Year-end Sale % OFF 
Abstract
As rare condition, mucoepidermoid carcinoma may occur in liver although its etiology and pathogenesis is still unclear. We report here a case of intrahepatic mucoepidermoid carcinoma misdiagnosed as cholangiocarcinoma and squamous cell carcinoma by preoperative radiologic and intraoperative histological examinations, respectively. A 60-year-old woman presented with a 1-month history of progressive jaundice, epigastric discomfort, and weight loss with slightly increased carbohydrate antigen 19-9 (CA19-9). Computed tomography (CT) showed a large tumor, 8.0 cm in diameter, in the left lobe of the liver. A preliminary diagnosis of a cholangiocarcinoma of the liver was made. In the intraoperative histological examination, a diagnosis of squamous cell carcinoma was made based on predominantly invasive epidermoid cells with abundant keratinization and absence of mucin-producing cell component. However, postoperative histological diagnosis of the lesion was mucoepidermiod carcinoma of liver by thoroughly microscopical inspection and the presence of mucin-producing cells confirmed by Alcian blue staining. Despite surgical excision and chemotherapy, the tumor showed very aggressive malignancy with tumor recurrence. The patient died shortly afterward, surviving 6 months after surgery. Due to its rarity and distinct morphological features, mucoepidermoid carcinoma might be erroneously interpreted as squamous cell carcinoma by those who were not familiar with this condition in unusual locations. Therefore, removal of sufficient tissue from different portions of the lesion is essential for the surgeons and pathologists to make a precise diagnosis in the intraoperative histological examination.Virtual slideThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/4956311271136060
Highlights
Mucoepidermoid carcinoma is a relatively common neoplasm of the salivary glands, which rarely arises in other sites, including esophagus, anal canal, skin of the breast, lachrymal sac, thymus, thyroid gland, lung or uterine cervix [1,2,3,4]
We present a case of mucoepidermoid carcinoma occurring in an old female patient that was misdiagnosed as cholangiocarcinoma and squamous cell carcinoma by both radiologic and intraoperative histopathological examination, respectively
Some authors proposed that mucoepidermoid carcinoma of the liver might originate from a congenital cyst because the main tumors were located in the vicinity of multiple seromucinous cysts lined with columnar, cuboidal glandular epithelium with no connection to the biliary system and no bile content [8,11]
Summary
Mucoepidermoid carcinoma is a relatively common neoplasm of the salivary glands, which rarely arises in other sites, including esophagus, anal canal, skin of the breast, lachrymal sac, thymus, thyroid gland, lung or uterine cervix [1,2,3,4]. Intraoperative finding revealed an elastic hard tumor was found in the left lobe of the liver. There were no distinct mucin-producing cells in the tissues (Figure 2B). Based on these findings, the diagnosis of squamous cell carcinoma of liver was made. Histopathological examination revealed that the main tumor was composed of solid and invasive nests of epidermoid cells with desmoplastic stroma. In some areas, squamous cells, and mucin-producing and intermediate cells were observed in the tumor These tumor cells were intermingled or intimately mixed with epidermoid cells, unlike adenosquamous carcinoma. Alcian blue staining revealed mucin in the cytoplasm of the mucinproducing cells Based on these findings, the final diagnosis of tumor was revised as mucoepidermoid carcinoma (Figure 3).
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
