Primary Mucoepidermoid Carcinoma Research Articles

Abstract #1605305: Primary Mucoepidermoid Carcinoma of the Thyroid Gland: A Case Report

Abstract #1605305: Primary Mucoepidermoid Carcinoma of the Thyroid Gland: A Case Report

P7-10 Primary mucoepidermoid carcinoma of the lung: A case report

P7-10 Primary mucoepidermoid carcinoma of the lung: A case report

Critical Appraisal of Histologic Grading for Mucoepidermoid Carcinoma of Salivary Gland: Is an Objective Prognostic 2-tiered Grading System Possible?

Multiple 3-tiered grading systems exist for mucoepidermoid carcinoma (MEC), leading to controversial results on the frequency and prognostic values of each grade. We aimed to identify prognostic histologic factors and to evaluate grading schemes in this retrospective study of 262 resected primary head and neck MECs. The rate of nodal metastasis was 8.4%. Large tumor size, tumor fibrosis, infiltrative border, lymphovascular invasion, perineural invasion, atypical mitosis, mitotic index (MI) ≥4/2mm 2 (4/10HPFs), necrosis, and pT4 stage were associated with increased risk of nodal metastasis. The 5-year recurrence-free survival (RFS) was 95%. Significant prognostic factors for RFS included infiltrative border, tumor-associated lymphoid stroma, architectural patterns (macrocystic, microcystic, and noncystic), anaplasia, atypical mitosis, MI, necrosis, lymphovascular invasion, margin, pT stage, and tumor size. Nuclear anaplasia, high mitotic rate, and ≥25% microcystic component were significant independent prognostic factors on multivariate survival analysis. There was no significant difference between low-grade (LG) and intermediate-grade (IG) MECs in terms of risk of nodal metastasis and outcomes using all 4 known grading systems. Rather, high-grade MEC was consistently associated with an increased risk of nodal metastasis at presentation and decreased RFS and distant metastasis-free survival (DMFS) compared with the LG/IG MECs. We therefore recommend simplifying MEC grading to a 2-tiered grading scheme using MI and/or tumor necrosis. Using a 2-tiered grading, high-grade histology independently predict RFS, and is associated with a 25% risk of nodal metastasis, a 5-year RFS of 76%, and a 5-year DMFS of 76%, whereas LG MEC has a nodal metastasis rate of 7.0%, 5-year RFS of 97% and 5-year DMFS of 99%.

Zorlayıcı ve Nadir Bir Vaka: Karaciğerin Mukoepidermoid Karsinomu

Mucoepidermoid carcinoma is the most common malignant tumor of the salivary gland. It rarely occurs in other organs. Less than 20 cases of mucoepidermoid carcinoma of liver have been reported in the literature.
 
 A 70-year-old woman with a liver mass is reported in this case report. After liver segmentectomy operation, the specimen was examined microscopically, a tumor consisting of epidermoid, mucinous, and intermediate cells was observed. It was interpreted as mucoepidermoid carcinoma. As no other focus was detected from comprehensive scanning of the patient, it was diagnosed as primary mucoepidermoid carcinoma of liver. Due to mimicking other tumors such as adenosquamous carcinoma and squamous cell carcinoma; cautious examination and differential diagnosis are important.

Mucoepidermoid Carcinoma of Breast Presenting as Abscess-like Pus Discharging Mass; A Rare Tumour With Unusual Presentation

Background: Mucoepidermoid carcinoma (MEC) breast is a very rare triple negative breast cancer with relatively better overall prognosis. They have histomorphological and immunohistochemical features similar to the salivary gland MEC. Literature suggests that they also carry molecular characteristics similar to the salivary gland MEC. Case Presentation: A 73-years-old woman presented with complaints of painful, foul smelling pus discharging mass in right breast. Patient underwent therapeutic incision and drainage along with diagnostic biopsy. On histopathology, diagnosis of MEC, high grade was made. Conclusion: Primary MEC is a very rare triple negative breast cancer (TNBC) usually with much better survival outcome in comparison to other TNBCs. However, the index case had locally advanced disease with unique presentation leading to an alternative initial management.

Immunotherapy combined with chemotherapy in the treatment for rare primary mucoepidermoid carcinoma of the liver: a case report.

Primary mucoepidermoid carcinoma of the liver (PMCL) is rare in the hepatic system, with no standard treatment and poor prognosis with a median overall survival of only 120 days. PMCL with immunotherapy has not been reported yet. Here, we present a case of PMCL treated by immunotherapy and chemotherapy. A 64-year-old male with PMCL underwent partial right hepatectomy and liver lesion resection on 19 June 2020. Two months later, the chest computed tomography indicated the presence of multiple nodules in both lungs with higher tumor markers. Considering the presence of a tumor metastasis, the patient received four courses of immunotherapy plus mGEMOX chemotherapy from 8 September 2020. The patient tolerated the combined therapy well, with red moles on the face and chest which were considered as grade 1 reactive cutaneous capillary endothelial proliferation. He also had grade 2 thrombocytopenia and leucopenia after the first course of chemotherapy, but no neutropenia, fatigue, vomiting or diarrhea. However, his disease progressed. The patient refused further treatment and died on 20 April 2021. The overall survival time after diagnosis was 301 days. We describe here the first case report on immunotherapy treatment for PMCL. That suggested immunotherapy combined with chemotherapy may be an option after a hepatic lobectomy for PMCL.

A RIDDLE WRAPPED IN A MYSTERY: MUCOEPIDERMOID CARCINOMA (MEC) FOUND DURING EVALUATION OF PERSISTENT LUNG COLLAPSE

A RIDDLE WRAPPED IN A MYSTERY: MUCOEPIDERMOID CARCINOMA (MEC) FOUND DURING EVALUATION OF PERSISTENT LUNG COLLAPSE

Primary Mucoepidermoid Carcinoma of Esophagus: A Rare Case Report

Primary mucoepidermoid carcinoma (MEC) of the esophagus is an uncommon malignant esophageal neoplasm characterized by a diffuse mixture of squamous and mucus secreting glandular carcinoma cells. The diagnostic challenges are associated with the distinction between adenosquamous carcinoma and MEC. Here we report a case of 60 year old male with dysphagia. Due to its rarity, the prognosis of this disease has not been well established. Keywords: Mucoepidermoid Carcinoma, esophagus, diagnostic challenge. .

Morphologic CT and MRI features of primary parotid squamous cell carcinoma and its predictive factors for differential diagnosis with mucoepidermoid carcinoma

BackgroundPrimary parotid squamous cell carcinoma (SCC) is a rare entity with a poor prognosis. Pathologically, the diagnosis of it requires the exclusion of parotid mucoepidermoid carcinoma (MEC). Currently, the imaging features of primary parotid SCC and the predictive indicators for differential diagnosis of the two entities have not been well reported. Our purpose was to identify the imaging characteristics of primary parotid SCC and to determine the predictive factors for its’ differential diagnosis.ResultsThirty-one participants with primary parotid SCC and 59 with primary parotid MEC were enrolled. Clinical, CT and MRI features were reviewed and compared by univariate analysis. Then, multinomial logistic regression was used to determine the predictors to distinguish parotid SCC from MEC. Most primary parotid SCCs exhibited irregular shape, ill-defined margin, incomplete or no capsule, heterogeneous and marked or moderate enhancement, necrosis, local tumor invasiveness (LTI). Age, maximal dimension, shape, degree of enhancement, gradual enhancement, necrosis, and LTI were different between the primary parotid SCCs and MECs in univariate analysis (p < 0.05). While in multinomial logistic regression analysis, only age and necrosis were the independent predictors for distinguishing parotid SCC from MEC, and this model exhibited an area under curve of 0.914 in ROC curve analysis.ConclusionsPrimary parotid SCC has some distinct imaging features including the large tumor size, irregular shape, ill-defined margin, and particularly the marked central necrosis. Patients with age ≥ 51.5 years and necrosis on the image of the primary tumor in the parotid gland could be more likely to be SCCs than MECs.

Primary Mucoepidermoid Carcinoma of the Lacrimal Apparatus

In this study, we evaluated the clinicopathologic and molecular characteristics of lacrimal apparatus mucoepidermoid carcinoma (MEC) to define its typical diagnostic features. Retrospective observational case series. Institutional pathology records between 2011 and 2021 were searched for all cases of lacrimal apparatus MEC. A total of 2 male and 6 female patients ranging in age from 18 to 83 years (median 56, mean 54) were included. Six lacrimal apparatus MECs were found in the lacrimal gland, and 2 cases occurred in the lacrimal sac and nasolacrimal duct. Histologically, there were 6 cases of conventional MEC, 1 clear-cell variant of MEC, and 1 oncocytic variant of MEC for a total of 8 cases. There were 3 low-grade cases and 5 high-grade cases. All 8 cases were evaluated via immunohistochemistry, and the results were positive (scores 1-4) for pankeratin, 34betaE12, p63, p40, CK7, CK8, and CK19, with a relatively higher expression of p63 observed in high-grade MEC. The presence of human papillomavirus (HPV) type 6 DNA was found in 4 patients. MAML2 fluorescence in situ hybridization was positive for MAML2 rearrangement in 3 lacrimal gland tumors (2 low-grade and 1 high-grade). Six tumors were managed with radical resection, and 2 patients underwent orbital exenteration. Postoperative radiation therapy was delivered to 6 patients, and chemotherapy was administered to 1 patient. MECs of the lacrimal apparatus are rare tumors, and the rate of MAML2 translocations is lower than that in salivary MECs. Lacrimal gland and lacrimal sac MECs may not be of the same subtypes intrinsically because of the difference in MAML2 translocation, anatomy, and clinical course. The etiologic function of HPV type 6 infection should be explored in lacrimal apparatus MECs. Radical surgery is the treatment of choice. The description of these unique findings may assist in the definitive diagnosis of and improve our understanding of lacrimal apparatus MEC.

Metastatic mucoepidermoid carcinoma to the pleura: a case report

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.

Imaging findings of the primary mucoepidermoid carcinoma of the breast.

Mucoepidermoid carcinoma (MEC) is an invasive tumor that has been reported in many organs, such as the salivary glands, lungs, esophagus, and thymus; however, it rarely affects the breast. Here, we report a case of primary breast MEC with imaging, including mammography, ultrasonography, and magnetic resonance imaging.

Primary mucoepidermoid carcinoma of the intrahepatic bile duct: A case report

Mucoepidermoid carcinoma (MEC) is the most common salivary gland carcinoma; however, hepatobiliary MEC is extremely rare. A 74‐year‐old patient was diagnosed with hepatobiliary MEC after hepatectomy. We considered its origin could be the peribiliary glands. Its genome profile was similar to salivary MEC rather than standard biliary tract carcinoma.

A rare case of mucoepidermoid carcinoma of the skin: A case report and a literature review

This report presents the case of primary Mucoepidermoid Carcinoma of the skin on the leg of a 74-year-old man. The epidemiological data of the neoplasm are examined, and the morphological picture and immunophenotypic profile are compared with those of the homologous tumor of the salivary glands. According to the scoring system of this type of tumor, our case is classified as low-grade.

A rare case of easily misdiagnosed primary mucoepidermoid carcinoma of the liver

A rare case of easily misdiagnosed primary mucoepidermoid carcinoma of the liver

P12-7 A young woman with muco-epidermoid carcinoma of the lung

Mucoepidermoid carcinoma (MEC) is a rare lung cancer constitute 0.1-0.2% of all lung cancer. MECs most often arise from the salivary glands most commonly from parotid and submandibular. Pulmonary MECs are proximal bronchial origin with symptoms related to bronchial obstruction such as cough, hemoptysis, wheezing and post obstructive pneumonia. Histologically, collection of mucus-secreting, squamous, and intermediate cell types are common. The prognosis of localized low-grade disease is excellent. Locally advanced high-grade disease has less favorable prognosis and most of the patients subsequently succumb to the disease. We are reporting a case of locally advanced MEC of left lung at the age of 13 years on 2003, received systemic therapy but the patient did not continue the treatment. Presented after 10 years with same type of features and repeat biopsy was confirmed. In 2013 she has been treated as locally advanced tumor with local EBRT 4000 cGy in 20# followed by 6 cycle chemotherapy with ifosphamide and Etoposide with improved clinical condition and we continued to follow up. Later presented with recurrent flare with metastatic disease during 2019 and subsequently died. Primary pulmonary MEC are very few in number as reported, most occurring in younger age groups as compared to the other more common types of lung cancer. The lack of cytological atypia including nuclear pleomorphism and absence of significant mitotic activity and cellular necrosis are distinguishing difference between low and high grade tumor. High-grade MECs demonstrating a greater risk for metastases, tumor recurrence, and death and comprises an important prognostic feature. Surgical excision remains the mainstay of treatment and low grade tumor's 5 years survival rate is around 95%. Though we did not go for surgery in our case of locally advanced tumor the survival time from diagnosis 17 years are comparable to surgically treated locally advanced cases.

Whole-exome sequencing reveals the etiology of the rare primary hepatic mucoepidermoid carcinoma

BackgroundPrimary hepatic mucoepidermoid carcinoma (HMEC) is extremely rare and the molecular etiology is still unknown. The CRTC1-MAML2 fusion gene was previously detected in a primary HMEC, which is often associated with MEC of salivary gland in the literature.MethodsA 64-year-old male was diagnosed with HMEC based on malignant squamous cells and mucus-secreting cells in immunohistochemical examination. Fluorescence in situ hybridization (FISH) was used to detect the CRTC1-MAML2 fusion gene in HMEC. Whole-exome sequencing and Sanger sequencing were used to reveal the molecular characteristics of HMEC and analysis was performed with public data. Pedigree investigation was performed to identify susceptibility genes.ResultsHematoxylin–eosin staining and immunohistochemistry revealed that the tumor cells were composed of malignant epidermoid malignant cells and mucous cells, indicating a diagnosis of HMEC. The CRTC1-MAML2 fusion gene was not detected in the primary HMEC, and somatic mutations in GNAS, KMT2C and ELF3 genes were identified by sequencing. Analyses of public data revealed somatic GNAS alterations in 2.1% hepatobiliary tumors and relation with parasite infection. Heterozygous germline mutations of FANCA, FANCI, FANCJ/BRIP1 and FAN1 genes were also identified. Pedigree investigation verified that mutation of Fanconi’s anemia susceptibility genes were present in the pedigree.ConclusionsHere we provide the first evidence of the molecular etiology of a rare HMEC associated with germline Fanconi’s anemia gene mutations and somatic GNAS R201H mutation.

Predictive CT features for the diagnosis of primary pulmonary mucoepidermoid carcinoma: comparison with squamous cell carcinomas and adenocarcinomas

BackgroundTo determine the predictive CT imaging features for diagnosis in patients with primary pulmonary mucoepidermoid carcinomas (PMECs).Materials and methodsCT imaging features of 37 patients with primary PMECs, 76 with squamous cell carcinomas (SCCs) and 78 with adenocarcinomas were retrospectively reviewed. The difference of CT features among the PMECs, SCCs and adenocarcinomas was analyzed using univariate analysis, followed by multinomial logistic regression and receiver operating characteristic (ROC) curve analysis.ResultsCT imaging features including tumor size, location, margin, shape, necrosis and degree of enhancement were significant different among the PMECs, SCCs and adenocarcinomas, as determined by univariate analysis (P < 0.05). Only lesion location, shape, margin and degree of enhancement remained independent factors in multinomial logistic regression analysis. ROC curve analysis showed that the area under curve of the obtained multinomial logistic regression model was 0.805 (95%CI: 0.704–0.906).ConclusionThe prediction model derived from location, margin, shape and degree of enhancement can be used for preoperative diagnosis of PMECs.

Metastatic Mucoepidermoid Carcinoma to the Pleura: An Unusual Presentation

Abstract Casestudy Mucoepidermoid carcinoma is the most common malignant tumor arising in salivary glands. Predictors of poor prognosis include high-grade tumors, positive surgical margins, lymph node metastasis, or distant metastasis. The most common sites for distant metastasis include skin, lung, liver, and bone. We herein present a case of salivary gland mucoepidermoid carcinoma with pleural involvement, which is an infrequent site for metastasis. A 64-year-old female presented with worsening dyspnea and cough, which showed no improvement with antibiotics. Imaging showed a right lung nodule measuring 1.2 cm along with bilateral pleural effusion and pleural based nodularities. The dominant nodules in right and left chest measured 5.8 cm and 4.8 cm in greatest dimension, respectively. The findings were suspicious for metastatic disease. Cytological examination of pleural fluid showed reactive mesothelial cells and inflammatory cells. Subsequent biopsy of the right pleural nodule showed sheets of tumor cells with abundant eosinophilic cytoplasm and few scattered clear cells. Mucocytes were absent. The tumor cells were positive for p40 and negative for TTF-1 by immunohistochemistry. A review of patient’s medical history was significant for high-grade salivary gland mucoepidermoid carcinoma, which was resected and radiated six years prior. A comparison of both lesions showed similar morphologic features. Mucicarmine stain was positive in resection specimen but negative in pleural biopsy, confirming the absence of mucocytes. Molecular studies on both specimens showed positivity for fusion of CRTC1 (19p13) and MAML2 (11q21) loci. The overall findings were consistent with metastatic mucoepidermoid carcinoma to pleura. Conclusion Pleura is an uncommon site for metastasis from primary salivary gland mucoepidermoid carcinoma but should be part of differential diagnosis. Extensive review of patient’s past medical history plays a crucial role in correctly classifying these lesions as primary or metastatic. Differential diagnoses should include primary squamous cell carcinoma, mesothelioma, and the rare primary mucoepidermoid carcinoma of pleura.

Clinicopathologic Findings in Primary Intraosseous Mucoepidermoid Carcinoma of the Jaws

Clinicopathologic Findings in Primary Intraosseous Mucoepidermoid Carcinoma of the Jaws