Epithelial Myoepithelial Carcinoma of the Hard Palate: A Case Report with a Review of the Literature

Abstract

Background: Epithelial myoepithelial carcinoma (EMC) is a rare biphasic tumour of the salivary gland with two cell types of inner ductal cells and outer layer of clear cells. In the literature, there are only a few reports of EMC originating from the hard palate. Case report: A 58-year-old female presented to the authors’ institution with partially submucosal lesion in the posterior aspect of the hard palate on the left side for 1 month. Biopsy was suggestive of a multinodular tumour with round to oval cells and a moderate number of pale eosinophilic to clear cytoplasm and round to oval, centrally to eccentrically placed, mildly pleomorphic vesicular nuclei suggestive of EMC of the hard palate. Immunohistochemically, cytokeratin (CK 5/6) showed strong cytoplasmic positivity highlighting the luminal epithelial cells. The myoepithelial cells showed strong nuclear positivity for p63 and cytoplasmic positivity for calponin. The patient underwent surgical resection of the tumour with a local flap cover and split skin graft and all the margins were negative in the final histopathological examination with erosion of the underlying bone. The patient was kept under observation and has been free of the disease for the past 12 months. Conclusion: Diagnosis of EMC is rare and is to be kept as a differential diagnosis during the evaluation of minor salivary gland tumours of palate.