Abstract
IntroductionBecause well-documented cases of mucoepidermoid carcinomas that are of minor salivary gland origin and occur in children and adolescents have rarely been reported, little information regarding their clinical features and biologic behavior is available. This case report represents a retrospective clinical analysis of five minor salivary gland mucoepidermoid carcinomas accessioned from a 35-year period at the Louisiana State University School of Dentistry and combines the data with 15 well-documented cases from the English language literature.Case presentationThe five mucoepidermoid carcinomas in patients from birth to 19 years of age accounted for 1.3% of the accessioned minor salivary gland neoplasms. There were an additional 15 well-documented cases in the literature. Combining the data for the 20 mucoepidermoid carcinomas resulted in a mean age of 13.5 years and a 2.3:1 female-to-male ratio. Collectively, the hard palate, soft palate, and hard palate/soft palate junction accounted for 85% of the cases. Thirty-five percent of the cases presented as a fluctuant submucosal swelling with surface color alterations. The average duration was five months, and bone involvement occurred in seven cases. A histologic grade of low to intermediate predominated (95%). Surgical removal was the treatment in all cases. Thirteen cases had adequate follow-up of three years or more, and recurrence was documented in only one case. There were no cases of death or metastasis in this series.ConclusionsIn children and adolescents, mucoepidermoid carcinomas have a female predilection and occur most commonly on the hard or soft palate or both. A fluctuant submucosal lump with a bluish color is a helpful diagnostic clue. The histologic grades of most mucoepidermoid carcinomas in the first and second decades of life are low and, to a lesser degree, intermediate. Complete surgical excision is the treatment of choice and results in a recurrence rate of less than 10%.
Highlights
Because well-documented cases of mucoepidermoid carcinomas that are of minor salivary gland origin and occur in children and adolescents have rarely been reported, little information regarding their clinical features and biologic behavior is available
Pathology archives of a 35-year period supports the paucity of malignant intraoral salivary gland tumors and the reported frequency of mucoepidermoid carcinoma (MEC) in the first two decades of life. The purposes of this retrospective analysis were to investigate the clinical features and biologic behavior of minor salivary gland MECs occurring in children and adolescents from the Louisiana State University School of Dentistry (LSUSD) and to compare these findings with well-documented cases reported in the English language literature
In the current LSUSD series, 3.5% of the epithelial minor salivary gland neoplasms occurred in patients 19 years of age or younger; this is in close agreement with the series reported by Waldron et al [38] and Kusama et al [41], who found incidences of 3.7% and 5.4%, respectively
Summary
MECs have a female predilection and are decidedly uncommon in the first decade of life. MECs have a high predilection for the hard or soft palate or both. The histologic grades of most MECs in the first and second decades of life are low and, to a lesser degree, intermediate. Competing interests The authors declare that they have no competing interests. Authors’ contributions PR helped to review the clinical and histopatholgic data from the selected cases and the literature and to analyze the data. RBB helped to review the clinical and histopatholgic data from the selected cases and the literature and to analyze the data, reviewed histopathologic microslides, and confirmed the diagnoses for the cases from the LSUSD series. All authors read and approved the final manuscript
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