Epithelial-Myoepithelial Carcinoma of the Palate on Pleomorphic Adenoma: Case Report and Review of the Literature: Experience of the Oncology-Radiotherapy Department of the Mohammed VI University Hospital, Marrakech

Abstract

Epithelial-myoepithelial carcinoma (EMC) is a rare malignant tumor of the salivary glands, mainly affecting the parotid gland. Its association with a pleomorphic adenoma is exceptional. We report the case of a 64-year-old Moroccan woman with a pleomorphic adenoma of the palate that had been evolving for several years. The recent increase in the mass associated with the appearance of homolateral cervical adenopathies led us to think of a malignant transformation. Final histological examination after resection of the mass showed an unexpected association of a pleomorphic adenoma and EMC. EMC is a low-grade malignant tumor. It can arise de novo or on a pleomorphic adenoma. Malignant transformation of the adenoma is suspected when the volume of the adenoma increases rapidly, with the appearance of cervical adenopathy. However, these clinical changes may herald the appearance of a distinct tumor. Despite its tendency to local recurrence and low metastatic potential, rare cases of EMC may exhibit aggressive behavior and distant metastases. Treatment consists mainly of complete surgical resection if possible, followed by radiotherapy to prevent local recurrence, and this is the treatment our patient received in this case.