However, unlike cellular pa, the stroma in a bca does not blend into the. Myoepithelioma of the head and neck a usually benign tumor of the headneck consisting of solely myoepithelial cells. Salivary gland myoepithelioma with focal capsular invasion. Myoepithelioma me is a benign salivary gland tumor composed almost exclusively of sheets, islands, or cords of cells with myoepitheliomal differentiation. Immunohistochemical analysis of salivary gland tumors ncbi.
Two cases of myoepithelioma occurring in the parotid gland were reported. Epithelialmyoepithelial carcinoma of the parotid gland. The study comprised six female and four male patients aged 1463 years mean age 38. Rare primary lesions that have been known to metastasize to the skin include an adenoid cystic carcinoma, an acinic cell carcinoma, a myoepithelial carcinoma, and adenocarcinoma of the salivary gland, 365370 an adenoid cystic carcinoma of the lacrimal gland, 371 an ameloblastoma, 372 a thymoma, 373 an adrenal carcinoma, 374,375 a pheochromocytoma, 376 and carcinomas of the. Myoepitheliomas are rare benign neoplasias of the salivary gland, more commonly found in the parotid1,2, being responsible for less than 7% of salivary gland. Myoepithelioma of the salivary gland was formally categorized as a salivary neoplasm in 1991 2,3. Myoepithelioma is a rare neoplasm of the salivary glands, generally occurring in the parotid gland and less often in the minor accessory salivary gland of the oral. Myoepitheliomas mes are rare tumors of the parotid gland. The diagnosis is rendered histopathologically, and it includes the.
It can be present in individuals of a wide age range including children and adults the cause of formation of salivary gland myoepithelioma is not wellunderstood, although certain chromosomal alterations and gene mutations have been identified, based on the cases studied. Myoepithelial carcinoma malignant myoepithelioma of the parotid. These tumors consisted of spindle cells that exhibited an arrangement similar to leiomyoma or fibroma. Myoepithelioma of minor salivary gland of cheek cytology description nuclear grooves, intranuclear cytoplasmic inclusions, nuclear striations zebra lines, myxoid matrix. The tumor is composed exclusively of myoepithelial cells that show spindle, plasmacytoid, and clear cell morphology. Myoepithelial cells mec are found in the secretory units of many mammalian exocrine glands such as mammary, sweat, lacrimal and salivary glands. Mar 27, 2018 myoepithelioma of salivary gland is an uncommon benign tumor typically arising in the major salivary glands. Salivary gland myoepithelial cell pleomorphic adenoma minor salivary gland major salivary gland these keywords were added by machine and not by the authors. Myoepithelioma of a minor salivary gland of the cheek. To the best of our knowledge, such an association has never been reported in the literature. Myoepithelioma is a rare benign tumor of the salivary glands and is usually seen in the parotid gland and the minor salivary glands. Myoepitheliomas are very rare tumurs of the salivary glands constituting less than 1. Pdf myoepithelioma of a minor salivary gland of the.
Tumour cells were positive for cytokeratins, and in minor intraoral salivary glands. Nov 18, 2016 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. Myoepithelioma is a rare but wellcharacterized group of tumours, among which myoepithelioma of the salivary glands is the best known. Malignant myoepithelioma of salivary gland is very rare, accounting for only 0. Original article, clinical report by ear, nose and throat journal. The cystic lesion has a mildly fibrotic appearing wall, is lined by histiocytes intermixed with rare lymphocytes, and contains mucous and macrophages. Myoepithelioma of minor salivary glands a diagnostic. Malignant myoepithelioma of the parotid gland wiley online library. These tumors can occur in most of the glandular structures like salivary glands, breast and sweat glands of the skin. Original research myoepithelioma of the p arotid gland.
The lesions were clinically suspected to be epidermal cyst. We report two patients with myoepithelioma of parotid gland presenting as infraauricular subcutaneous mass. This tumour may be particularly locally aggressive, but its clinical and biological features are not yet fully understood. Primary myoepithelioma of the testis a case report. Myoepithelioma definition of myoepithelioma by medical. Eleven months after the completion of the radiotherapy treatment the patient died as a result of undercurrent heart disease, without any.
Hamperl defined tumors containing mainly myoepithelial cells that are composed of three morphologic types. Approximately 66% of these tumors occur in a part of the salivary gland, known as the parotid gland. Review and updates of immunohistochemistry in selected salivary gland and head and neck tumors shaobo zhu, md. Sep 24, 2014 soft tissue myoepithelial carcinoma and myoepithelioma are rare entities, part of myoepithelial tumors. Pdf myoepithelioma is a benign salivary gland tumor in the head and neck region, accounting for 11. Malignant salivary gland tumors were seen in 16 cases. The prognosis of the individual depends upon a set of several factors including the tumor stage and overall health of the individual. Case report open access plasmacytoid myoepithelioma of. Who gets myoepithelial carcinoma of salivary gland. Despite wide distribution of myoepithelial cells in the bronchial mucous glands, few tumors of myoepithelial origin have been reported in the lung.
Sheldon initially published his work on a myoepithelioma in 1943, and first in 1991 and later in 2005 myoepithelioma was recognized from the who as a distinct entity 2, 3. Myoepithelial cells mec of the salivary glands in health. Though they were first identified long back, still their histopathologic features and immunohistochemistry ihc profile are not well characterized and there is no definitive criterion for this tumor with complex and varied features remaining a major barrier. Dedifferentiated salivary gland tumor is a rare, recently recognized tumor type. Myoepithelioma is a wellcircumscribed or encapsulated tumor. Histologically, two distinct neoplastic cell populations were observed in the same tumor mass. Myoepithelioma and related lesions pocket dentistry. A similar tumor type may be found in the tongue, referred to as ectomesenchymal chondromyxoid tumor.
They help in expelling secretions from the lumen of secretory units and facilitate the movement of saliva in salivary ducts. Malignant myoepithelioma of the salivary gland is discussed in terms of its clinical behaviour, morphological features and the frequent preexistence of a pleomorphic adenoma. Combined myoepithelial carcinoma and myoepithelioma in. Myoepithelioma is a benign salivary gland tumor in the head and neck region, accounting for 11. Salivary gland like tumors of the breast show a great variety of architectural patterns and cellular differentiations such as glandular, myoepithelial, squamous, and even mesenchymal phenotypes. Here, the author reports a case of myoepithelioma of the soft palate in a 42yearold turkish man. Myoepithelial carcinoma an overview sciencedirect topics.
Review and updates of immunohistochemistry in selected. Health, general cancer diagnosis research cancer diagnosis carcinoembryonic antigen genetic aspects cea oncology immunohistochemistry intermediate filament proteins medical research medicine, experimental salivary gland tumors tumor proteins. Myoepithelioma of the lung european journal of cardio. Myoepithelial cells are normal components of salivary glands, sweat glands and breast. The tumors mostly present as asymptomatic, slowly progressive masses over a period of months to years in the patient with average age in the fourth decade 1. Two tumours presented as intraoral lesions and eight were located in the parotid gland. It becomes very difficult to diagnose due to its varied presentation and propensity for malignant transformation. Myoepithelioma common malignancies mucoepidermoid carcinoma variants adenoid cystic carcinoma carcinoma ex pleomorphic adenoma salivary duct carcinoma mucoepidermoid carcinoma incidence most common malignant salivary gland tumor children and adults major and minor salivary glands p k i id 5th t 6th d d 36. Myoepithelial tumors of the salivary gland including myoepitheliomas. Myoepithelial carcinoma, also know as malignant myoepithelioma, is rare in the salivary gland, and its cytologic features have rarely been reported.
Myoepithelioma is a rare and usually benign salivary gland tumor derived from myoepithelial cells. They present as bulky, bosselated, slowgrowing tumors that maybecomelarge. Fine needle aspiration cytology of salivary gland lesions. Myoepithelioma mixed tumor morphology presence of ductal structures genetics rearrangement of plag1 or hmga2 salivary gland rearrangement of ewsr1 soft tissue spindle, plasmacytoid, epithelioid, clear cells, myxoid or hyalinized stroma keratin, ema, s 100, keratin, ema, simmunophenotype gfap, p63, calponin, sma, desmin 100.
They commonly occur in salivary glands, but they have also been reported in the nasopharynx, larynx, breast and lung 1, 2. Salivary gland myoepithelial carcinoma springerlink. The histological appearance includes solid, myxoid and reticular growth patterns. Myoepitheliomas are most common in young adults between. The diagnosis was made on the basis of characteristic ultrastructural as well as immunohistochemical findings. Myoepithelioma of parotid gland presenting as infraauricular. About 60% to 70% of mca develop in a benign mixed tumor. Solid nonmyxoid, myxoid pleomorphic adenomalike, reticular canalicularlike or mixed patterns of myoepithelial cells with no ductal differentiation. Different cytogenetics from salivary gland myoepithelial carcinoma and breast ductal carcinomas with myoepithelial differentiation, based on study in one case cancer genet cytogenet 2008. The uncommon diagnosis of myoepithelioma in salivary glands was initially reserved for those tu. Immunohistochemical analysis of salivary gland tumors.
Plasmacytoid myoepithelioma of minor salivary glands. Clinically it resembles like other tumour masses and thus posed challenge to clinician and pathologist. Salivary gland myoepithelial carcinoma mc or malignant myoepithelioma is a rare entity. Myoepithelial cells are ectodermal in origin and envelope glandularacinar and ductal elements of salivary gland. Myoepithelial cells of ectodermal origin and mesodermal functionality, normal constituent cells of ductal structures in major and minor salivary glands and other organs, are modified cellular elements with both epithelial and myocontractile properties. They most commonly affect the major and minor salivary glands with the parotid gland being the most common, approximately 40%. Myoepithelioma is rare benign neoplasm, usually involves salivary glands and very less often seen in minor salivary glands of nose. Pure accounting for less than 1% of all salivary gland tumors.
Dec 12, 2011 myoepithelioma is a rare benign tumor of the salivary glands and is usually seen in the parotid gland and the minor salivary glands. Dec 01, 2018 the treatment for myoepithelial carcinoma of salivary gland involves a combination of surgery, chemotherapy, and radiation therapy, in most cases. In 1898, zimmerman first described the salivary gland myoepithelium. Mar 18, 2015 myoepithelioma was recognized as a histologically distinct entity by the world health organization who in 1991. It can be present in individuals of a wide age range including children and adults.
Abstract myoepithelioma is a rare neoplasm of the salivary glands, generally occurring in the parotid gland and less often in the minor accessory salivary gland of the oral cavity. Treatment should be designed as for a benign salivary gland tumor with a margin of normal uninvolved tissue being included within the surgical excision. Myoepithelial neoplasms myoepithelioma mixed tumor morphology presence of ductal structures genetics rearrangement of plag1 or hmga2 salivary gland rearrangement of ewsr1 soft tissue spindle, plasmacytoid, epithelioid, clear cells. Myoepithelioma occurring in minor salivary glands of oral cavity accounts for 26% of all salivary gland myoepitheliomas and palate being the most common site 69. The sections show a stratified squamous epithelium with a thin layer of parakeratosis, minor salivary glands, and a wellcircumscribed cystic lesion. The benign salivary corpuscular bassinetmyoepithelioma. Myoepithelioma is usually a benign tumor arising from neoplastic myoepithelial or basket cells which are found between the basement membrane and the.
Minor salivary glands also have mixed serous and mucous acini in. It is a benign salivary gland tumor that consists entirely of myoepithelial cells with variable cellular morphologies including spindle, epithelioid, plasmacytoid, or clear cells. As the name suggests, it consists of myoepithelial cells. Myoepithelioma me is a rarely encountered tumor of salivary gland accounting for about 1% of all salivary gland tumors. This process is experimental and the keywords may be updated as the learning algorithm improves. Oncocytic myoepithelioma and pleomorphic adenoma of the salivary glands. This included 6 cases of mucoepidermoid carcinoma, 3. In this report, we describe two cases of a benign myoepithelioma of the p arotid gland. Salivary gland neoplasms are rare tumors, they account about less than 310% of head and neck neoplasms2.
Variability in cellular morphology and stromal composition leads to diagnostic pitfalls on fine. Pdf plasmacytoid myoepithelioma of the palate in a child. While myoepithelioma has no specific clinical features, it is accepted pathologically as a distinct entity. Myoepithelioma of salivary gland is an uncommon benign tumor typically arising in the major salivary glands. Discussion myoepithelioma is a benign tumor that is exclusively or almost exclusively composed of neoplastic cells that exhibit myoepithelial differentiation. Myoepithelioma of salivary glands are very rare, accounting for only 1%1.
Myoepithelioma is a rare neoplasm of the salivary glands, generally occurring in the parotid gland and less often in the minor accessory salivary gland of the oral cavity. Diagnosis of myoepithelioma through light microscopy is possible and immunohistochemistry is done to facilitate the diagnosis. Immunohistochemistry is a useful tool for diagnosing salivary gland and head and neck tumors. Myoepithelioma is a rare benign salivary was consistent with myoepithelioma, plasmocytoid gland tumour, localized most frequently in the parotid variant. Myoepithelioma of salivary glands is a rare neoplasm generally occurs in parotid glands and less often in minor salivary glands of the palate and oral cavity. Myoepitheliomas of minor salivary glands accounts to only 1. Subsequently, it was designated variously as the parotid clear cell adenoma probably of myoepithelial derivation or adenomyopeithelioma. Vimentin and s100 protein are very sensitive but nonspecific immunohistochemical markers of neoplastic myoepithelium.
A case of dedifferentiated malignant myoepithelioma in a 59. Although, clear cell myoepitheliomas have been reported at other sites58, most of the cases of palatal myoepitheliomas have been plasmacytoid or spindle cell type9. It was once considered to be a type of pleomorphic adenoma pa, but myoepitheliomas are today believed to be relatively aggressive tumors. Myoepithelioma, salivary glands, mouse springerlink. We present here a case of a malignant myoepithelioma of the parotid gland. R l font and a garner department of pathology, institute of ophthalmology, london. The diagnosis is rendered histopathologically, and it includes the proliferation of myoepithelial cells, without chondroid or myxochondroid stroma and ductal components up to 5% of ductal component is acceptable. Rather, we believe that in general, physicians are simply unaware of its existence. Only 1% of all salivary gland neoplasms are myoepitheliomas.
Soft tissue myoepithelial me carcinoma, also known as soft tissue malignant myoepithelioma stmm, and myoepithelioma are rare entities, part of me tumors. Only three cases of sinonasal myoepithelioma have been reported in the literature. The most common site is parotid gland with a few arising in minor salivary glands of the oral cavity and palate. There was no recurrence during the followup period of 10 months.
Losito nsbotti gionna fpasquinelli gminenna pbisceglia m clearcell myoepithelial carcinoma of the salivary glands. A 53yearold man presented with a 1year history of a painless. Dedifferentiated malignant myoepithelioma of the parotid gland. K5k14positive cells contribute to salivary glandlike.
Myoepithelioma of the head and neck, also myoepithelioma, is a salivary gland tumour of the head and neck that is usually benign. Combined myoepithelial carcinoma and myoepithelioma in soft. 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. They were incorporated into the world health organization classification of soft tissue tumors in 2002. Basaloidblue salivary gland tumors modern pathology nature. The 2005 revised who classification of salivary gland tumors account for more than 35 distinct variants of salivary gland neoplasms3. The tumor cells of the two cases likewise contained myofilaments and gave a positive result for the s. In this report, we describe two cases of a benign myoepithelioma of the parotid gland. Myoepithelioma salivary gland, soft tissue, bone, breast p63. Myoepithelioma is a benign salivary gland tumor that consists entirely of myoepithelial cells. Here we present an exceptional case of myoepithelial carcinoma and myoepithelioma association. Design four cases of myoepithelial carcinoma with cytology were retrieved from the archives of the pathology departments of two academic institutes. Benign salivary gland tumors were seen in 38 cases. Only a few case reports describing ct imaging features of me have been published.
Myoepithelial cells are a normal constituent of the major and minor salivary glands. Classically, they are found in the parotid gland or palate. Cytology of myoepithelial carcinoma of the salivary gland. Myoepitheliomas are most common in young adults between the ages of 30 and 50 and there are very few cases reported in. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. The recurrence rate is similar to that of the pleomorphic adenoma 1518%. Myoepithelial cells are a significant component of most types of salivary gland neoplasms. Spindle cell myoepithelioma of the parotid gland europe pmc.
Rare primary lesions that have been known to metastasize to the skin include an adenoid cystic carcinoma, an acinic cell carcinoma, a myoepithelial carcinoma, and adenocarcinoma of the salivary gland, 365370 an adenoid cystic carcinoma of the lacrimal gland, 371 an ameloblastoma, 372 a thymoma, 373 an adrenal carcinoma, 374,375 a pheochromocytoma, 376 and carcinomas of the hypopharynx, 377 nasopharynx, 31,378,379 and larynx. Myoepithelioma of the parotid gland with extensive. Basaloid tumors are a common diagnostic problem in salivary gland pathology. Myoepithelioma was recognized as a histologically distinct entity by the world health organization who in 1991. Mc usually presents as a slowgrowing painless mass arising in the parotid gland, but may involve other salivary glands. The mass was removed by local excision under general anesthesia. Capsules are generally better developed in tumors of the major glands, whereas those arising in the palate or other minor salivary or seromucinous gland sites are circumscribed but not usually encapsulated. Aug 26, 2009 myoepithelioma is a rare salivary gland tumor arising from proliferation of myoepithelial cells.
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