Diagnosis Of Epithelial-myoepithelial Carcinoma Research Articles

Repeated Surgery in a Case of Epithelial-Myoepithelial Carcinoma of the Parotid Gland that was Difficult to Distinguish from Pleomorphic Adenoma.

Epithelial-myoepithelial carcinoma (EMC) of the parotid gland is a comparatively rare tumor that accounts for less than 1% of all salivary gland tumors. A patient with EMC of the parotid gland that was initially diagnosed as pleomorphic adenoma and that recurred locally during the watchful waiting period but was controlled by surgery under local anesthesia is reported. An 80-year-old man had noticed a swelling in the left infra aural region. A left parotid gland tumor was suspected, and he was referred to our department. Magnetic resonance imaging (MRI) and fine-needle aspiration cytology findings were suggestive of pleomorphic adenoma of the superficial lobe of the parotid gland, and this was therefore resected under general anesthesia. Postoperative histopathological examination, immunostaining, and genetic tests resulted in a diagnosis of EMC. Postoperative pathological review showed that part of the resection margin was positive. The possibility of recurrence was explained to the patient, and additional treatment was recommended, but since the patient did not desire this, a policy of watchful waiting was adopted. Signs of cutaneous metastasis in the left infra aural region were detected at 13 months postoperatively, and this metastasis was excised under local anesthesia. The resection margin was negative, and the patient's course remains uneventful. EMC is classified as a low-grade malignant tumor, but it requires stringent monitoring because of its frequent local recurrence. Since local control can usually be achieved by surgical treatment alone, and postoperative adjuvant therapy may not necessarily warranted.

Epithelial myoepithelial carcinoma in an ectopic salivary gland: A diagnostic dilemma

The ectopic Salivary Gland is the presence of salivary tissue in unusual locations which do not normally host it. Moreover, neoplasms arising from these ectopic tissues are very rare, however, tumourigenic changes in these inclusions have been observed in a few cases.We present a clinically unsuspected case of an ectopic salivary gland tissue present on the mid-neck, which was diagnosed as Small lymphocytic leukaemia outside Jawaharlal Nehru Medical College, Aligarh. On further evaluation, a definitive diagnosis of epithelial myoepithelial carcinoma arising in ectopic salivary gland tissue within the cervical lymph node was made. Therefore, these tumours need to be included in the differential diagnosis of neck masses, for a prompt diagnosis and adequate treatment.

EPITHELIAL-MIOEPITELIAL CARCINOMA IN THE SOFT PALATE: CASE REPORT

Epithelial-myoepithelial carcinoma is a rare low-malignant neoplasm consisting of 1% of all tumors in the salivary glands. A 53-year-old black female patient complained of pain in the palate. Past medical history included an incisional biopsy whose histologic slices stained in hematoxylin and eosin (H&E) showed atypical glandular proliferation compatible with myoepithelial carcinoma, low-grade polymorphous adenocarcinoma, and adenoid cystic carcinoma. A reddish area of 1 cm was observed in the soft palate, with no symptoms. Faced with the lack of diagnostic definition, excisional biopsy was chosen where the anatomopathologic analysis corroborated previous findings, but immunohistochemistry showed positivity for Ki67, P63, cytokeratin 7, cytokeratin 8/18, and calponin, leading to the definitive diagnosis of epithelial-myoepithelial carcinoma. Because of the free margins observed in H&E, we chose to follow-up, who after oral rehabilitation continues without signs of local recurrence in a 2-year follow-up.

Epithelial Myoepithelial Carcinoma of the Hard Palate: A Case Report with a Review of the Literature

Background: Epithelial myoepithelial carcinoma (EMC) is a rare biphasic tumour of the salivary gland with two cell types of inner ductal cells and outer layer of clear cells. In the literature, there are only a few reports of EMC originating from the hard palate. Case report: A 58-year-old female presented to the authors’ institution with partially submucosal lesion in the posterior aspect of the hard palate on the left side for 1 month. Biopsy was suggestive of a multinodular tumour with round to oval cells and a moderate number of pale eosinophilic to clear cytoplasm and round to oval, centrally to eccentrically placed, mildly pleomorphic vesicular nuclei suggestive of EMC of the hard palate. Immunohistochemically, cytokeratin (CK 5/6) showed strong cytoplasmic positivity highlighting the luminal epithelial cells. The myoepithelial cells showed strong nuclear positivity for p63 and cytoplasmic positivity for calponin. The patient underwent surgical resection of the tumour with a local flap cover and split skin graft and all the margins were negative in the final histopathological examination with erosion of the underlying bone. The patient was kept under observation and has been free of the disease for the past 12 months. Conclusion: Diagnosis of EMC is rare and is to be kept as a differential diagnosis during the evaluation of minor salivary gland tumours of palate.

Epithelial-Myoepithelial Carcinoma in a Canine Salivary Gland

A 7-year-old male cavalier King Charles spaniel was presented with a cervical subcutaneous mass. The mass had a multilobular growth pattern and each individual lobule contained ductal epithelial cells and myoepithelial cells surrounding the ductal cells. Immunohistochemically, the ductal epithelial cells were positive for cytokeratin (CK) 7 and CAM5.2 and the myoepithelial cells were positive for α-smooth muscle actin and p63. Both types of cells were positive for CK14, a myoepithelial cell marker. Ultrastructurally, the ductal epithelial cells were attached by desmosomes and contained abundant intracytoplasmic tonofilaments. Some ductal epithelial cells contained myofilaments characteristic of myoepithelial cells. Based on these findings, a diagnosis of epithelial-myoepithelial carcinoma was made. It is presumed that the tumour originated from an intercalated duct in a parotid salivary gland.

Une localisation parotidienne bilatérale d’un carcinome épithélial myoépithélial

We report the case of a 52-year-old man, who was admitted in the department of otorhinolaryngology for a mass of the right parotid gland. The radiological and clinical hypothesis was a squamous cell carcinoma. Histopathological examination revealed a biphasic proliferation composed of epithelial cells arranged in a tubular pattern stained with cytokeratins 5-6 and 7 and EMA surrounded by clear myoepithelial cells stained with smooth muscle actin and p63. Ki-67 labeling index was low. The diagnosis of epithelial myoepithelial carcinoma was proposed. One year after, the patient noticed a centimetric mass of the left parotid gland. The radiological hypothesis was the presence of an intraparotidian lymph node. Histopathological examination showed a second epithelial myoepithelial carcinoma. This is an uncommon neoplasm comprising approximately 1% of all salivary gland tumours, affecting mainly the parotid gland. It is occurring preferably in patients older than 60years old. This is a low-grade malignant tumour with tendency to local recurrence and lymph node metastatic potential. We describe an exceptional bilateral epithelial myoepithelial carcinoma of the parotid gland.

Primary Epithelial Myoepithelial Carcinoma of Lung, Reporting of a Rare Entity, Its Molecular Histogenesis and Review of the Literature

Primary epithelial myoepithelial carcinoma of lung is a rare entity and is thought to arise from the submucosal bronchial glands distributed throughout the lower respiratory tract. Because of the rarity of this tumor, we describe one case of epithelial myoepithelial carcinoma arising in the bronchus intermedius and presenting as an endobronchial mass. A 57-year-old male patient presented with an incidental finding of an endobronchial mass located in the lumen of the right lower lobe bronchus and caused near total luminal occlusion of the bronchus. An endobronchial carcinoid tumor was entertained clinically. Subsequently the patient underwent an uneventful videothoracoscopic lobectomy of lower and middle lobes of the right lung. Morphologically and immunohistochemically the tumor was characterized by two cell populations with epithelial and myoepithelial cells forming duct-like structure. The final diagnosis of epithelial myoepithelial carcinoma of lung was rendered.

Epithelial-Myoepithelial Carcinoma of Parotid Gland: A Cytological Challenge with Histological Correlation

Background: Epithelial-Myoepithelial Carcinoma (EMC) is a rare type of malignant tumor of salivary gland accounting for less than 1.5% of all salivary neoplasms. Differential diagnosis of this tumor is complicated, especially by cytological examinations. Case: We present the case of an 86-year-old female who presented clinically with a bulky lesion behind her right ear. Fine needle aspiration cytology with immunocytochemistry has been performed and the patient was diagnosed with a biphasic neoplasm, epithelial-myoepithelial, highly suggestive of EMC. She underwent a wide surgical excision and diagnostic was confirmed by histological examinations, which showed a tumor composed of ducts with double cell lining surrounded by a basement membrane in a sclerotic stroma. Immunohistochemistry was carried on to highlight the biphasic cell pattern. The patient is free of disease after 20 months of surgical procedure. Conclusion: Although there isn’t any antibody that confirms the diagnosis of EMC, due to the difficulty to make a correct diagnostic of this lesion by cytology, we have highly recommended the use of immunocytochemistry assay as an important tool to confirm the double-cell pattern, which in together with a clinical course may help in the diagnostic of EMC. Cytology and histology correlation are rarely reported.

Fine-Needle Aspiration Cytology of Epithelial-Myoepithelial Carcinoma of Parotid Gland -A Report of Two Cases-

Epithelial-myoepithelial carcinoma (EMC) is a rare low grade malignant tumor of the salivary glands and it shows a characteristic biphasic population of epithelium and myoepithelium. It shows various cytologic and histologic features, so making an exact diagnosis is difficult. We report here on two cases of epithelial-myoepithelial carcinoma arising from the parotid gland and we compare the cytologic findings of the aspirated samples with the histologic findings of the tumors. We think the finding of mixed pattern of large, clear myoepithelia and small epithelia is the most valuable finding in the diagnosis of EMC.