Case Of Myoepithelial Carcinoma Research Articles

MYOEPITHELIAL CARCINOMA OF SOFT TISSUES OF THE RIGHT AXILLARY REGION WITH METASTASIS TO THE CECUM: A CLINICAL CASE

Relevance: Myoepithelial carcinoma is a morphologically diverse tumor that arises either de novo or due to the malignant transformation of its benign counterpart, myoepithelium. These are relatively lesser-known lesions rarely found in the head and neck area. Myoepithelial carcinoma (MC) is a rare malignancy primarily found in the salivary gland. MK can be confused with many other tumors outside the salivary glands, as a wide range of cytomorphological and immunohistochemical features characterizes them. Soft tissue MCs are extremely rare, although a salivary gland MC is relatively common and well-known with similar morphology. The histogenesis of soft tissue MC is still unknown. The tumor may have myoepithelial differentiation but is not derived from myoepithelial cells. Due to the rarity of soft tissue MCs, the number of studies and data on this tumor’s clinical and pathological characteristics are limited. In addition, the limited number of diagnostic criteria and prognostic parameters makes diagnosing and treating soft tissue MC difficult. The article describes a rare case of MC, formed from the soft tissues of the axillary region, with metastasis to the cecum. The purpose was to describe the imaging and clinicopathological features of axillary myoepithelial carcinoma of soft tissues with metastasis to the cecum and to form an understanding of this disease. Methods: A rare case of soft tissue CM of the axillary region with metastasis to the cecum is described. A 57-year-old woman complained of lymphadenopathy in the right axillary region in October 2020. Results: According to ultrasound examination, the lymph node is up to 3.0x3.5 cm in the right axillary region. Based on histopathological and immunohistochemical (IHC) data, on 02/03/2022, the final diagnosis was made: MK of the soft tissues of the right axillary region. According to positron emission tomography/computed tomography (PET/CT), after 4 months, a local focus of active accumulation was detected in the projection of the cecum, with an adjacent enlarged regional lymph node of the paracolic group. On January 18, 2023, surgical treatment was performed in the following volume: “Right-sided hemicolectomy.” Histological examination confirmed MC. According to the multidisciplinary team’s (MDG) decision, the patient received 3 courses of targeted therapy. Conclusion: This case report raises awareness and improves MC diagnostics and treatment.

Fine-needle aspiration cytology of retroperitoneal myoepithelial carcinoma: A rare encounter with diagnostic dilemmas.

Myoepithelial carcinoma (MC) arises from the myoepithelial cells. It is a rare tumor with a predilection for salivary glands. MC in soft tissue is uncommon. Soft tissue MC exhibits dual epithelial and smooth muscle phenotype. The extremities and limb girdles are commonly affected. We present cytological findings of retroperitoneal MC with an accurate diagnosis being rendered with the aid of immunocytochemistry on the cell block and demonstration of EWSR1 rearrangements by fluorescence in situ hybridization on cytology smear. The smears were cellular, showing loose clusters and sheets of tumor cells embedded in dense eosinophilic to myxoid matrix material. The cells were oval to polygonal, with focal areas showing moderate nuclear pleomorphism, vesicular to coarse chromatin, and vacuolated cytoplasm with clearing. On immunocytochemistry, tumor cells were positive for epithelial membrane antigen, pan-cytokeratin, calponin, smooth muscle actin, and S-100. A literature review shows only a handful of cases of soft tissue MC. The current report emphasizes the need for cytomorphological awareness with the employment of ancillary testing for accurately diagnosing this rare tumor at an uncommon location. We also discuss the diagnostic challenges and troubleshooting.

SALTT study: A retrospective analysis of 111 SAlivary gland tumors of Lung and Tracheobronchial Tree

IntroductionPrimary pulmonary salivary gland-type tumours (PPSGT) are rare lung neoplasms arising from submucosal seromucinous glands in the central airway. Methods and resultsWe retrospectively analysed the clinicopathological features of 111 PPSGTs diagnosed at our institute between 2003 and 2021. The mean age at diagnosis was 43.8 years(range 6–78 years) and a male-to-female ratio of 2:1. On imaging, 92 % of cases had centrally located tumours and 37.3 % were early stage. The histopathological types included 70 cases (63 %) of mucoepidermoid carcinoma (MEC), 31 cases (27.7 %) of adenoid cystic carcinoma (ADCC), two cases of myoepithelial carcinoma, one case each of acinic cell carcinoma (ACC), clear cell carcinoma (CCC), epithelial myoepithelial carcinoma (EMC) and 5 others [including adenocarcinoma of minor salivary gland origin(n = 3), carcinoma with sebaceous differentiation(n = 1) and poorly differentiated carcinoma of salivary gland type(n = 1)]. The size of the tumours found in the resection specimens ranged from 1 cm to 13 cm, with an average size of 4.9 cm. High-risk attributes such as lymphovascular invasion (LVI), perineural invasion (PNI), pleural involvement, positive resection margins, and nodal metastasis were identified in 15.3 %, 15.3 %, 13.6 %,15.2 % and 6.7 % of cases, respectively. These attributes were found to be more frequent in ADCC than in MEC. Surgery was the main treatment modality [68/84 (80 %) cases]. ADCC cases had more recurrence and distant metastasis than MEC cases. The 3- year overall-survival (OS) and recurrence-free survival(RFS) were better in patients with age lesser than 60 years(p-value <0.0001), low pT stage (p-value 0.00038) and lower grade of MEC(p-value-0.0067). ConclusionIt is crucial to have an acquaintance with the morphologic spectrum and immunophenotypic characteristics of PPSGT to recognize them in this unusual location. In tandem, it is crucial to differentiate them from conventional primary non-small cell lung carcinoma, as the management protocols and prognostic implications differ significantly.

Abstract P1-05-31: A single center retrospective analysis of 259 cases of metaplastic breast cancer

Abstract Introduction: Metaplastic breast cancer (MBC) is a rare breast tumor.WHO histological classification of breast tumors in 2019 divided MBC into the following seven types: low-grade adenosquamous carcinoma, fibromatoid metaplastic carcinoma, squamous cell carcinoma, spindle cell carcinoma, metaplastic carcinoma with mesenchymal differentiation, mixed metaplastic carcinoma and myoepithelial carcinoma. Based on single center data, this study intends to conduct a detailed analysis of the clinicopathological features, treatment and prognostic factors of MBC. Methods:We collected 259 MBCs treated in our center from 2006 to 2022. The patient’s age, histological type, image feature, tumor size, lymph node metastasis, tumor stage, immunohistochemical information, surgical plan and systemic adjuvant therapy were summarized and considered to explore the factors affecting the overall survival rate (OS) and disease-free survival rate (DFS). T-test and chi-square test were performed on the data. P&amp;lt; 0.05 showed that the difference was statistically significant. Kaplan-Meier survival was used to analyze the long-term efficacy. Results: The incidence rate of MBC in breast cancer patients in our center is about 0.5%. They included 105 cases of squamous cell carcinoma (40.5%), 49 cases of mixed metaplastic carcinoma (18.9%), 41 cases of spindle cell carcinoma (15.8%), 27 cases of metaplasia carcinoma secreting matrix (10.4%), 6 cases of metaplastic carcinoma with mesenchymal differentiation (2.3%), 6 cases of myoepithelial carcinoma (2.3%), 3 cases of low-grade adenosquamous carcinoma (1.2%), 1 case of fibromatoid metaplasia carcinoma (0.4%) and 21 cases of unknown (8.1%). MBC were mainly three negative subtypes, which were 204 cases (78.8%), 41 cases (15.8%) luminal subtypes and 14 cases (5.4%) HER2 positive subtypes. There was no significant difference in the distribution of breast cancer subtypes among different histological types of MBC. There were 63 cases (24.3%) in clinical stage I, 171 cases (66.0%) in stage II, 23 cases (8.9%) in stage III and 2 cases (0.8%) in stage IV. 58 patients underwent core needle biopsy, of which only 7 (12.1%) reported histological types consistent with MBC. Among 154 patients with molybdenum target reports, 59 of them (38.3%) had malignant calcifications. The diagnostic coincidence rates of MRI, ultrasound and molybdenum target were 90.0%, 85.1% and 74.7% respectively. 258 cases of MBC received surgical treatment, including 183 cases of total mastectomy (70.9%), 53 cases of breast conserving surgery (20.5%) and 22 cases of quadrant resection (8.5%); 132 patients (51.2%) underwent axillary lymph node dissection and 93 patients (36.0%) underwent sentinel lymph node biopsy. 24 patients (9.3%) received neoadjuvant chemotherapy, of which only 2 (8.3%) achieved pathological complete remission. 56 patients (21.6%) received adjuvant radiotherapy, with a median of 25 times. 167 patients (64.5%) received adjuvant chemotherapy, and anthracycline sequential paclitaxel was the most commonly used regimen. The median follow-up was 31 months. The five-year DFS was 82.0%, and the five-year OS was 89.4%. Through Cox regression analysis, it was found that patients’ N stage (P=0.036) and receiving anthracycline sequential paclitaxel adjuvant chemotherapy (P=0.004) were independent prognostic factors. Conclusion: The histological types of MBC are complex. MRI is of high value in diagnosis. Conventional CNB is difficult to meet the needs of pathological tissue classification. Patients without lymph node metastasis and receiving anthracycline sequential paclitaxel adjuvant chemotherapy are associated with better prognosis. Through multidisciplinary standardized diagnosis and treatment, there is no significant difference between the prognosis of MBC and the common types of breast cancer. Keyword: metaplastic breast cancer; pathological characteristics; imaging; treatment; prognosis. Citation Format: Douwaner Liu, Jiajian Chen, Shuang Hao, Bingqiu Xiu, Qi Zhang, Liyi Zhang, Guangyu Liu, Zhimin Shao, Jiong Wu. A single center retrospective analysis of 259 cases of metaplastic breast cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P1-05-31.

Postoperative Intensity-Modulated Radiation Therapy for Myoepithelial Carcinoma in the Parotid Gland

Myoepithelial carcinoma (MC) is an extremely rare form of tumor, with no standard treatment established to date. Although several reports have discussed postoperative radiation therapy (PORT), few have applied intensity-modulated radiation therapy (IMRT), and none has described the dose and radiation field in detail. In this report, we describe a case of MC of the parotid gland that was treated with high-dose IMRT (70 Gy) after partial resection. The patient, a 61-year-old female, underwent excisional surgery and was diagnosed with MC arising from a pleomorphic adenoma (PA). Postoperative irradiation was administered as 70 Gy in 35 fractions of local radiation. The patient had cancer recurrence in the irradiated field. However, no serious adverse events associated with the radiation therapy have been confirmed, implying that postoperative high-dose radiation therapy may be safely administered via IMRT.

A case of myoepithelial carcinoma ex pleomorphic adenoma of the palate in a young adult

A case of myoepithelial carcinoma ex pleomorphic adenoma of the palate in a young adult

Myoepithelial carcinoma of mandible: A rare case with literature review

Primary salivary gland carcinomas of intraosseous origin of the mandible are uncommon neoplasms. Myoepithelial carcinoma (MC) happens to be the rarest. Detailed descriptions of its clinical course are hence not available. Herein, we report a case of MC affecting the mandibular central arch in a bizarre way in a 15-year-old adolescent girl who was treated effectively with definitive radiotherapy (RT) along with concurrent chemotherapy in view of unresectability. To the author's best knowledge, this is the fifth reported case of MC affecting the mandible and the first case to be treated by radical RT. Our study sheds light on the fact that RT can be an effective alternative to surgery where it is not feasible.

Immunohistochemical Expression of Fatty Acid Synthase (FASN) is Correlated to Tumor Aggressiveness and Cellular Differentiation in Salivary Gland Carcinomas.

Fatty acid synthase (FASN) expression is closely related to cancer progression, in particular, tumor aggressiveness and poor prognosis. This study aimed to analyse the expression of FASN in carcinomas of the salivary glands and correlate it with Ki-67 expression. We analysed by immunohistochemistry the expression of FASN and Ki-67 on tissue sections from 7 cases of adenocarcinoma, not otherwise specified (AdNOS), 6 cases of polymorphous adenocarcinoma (PAC), 16 cases of acinic cell carcinoma (AcCC), 19 cases of adenoid cystic carcinoma (AdCC), 15 cases of epithelial-myoepithelial carcinoma (EMC); 10 cases of secretory carcinoma (SC), 13 cases of mucoepidermoid carcinoma (MEC), 10 cases of salivary ductcarcinoma (SDC) and 7 cases of myoepithelial carcinoma (MC). These carcinomas were classified into aggressive and indolent regarding their biological behaviour. Additionally, MEC and AdCC were also classified according to the histological grade. High expression of FASN was found in SDC (100%), SC (100%), AcCC (68.7%) and AdNOS (57.2%). No association was found between FASN and Ki-67 expression. Aggressive carcinomas showed a higher rate of Ki-67 proliferation (p < 0.001) and greater expression of FASN when compared to indolent carcinomas (p < 0.05). With regards to carcinomas categorized as indolent, FASN expression was much higher in the lesions that presented cell differentiation (SC and AcCC). Also, FASN expression was significantly higher in high-grade AdCC and MEC when compared to low-grade tumors (p < 0.05). We concluded that FASN expressionwas correlated to tumor aggressiveness and cellular differentiation in salivary gland carcinomas.

A rare malignant transformation in pleomorphic adenoma

Carcinoma ex pleomorphic adenoma (Ca ex PA) is a rare type of malignant salivary gland tumor. Myoepithelial carcinoma (MEC) as the malignant component in Ca ex PA is an even rarer occurrence. Preoperative pathological diagnosis of Ca ex PA often goes unnoticed in many cases as they may be clinically indolent and the malignant component may not be picked up on fine-needle aspiration cytology. However, features such as rapid growth, recurrent tumor, and pain point toward a malignant transformation. We present a case of a 40-year-old female who presented with a history of recurrent swelling over parotid region with cytological diagnosis of pleomorphic adenoma, which on excision was reported as Ca ex PA with MEC being the malignant constituent. Till date, few cases of MEC arising from PA have been reported. It presents as a diagnostic challenge to both clinicians and pathologists alike; prognosis is still not clear due to few number of cases and lack of follow-up in most of them.

A Case of Myoepithelial Carcinoma Originated from the Retroauricular Skin

A Case of Myoepithelial Carcinoma Originated from the Retroauricular Skin

AN UNUSUAL CASE OF MYOEPITHELIAL CARCINOMA OF THE FLOOR OF THE MOUTH

Myoepithelial carcinoma (MEC) is a rare neoplasm of salivary glands. Here, we present a case of MEC in a 73-year-old female patient with a large swelling in the floor of the mouth region during 4 months. Clinically, it simulated a granulomatous infection or malignant squamous cell neoplasm. However, a histologic examination revealed atypical myoepithelial cells in solid sheets or nests suggestive of epithelial-myoepithelial carcinoma. Diagnosis was further confirmed by positive immunohistochemical staining with cytokeratin AE1/AE3, CK5, CK14, calponin, vimentin, and negative for smooth muscle actin (SMA), muscle actin monoclonal antibody (HHF-35), and CK7. This case is important because sometimes diagnosis of myoepithelial carcinoma is difficult only by histopathologic examination; therefore, the role of immunohistochemistry in diagnosis should be considered as demonstrated in the present case.

肺原発筋上皮癌の1手術例

肺原発筋上皮癌の1手術例

A case of myoepithelial carcinoma of the left shoulder

A case of myoepithelial carcinoma of the left shoulder

Myoepithelial carcinoma of the male breast: a rare case report

Myoepithelial carcinoma (malignant myoepithelioma) of the breast is a rare entity and in the male breast it is even rarer. Two cases of benign myoepithelioma in the male breast have been reported so far. Here we report, probably the first case of Myoepithelial carcinoma in a male breast with clinical features mimicking locally advanced breast carcinoma, together with illustration of pathological finding, microscopic appearance and management.Keywords: Myoepithelial carcinoma; Modified radical mastectomy; Chemotherapy

De novo myoepithelial carcinoma with multiple metastases arising from a submandibular salivary gland: A case report.

Salivary gland carcinomas are rare tumors, representing ~0.5% of all malignancies. Myoepithelioma is also uncommon, representing ~1% of all salivary gland tumors. Myoepithelial carcinoma (MC) is even rarer, representing 0.2 to 0.6% of all salivary gland tumors. We herein report a case of MC with multiple metastases arising from a submandibular gland in a 71-year-old male patient and present the associated imaging findings. The patient was considered to have a de novo type of myoepithelial carcinoma, which is reportedly associated with higher malignancy than the transformation type of the disease (i.e., a malignant change from pleomorphic adenoma or myoepithelioma). This was reflected in the multiple lung and bone metastases sites and strong positivity for p53 and Ki-67.

Myoepithelial Carcinoma: The Role of Radiation Therapy. A Case Report and Analysis of Data From the Surveillance, Epidemiology, and End Results (SEER) Registry

The role of radiation therapy in the treatment of myoepithelial carcinoma (MC) is unknown. We present a case of a high-grade soft-tissue MC in a pediatric patient and retrospectively examine the effect of postoperative radiation on survival in patients with MC. Our patient was treated with 4 cycles of ifosfamide, cisplatin, and etoposide followed by 3 cycles of ifosfamide vincristine and etoposide. Radiation was delivered to a total dose of 5580 cGy in 180 cGy/fraction to the surgical bed with a 2 cm margin starting after the third cycle of chemotherapy. The Surveillance, Epidemiology, and End Results (SEER) registry database was queried for cases of surgically resected MC. Retrospective analysis was performed with the endpoint of overall survival (OS). Two hundred thirty-four cases of MC were identified; for 62 of these cases, the grade of the tumor wasidentified. Of these 62 patients, 27 received postoperative radiation. OS was improved with adjuvant radiation therapy in patients with grade III or IV MC (P<0.01) as determined by the log-rank test. This analysis of SEER data showed an OS benefit with adjuvant radiation therapy in the treatment of high-grade MC. Physicians should report all cases of MC to improve clinical decision making in the treatment of this rare disease.

Myoepithelial carcinoma of the vallecula: A case report and review of the literature.

Myoepithelial carcinoma (MEC) of the vallecula is relatively rare, and there is no specific surgical guideline for resecting MEC in the vallecula. To the best of our knowledge, the current study reports the first case of MEC involving the vallecula of a 48-year-old female patient. In the present study, the lesion was correctly diagnosed as MEC and successfully managed using lateral pharyngotomy and by the construction of a sternohyoid myofascial flap. The patient was free of local recurrence or metastasis 18 months after surgery. The present study briefly reviews the current knowledge concerning the diagnosis and treatment of MECs in the head and neck area and offers suggestions for managing MEC in the vallecula. To conclude, MEC of the vallecula may be successfully managed by surgical treatment without evident post-surgery complications.

Investigating a case of minor salivary malignancy: a report

Myoepithelial carcinoma, also known as malignant myoepithelioma, is a rare locally aggressive primary salivary gland neoplasm. It is composed almost exclusively of neoplastic cells with myoepithelial differentiation and characterised by infiltrative growth and potential for distant metastasis. There is limited data on the natural history of this tumour including its metastatic potential due to the lack of large case series. We report a case of myoepithelial carcinoma of minor salivary gland with multiple skeletal metastasis.

筋上皮腫由来の口蓋筋上皮癌の1例

筋上皮腫由来の口蓋筋上皮癌の1例

Intraoral myoepithelial tumors: A review and case reports

Myoepithelial cells that express both epithelial and smooth muscle phenotype have a potential to differentiate into various cytomorphologic forms such as spindle, plasmacytoid, epitheloid and clear cells. Salivary gland tumors composed entirely or almost exclusively of myoepithelial cells are referred to as myoepitheliomas. They may be benign or malignant in nature and about 90% of them are benign and only 10% are malignant. The palate is the most common intraoral site of occurrence for both the variants. In this paper, we report one case of myoepithelioma occurring on the palate and two cases of myoepithelial carcinomas, one seen on the palate and the other rare case seen on the alveolar mucosa, along with an elaborate review on benign and malignant myoepitheliomas of salivary glands along with their ultra-structural, cytological and immunohistochemical profiles.