotidectomy with preservation of facial nerve is the treatment of choice. Lowgrade mec tends to have an excellent prognosis, although recurrence of the disease is possible. It is a rapidly advancing lesion which, if not recognised and treated early, results in high morbidity and. Fine needle aspiration cytology fnac of the swelling was suggestive of pleomorphic adenoma. It is most commonly found in the major salivary glands parotid but may also present in the minor salivary glands. Mucoepidermoid carcinoma is the most common parotid malignancy, with an incidence rate of 2.
They are predominantly found in the parotid gland and represent approximately 1% of salivary gland tumours. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. It can also occur in other organs such as the thyroid, bronchi and lacrimal sac. The treatment for mucinous adenocarcinoma of salivary gland involves a combination of surgery, chemotherapy, and radiation therapy.
Given its rarity, epidemiologic data and data on the management of primary parotid scc are limited. The majority 75% of salivary gland tumors occur in the parotid gland, and while benign lesions are more common, mucoepidermoid carcinoma mec makes up 4050% of malignant parotid gland tumors. Mucoepidermoid carcinoma of parotid gland salman alkhalifa, frcs, dlo1 noor yousif abdulkarim, md, msc ucl2 fatima n abulfateh, md1 1king hamad university hospital, 2bdf hospital abstract objective. Cancer in the salivary gland is called salivary gland cancer. Case report salivary duct carcinoma originating in the right. The initial tumour was a pleomorphic adenoma with epithelial and myoepithelial elements. Sclerosing mucoepidermoid carcinoma of the salivary gland smec is a rare subtype of mucoepidermoid carcinoma mec, first described in 1987 by chan and saw. Intramedullary spinal cord metastasis from parotid gland carcinoma. We present a case of pilomatrixoma in the parotid region mimicking mucoepidermoid carcinoma on aspiration cytology.
An unusual presentation of mucoepidermoid carcinoma of the. Signs of salivary gland cancer include a lump or trouble swallowing. Salivary duct carcinoma sdc is a rare and aggressive malignant tumor that frequently arises in the major salivary glands. A rectangular piece of firm tissue measuring 85x40x30mm. Epithelialmyoepithelial carcinoma of the parotid gland. Squamous cell carcinoma involving the parotid gland is an aggressive and rapidly advancing lesion which if not recognized and treated early will result in a high morbidity and mortality. Case report case study of a parotid gland adenocarcinoma. We present an unusual case of mucoepidermoid carcinoma of the parotid gland in which the patient reported the presence of the lesion since childhood and initially suspected to represent a first branchial cleft cyst. Cases were excluded when the patient file was not located, when information.
Myoepithilial carcinoma is a rare tumor of small salivary glands most usually located in the parotid gland. We present a case of a 40yearold male with a history of parotid gland carcinoma ex pleomorphic adenoma. Mucoepidermoid carcinoma of the parotid gland is very rare in children. Mucoepidermoid carcinoma of salivary glands usually metastasizes.
Primary squamous cell carcinoma of the parotid gland is a rare aggressive malignancy. Although known to occur in submandibular gland and minor salivary glands, its most common location is parotid. A rare case of mucoepidermoid carcinoma of parotid with. Subsequently the tumour recurred twice and was characterised by invasion of the mandible.
Mucoepidermoid carcinoma of the salivary gland is one of the differential diagnoses. The tumor shows wide morphologic and cytologic diversity in a similar way to its benign counterpart, myoepithelioma, with evidence of malignant change. Myoepithelial carcinomas exhibit a wide spectrum of cytomorphologic features and diverse clinical outcomes. Mucoepidermoid carcinoma of the soft palate salivary gland. Case report primary parotid adenocarcinoma metastasis to the. Mucoepidermoid carcinoma of salivary glands radiology. Bulbar conjunctival metastasis from mucoepidermoid. Get detailed information about the treatment for newly diagnosed and recurrent salivary gland cancer in this summary for clinicians. Pdf sclerosing mucoepidermoid carcinoma of the parotid gland. The most common malignant salivary gland tumors include adenoid cystic carcinoma acc, mucoepidermoid carcinoma, secretory carcinomas, acinic cell carcinoma, and various adenocarcinoma histologies, including salivary ductal carcinoma. Postoperative radiation therapy for parotid mucoepidermoid. Mucoepidermoid carcinoma is the most frequently diagnosed malignancy of the salivary gland. Garrett griffin of midwest ear nose and throat and midwest facial plastic surgery, respectively, have joined forces to improve outcomes for patients with benign and malignant tumors of the parotid gland. Mucoepidermoid carcinoma is the most common type of minor salivary gland malignancy in adults.
Majority of the salivary gland tumors arise in parotid gland with maximum. As surgical method, superficial parotidectomy was applied to. Mucoepidermoid carcinoma incidence is about 16% of minor salivary gland tumours, second to adenoid cystic carcinoma. Epithelial myoepithelial carcinoma emc is a rare biphasic tumor of salivary glands with low malignant potential. Which surgical method is superior for the treatment of parotid tumor.
The purpose of this study was to correlate mr imaging and histopathology of parotid gland oncocytomas and to define the features that may distinguish these neoplasms from other benign and malignant parotid gland tumors. The major differential diagnosis of myoepithelioma is from pleomorphic adenoma. Mucoepidermoid carcinoma what is, treatment, survival. Mucoepidermoid carcinoma arising in warthins tumor of the. Epithelial myoepithelial carcinoma emec is a tumor composed of variable proportions of two cell types that typically form duct like structures. Mucoepidermoid carcinoma the salivary glands are those glands whose primary function is to produce saliva. Mucoepidermoid carcinoma is the most common type of salivary gland cancer in adults. Epithelialmyoepithelial carcinoma of parotid a rare case report. An epithelial myoepithelial carcinoma in parotid gland. Squamous cell carcinoma of the parotid gland request pdf. With over 4400 patients, this is the largest study of patients with mec of the parotid gland. We utilized tissue microarrays with 78 examples of mucoepidermoid carcinoma and 47 salivary duct carcinomas to evaluate the utility of an immunohistochemical panel consisting of androgen receptor, her2neu, p63, and cytokeratin 56 in distinguishing these entities.
Although mucoepidermoid carcinoma mec accounts for parotid gland and the secondmost common malignant tumor of the submandibular gland, after adenoid cystic carcinoma. Upon sectioning, the specimen is comprised of normal appearing salivary tissue with well circumscribed white nodules scattered throughout. Mucoepidermoid carcinoma of the parotid gland in children. Our patient, a 46yearold female, presented with a left parotid mass of 20year duration. Parotid gland squamous cell cancer scc occurs as metastasis from cutaneous scc or primary malignancy scc is the second most common parotid malignancy, and its incidence is increasing. Histological examination of the second recurrence showed a malignant spindle cell. Mucoepidermoid carcinoma mec is the most common malignancy of the major and minor salivary glands, comprising 34% of salivary gland malignancies. Salivary gland cancer is a rare disease in which malignant cancer cells form in the tissues of the salivary glands. Neck not addressed by surgery to include level ibiv tmg consensus for elective nodal irradiation 1 high grade histolgy 2 t3t4 disease 3 histology. I had a mucoepidermoid carcinoma of the parotid at age 17 in 1978. Myoepithelial carcinoma malignant myoepithelioma is a rare salivary gland tumor composed entirely of myoepithelial cells that exhibit a dual epithelial and smooth muscle phenotype. Mucoepidermoid carcinoma genetic and rare diseases. The parotid gland is the largest salivary gland, located in front of the ear. The hallmark of the histology of epithelialmyoepithelial carcinoma emc is the presence of a regular repetitive mixture of bilayered ductlike structures with an outer layer of myoepithelial cells and inner ductal epithelial cells.
A myoepithelial carcinoma, a rare malignant salivary gland neoplasm, arose in a pleomorphic adenoma of the parotid gland. Myoepithelial carcinoma malignant myoepithelioma of the. About 200 cases have been reported in the english literature. Who gets mucinous adenocarcinoma of salivary gland. Mucoepidermoid carcinoma mec is the most common primary salivary gland malignancy, accounting for approximately 25% of all malignancies. Parotid, parotidectomy, radiotherapy 1 introduction parotid squamous cell carcinoma scc is e ither primary, when another primary site of origin is unknown or when it is not present in parotidean lymph nodes, or metastatic. Salivary duct carcinoma is a highly aggressive salivary gland malignancy that may be misdiagnosed as highgrade mucoepidermoid carcinoma. Salivary gland cancer treatment options include surgery with or without postoperative radiation therapy, radiation therapy, and chemotherapy. As a result of their morphologic heterogeneity, they can be confused easily with many tumours.
Epithelialmyoepithelial carcinoma of parotid a rare. Myoepithelial carcinoma is a rare malignant cancerous tumor that usually occurs in the salivary glands in the mouth, but can also occur in skin and soft tissues. Mucoepidermoid carcinoma of the parotid gland, cancer 10. Treatment and survival outcomes based on histologic. I did have an unrelated tumor type on my left clavicle at age 20, but have been cancerfree since 1981.
An unusual presentation of mucoepidermoid carcinoma of the parotid gland author. Salivary gland neoplasms may be benign or malignant, and malignant tumors can be primary or metastatic. Primary scc originating in the parotid is a rare and aggressive tumor, with reported incidence of only 0. Mec can also involve a variety of other sites that have minor mucoserous glands. We here describe a case of epithelialmyoepithelial carcinoma emc of the parotid gland, a low grade malignant tumor, with spread to an intraparotid lymph node and with ct and mri findings mimicking a benign lesion. Salivary duct carcinoma of the parotid gland is an uncommon tumor, highly aggressive. The most often detected malignant neoplasm was mucoepidermoid carcinoma with 6 43% cases. Clinical stage and histologic grade are the main prognostic factors. Being exposed to certain types of radiation may increase the risk of salivary cancer. Epithelialmyoepithelial carcinoma emc is a rare tumor of salivary gland which presented in a 65 year old female as a swelling behind the right ear. Dedifferentiation is defined as highgrade malignant tumor development out of a lowgrade malignant tumor. Clear cell change in the myoepithelial component is common, but clearing of both cell types, giving an impression of a monocellular neoplasm, is rare. Epithelialmyoepithelial carcinoma emca is a rare malignant tumour that typically arises in a salivary gland and consists of both an epithelial and myoepithelial component.
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