Abstract
BackgroundMucoepidermoid carcinoma is the most common malignant neoplasm arising from the salivary glands (Ali et al. in J Ayub Med Coll Abbottabad 20(2): 141-2, 2008, Xi et al. in World J Surg Oncol 10: 232, 2012). When arising from anatomic sites other than the salivary glands it can be a diagnostic challenge. Primary and metastatic mucoepidermoid carcinoma from and to the pleura are extremely rare entities that are frequently misdiagnosed as adenocarcinoma, adenosquamous carcinoma, or squamous cell carcinoma (Xi et al. in World J Surg Oncol 10: 232, 2012).Case presentationWe describe an unusual case of a 64-year-old Caucasian female patient with metastatic high-grade mucoepidermoid carcinoma to the pleura, morphologically resembling squamous cell carcinoma. Molecular studies of both the parotid gland and pleural tumors helped prove the metastatic nature of the pleural lesion.Conclusions Metastatic mucoepidermoid carcinoma to the pleura is a rare entity, frequently misdiagnosed as squamous cell carcinoma. Differentiating between a lung primary and a metastatic disease has treatment implications and prognostic significance for the patient. When morphologic and immunophenotypic overlap exists, molecular testing can help distinguish mucoepidermoid carcinoma from other neoplasms.
Highlights
Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm arising from the salivary glands [1, 2]
Case presentation A 64-year-old Caucasian female with a past medical history of asthma, congestive heart failure, hypertension, and diabetes mellitus presented to the emergency department with worsening dyspnea and cough for 3 weeks, which showed no improvement with antibiotics
The tumor cells were negative for vimentin, CDX2, estrogen receptor (ER), CK20, chromogranin, transcription factor 1 (TTF-1), smooth muscle actin (SMA), synaptophysin, S100, and calponin
Summary
Metastatic MEC to the pleura is exceedingly rare and, to our knowledge, this is the second case reported on this occurrence. When morphologic and immunophenotype overlap exists, the molecular diagnosis should be included in the diagnostic arsenal
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