They help in expelling secretions from the lumen of secretory units and facilitate the movement of saliva in salivary ducts. Myoepithelioma of the lung european journal of cardio. R l font and a garner department of pathology, institute of ophthalmology, london. Diagnosis of myoepithelioma through light microscopy is possible and immunohistochemistry is done to facilitate the diagnosis. These tumors can occur in most of the glandular structures like salivary glands, breast and sweat glands of the skin. This included 6 cases of mucoepidermoid carcinoma, 3. Plasmacytoid myoepithelioma of minor salivary glands. Soft tissue myoepithelial me carcinoma, also known as soft tissue malignant myoepithelioma stmm, and myoepithelioma are rare entities, part of me tumors.
Pure accounting for less than 1% of all salivary gland tumors. Fine needle aspiration cytology of salivary gland lesions. Myoepithelial carcinoma malignant myoepithelioma of the parotid. The prognosis of the individual depends upon a set of several factors including the tumor stage and overall health of the individual. Myoepithelioma of parotid gland presenting as infraauricular. Mar 18, 2015 myoepithelioma was recognized as a histologically distinct entity by the world health organization who in 1991. Myoepithelial cells are a normal constituent of the major and minor salivary glands.
Sheldon initially published his work on a myoepithelioma in 1943, and first in 1991 and later in 2005 myoepithelioma was recognized from the who as a distinct entity 2, 3. The histological appearance includes solid, myxoid and reticular growth patterns. Myoepithelioma of the head and neck a usually benign tumor of the headneck consisting of solely myoepithelial cells. Myoepithelioma and related lesions pocket dentistry. Here, the author reports a case of myoepithelioma of the soft palate in a 42yearold turkish man. Combined myoepithelial carcinoma and myoepithelioma in soft. Dec 12, 2011 myoepithelioma is a rare benign tumor of the salivary glands and is usually seen in the parotid gland and the minor salivary glands. Treatment should be designed as for a benign salivary gland tumor with a margin of normal uninvolved tissue being included within the surgical excision. Oncocytic myoepithelioma and pleomorphic adenoma of the salivary glands.
Myoepithelioma common malignancies mucoepidermoid carcinoma variants adenoid cystic carcinoma carcinoma ex pleomorphic adenoma salivary duct carcinoma mucoepidermoid carcinoma incidence most common malignant salivary gland tumor children and adults major and minor salivary glands p k i id 5th t 6th d d 36. Salivary gland myoepithelial carcinoma mc or malignant myoepithelioma is a rare entity. Epithelialmyoepithelial carcinoma of the parotid gland. Myoepithelial carcinoma, also know as malignant myoepithelioma, is rare in the salivary gland, and its cytologic features have rarely been reported. Eleven months after the completion of the radiotherapy treatment the patient died as a result of undercurrent heart disease, without any. Myoepithelioma occurring in minor salivary glands of oral cavity accounts for 26% of all salivary gland myoepitheliomas and palate being the most common site 69. They commonly occur in salivary glands, but they have also been reported in the nasopharynx, larynx, breast and lung 1, 2. Two cases of myoepithelioma occurring in the parotid gland were reported. Immunohistochemical analysis of salivary gland tumors. Hamperl defined tumors containing mainly myoepithelial cells that are composed of three morphologic types. Malignant myoepithelioma of the salivary gland is discussed in terms of its clinical behaviour, morphological features and the frequent preexistence of a pleomorphic adenoma.
Myoepithelial cells are ectodermal in origin and envelope glandularacinar and ductal elements of salivary gland. Myoepithelioma was recognized as a histologically distinct entity by the world health organization who in 1991. Myoepithelioma definition of myoepithelioma by medical. Myoepitheliomas of minor salivary glands accounts to only 1. Salivary gland like tumors of the breast show a great variety of architectural patterns and cellular differentiations such as glandular, myoepithelial, squamous, and even mesenchymal phenotypes.
Myoepitheliomas are very rare tumurs of the salivary glands constituting less than 1. Capsules are generally better developed in tumors of the major glands, whereas those arising in the palate or other minor salivary or seromucinous gland sites are circumscribed but not usually encapsulated. Immunohistochemistry is a useful tool for diagnosing salivary gland and head and neck tumors. The mass was removed by local excision under general anesthesia. The tumors mostly present as asymptomatic, slowly progressive masses over a period of months to years in the patient with average age in the fourth decade 1. Myoepitheliomas are most common in young adults between. It can be present in individuals of a wide age range including children and adults the cause of formation of salivary gland myoepithelioma is not wellunderstood, although certain chromosomal alterations and gene mutations have been identified, based on the cases studied. Pdf plasmacytoid myoepithelioma of the palate in a child. Original research myoepithelioma of the p arotid gland. While myoepithelioma has no specific clinical features, it is accepted pathologically as a distinct entity. Myoepithelioma is a wellcircumscribed or encapsulated tumor. Combined myoepithelial carcinoma and myoepithelioma in. Myoepithelioma of a minor salivary gland of the cheek. Myoepitheliomas are rare benign neoplasias of the salivary gland, more commonly found in the parotid1,2, being responsible for less than 7% of salivary gland.
Design four cases of myoepithelial carcinoma with cytology were retrieved from the archives of the pathology departments of two academic institutes. Salivary gland neoplasms are rare tumors, they account about less than 310% of head and neck neoplasms2. In 1898, zimmerman first described the salivary gland myoepithelium. Myoepithelioma is a rare benign tumor of the salivary glands and is usually seen in the parotid gland and the minor salivary glands. The most common site is parotid gland with a few arising in minor salivary glands of the oral cavity and palate.
Myoepithelioma is usually a benign tumor arising from neoplastic myoepithelial or basket cells which are found between the basement membrane and the. Different cytogenetics from salivary gland myoepithelial carcinoma and breast ductal carcinomas with myoepithelial differentiation, based on study in one case cancer genet cytogenet 2008. Though they were first identified long back, still their histopathologic features and immunohistochemistry ihc profile are not well characterized and there is no definitive criterion for this tumor with complex and varied features remaining a major barrier. The salivary glands include paired major glands pa.
A 53yearold man presented with a 1year history of a painless. Myoepithelioma of the salivary gland was formally categorized as a salivary neoplasm in 1991 2,3. Myoepithelial neoplasms myoepithelioma mixed tumor morphology presence of ductal structures genetics rearrangement of plag1 or hmga2 salivary gland rearrangement of ewsr1 soft tissue spindle, plasmacytoid, epithelioid, clear cells. Myoepithelioma salivary gland, soft tissue, bone, breast p63.
Only three cases of sinonasal myoepithelioma have been reported in the literature. Myoepitheliomas are most common in young adults between the ages of 30 and 50 and there are very few cases reported in. Pdf myoepithelioma is a benign salivary gland tumor in the head and neck region, accounting for 11. They most commonly affect the major and minor salivary glands with the parotid gland being the most common, approximately 40%. The diagnosis was made on the basis of characteristic ultrastructural as well as immunohistochemical findings. Myoepithelial cells are normal components of salivary glands, sweat glands and breast. Rather, we believe that in general, physicians are simply unaware of its existence. Despite wide distribution of myoepithelial cells in the bronchial mucous glands, few tumors of myoepithelial origin have been reported in the lung. To the best of our knowledge, such an association has never been reported in the literature. It was once considered to be a type of pleomorphic adenoma pa, but myoepitheliomas are today believed to be relatively aggressive tumors. Myoepithelial cells of ectodermal origin and mesodermal functionality, normal constituent cells of ductal structures in major and minor salivary glands and other organs, are modified cellular elements with both epithelial and myocontractile properties. Solid nonmyxoid, myxoid pleomorphic adenomalike, reticular canalicularlike or mixed patterns of myoepithelial cells with no ductal differentiation. The diagnosis is rendered histopathologically, and it includes the.
Myoepithelioma mixed tumor morphology presence of ductal structures genetics rearrangement of plag1 or hmga2 salivary gland rearrangement of ewsr1 soft tissue spindle, plasmacytoid, epithelioid, clear cells, myxoid or hyalinized stroma keratin, ema, s 100, keratin, ema, simmunophenotype gfap, p63, calponin, sma, desmin 100. Myoepithelioma is a rare neoplasm of the salivary glands, generally occurring in the parotid gland and less often in the minor accessory salivary gland of the oral. Review and updates of immunohistochemistry in selected salivary gland and head and neck tumors shaobo zhu, md. Aug 26, 2009 myoepithelioma is a rare salivary gland tumor arising from proliferation of myoepithelial cells.
Myoepithelioma is rare benign neoplasm, usually involves salivary glands and very less often seen in minor salivary glands of nose. The cystic lesion has a mildly fibrotic appearing wall, is lined by histiocytes intermixed with rare lymphocytes, and contains mucous and macrophages. As the name suggests, it consists of myoepithelial cells. Only 1% of all salivary gland neoplasms are myoepitheliomas. It can be present in individuals of a wide age range including children and adults.
Myoepithelioma is a benign salivary gland tumor in the head and neck region, accounting for 11. Myoepithelial cells are a significant component of most types of salivary gland neoplasms. Case report open access plasmacytoid myoepithelioma of. Myoepithelial cells mec are found in the secretory units of many mammalian exocrine glands such as mammary, sweat, lacrimal and salivary glands. The sections show a stratified squamous epithelium with a thin layer of parakeratosis, minor salivary glands, and a wellcircumscribed cystic lesion.
About 60% to 70% of mca develop in a benign mixed tumor. Who gets myoepithelial carcinoma of salivary gland. A similar tumor type may be found in the tongue, referred to as ectomesenchymal chondromyxoid tumor. Two tumours presented as intraoral lesions and eight were located in the parotid gland. Dedifferentiated malignant myoepithelioma of the parotid gland. Spindle cell myoepithelioma of the parotid gland europe pmc.
Dedifferentiated salivary gland tumor is a rare, recently recognized tumor type. Myoepithelioma of minor salivary glands a diagnostic. The lesions were clinically suspected to be epidermal cyst. Myoepithelial tumors of the salivary gland including myoepitheliomas. This process is experimental and the keywords may be updated as the learning algorithm improves. Although, clear cell myoepitheliomas have been reported at other sites58, most of the cases of palatal myoepitheliomas have been plasmacytoid or spindle cell type9. Salivary gland myoepithelial carcinoma springerlink.
Subsequently, it was designated variously as the parotid clear cell adenoma probably of myoepithelial derivation or adenomyopeithelioma. Myoepithelioma of the parotid gland with extensive. Review and updates of immunohistochemistry in selected. Malignant salivary gland tumors were seen in 16 cases. Discussion myoepithelioma is a benign tumor that is exclusively or almost exclusively composed of neoplastic cells that exhibit myoepithelial differentiation. Sep 24, 2014 soft tissue myoepithelial carcinoma and myoepithelioma are rare entities, part of myoepithelial tumors.
It becomes very difficult to diagnose due to its varied presentation and propensity for malignant transformation. The study comprised six female and four male patients aged 1463 years mean age 38. Myoepithelioma is a rare and usually benign salivary gland tumor derived from myoepithelial cells. Histologically, two distinct neoplastic cell populations were observed in the same tumor mass.
Primary myoepithelioma of the testis a case report. They were incorporated into the world health organization classification of soft tissue tumors in 2002. This tumour may be particularly locally aggressive, but its clinical and biological features are not yet fully understood. Mar 27, 2018 myoepithelioma of salivary gland is an uncommon benign tumor typically arising in the major salivary glands. Myoepithelioma of salivary glands is a rare neoplasm generally occurs in parotid glands and less often in minor salivary glands of the palate and oral cavity. In this report, we describe two cases of a benign myoepithelioma of the parotid gland. Immunohistochemical analysis of salivary gland tumors ncbi. Clinically it resembles like other tumour masses and thus posed challenge to clinician and pathologist. Nov 18, 2016 myoepithelial carcinoma is a rare malignant cancerous tumor that usually occurs in the salivary glands in the mouth, but can also occur in skin and soft tissues. Pdf myoepithelioma of a minor salivary gland of the.
Myoepithelioma me is a rarely encountered tumor of salivary gland accounting for about 1% of all salivary gland tumors. These tumors consisted of spindle cells that exhibited an arrangement similar to leiomyoma or fibroma. In this report, we describe two cases of a benign myoepithelioma of the p arotid gland. Salivary gland myoepithelioma with focal capsular invasion. We present here a case of a malignant myoepithelioma of the parotid gland. Myoepithelial carcinoma an overview sciencedirect topics. A case of dedifferentiated malignant myoepithelioma in a 59. Tumour cells were positive for cytokeratins, and in minor intraoral salivary glands. The 2005 revised who classification of salivary gland tumors account for more than 35 distinct variants of salivary gland neoplasms3. Abstract myoepithelioma is a rare neoplasm of the salivary glands, generally occurring in the parotid gland and less often in the minor accessory salivary gland of the oral cavity. Myoepithelial carcinoma is a rare malignant cancerous tumor that usually occurs in the salivary glands in the mouth, but can also occur in skin and soft tissues. Variability in cellular morphology and stromal composition leads to diagnostic pitfalls on fine.
Myoepithelioma of salivary gland is an uncommon benign tumor typically arising in the major salivary glands. K5k14positive cells contribute to salivary glandlike. Minor salivary glands also have mixed serous and mucous acini in. Rare primary lesions that have been known to metastasize to the skin include an adenoid cystic carcinoma, an acinic cell carcinoma, a myoepithelial carcinoma, and adenocarcinoma of the salivary gland, 365370 an adenoid cystic carcinoma of the lacrimal gland, 371 an ameloblastoma, 372 a thymoma, 373 an adrenal carcinoma, 374,375 a pheochromocytoma, 376 and carcinomas of the hypopharynx, 377 nasopharynx, 31,378,379 and larynx. Cytology of myoepithelial carcinoma of the salivary gland. Benign salivary gland tumors were seen in 38 cases. Health, general cancer diagnosis research cancer diagnosis carcinoembryonic antigen genetic aspects cea oncology immunohistochemistry intermediate filament proteins medical research medicine, experimental salivary gland tumors tumor proteins. Dec 01, 2018 the treatment for myoepithelial carcinoma of salivary gland involves a combination of surgery, chemotherapy, and radiation therapy, in most cases. Myoepithelioma of salivary glands are very rare, accounting for only 1%1. Malignant myoepithelioma of salivary gland is very rare, accounting for only 0. Basaloidblue salivary gland tumors modern pathology nature.
The diagnosis is rendered histopathologically, and it includes the proliferation of myoepithelial cells, without chondroid or myxochondroid stroma and ductal components up to 5% of ductal component is acceptable. Myoepitheliomas mes are rare tumors of the parotid gland. Myoepithelioma of minor salivary gland of cheek cytology description nuclear grooves, intranuclear cytoplasmic inclusions, nuclear striations zebra lines, myxoid matrix. The tumor cells of the two cases likewise contained myofilaments and gave a positive result for the s. We report two patients with myoepithelioma of parotid gland presenting as infraauricular subcutaneous mass. The uncommon diagnosis of myoepithelioma in salivary glands was initially reserved for those tu.
Myoepithelioma of the head and neck, also myoepithelioma, is a salivary gland tumour of the head and neck that is usually benign. There was no recurrence during the followup period of 10 months. Vimentin and s100 protein are very sensitive but nonspecific immunohistochemical markers of neoplastic myoepithelium. The benign salivary corpuscular bassinetmyoepithelioma. This website is intended for pathologists and laboratory personnel, who understand that medical information is imperfect and must be interpreted using reasonable medical judgment. It is a benign salivary gland tumor that consists entirely of myoepithelial cells with variable cellular morphologies including spindle, epithelioid, plasmacytoid, or clear cells. The tumor is composed exclusively of myoepithelial cells that show spindle, plasmacytoid, and clear cell morphology. They present as bulky, bosselated, slowgrowing tumors that maybecomelarge. Here we present an exceptional case of myoepithelial carcinoma and myoepithelioma association. Only a few case reports describing ct imaging features of me have been published. Approximately 66% of these tumors occur in a part of the salivary gland, known as the parotid gland. Myoepithelial cells mec of the salivary glands in health. The recurrence rate is similar to that of the pleomorphic adenoma 1518%. Myoepithelioma is a rare neoplasm of the salivary glands, generally occurring in the parotid gland and less often in the minor accessory salivary gland of the oral cavity.
Myoepithelioma is a rare benign salivary was consistent with myoepithelioma, plasmocytoid gland tumour, localized most frequently in the parotid variant. Salivary gland myoepithelial cell pleomorphic adenoma minor salivary gland major salivary gland these keywords were added by machine and not by the authors. Basaloid tumors are a common diagnostic problem in salivary gland pathology. Myoepithelioma is a benign salivary gland tumor that consists entirely of myoepithelial cells. Rare primary lesions that have been known to metastasize to the skin include an adenoid cystic carcinoma, an acinic cell carcinoma, a myoepithelial carcinoma, and adenocarcinoma of the salivary gland, 365370 an adenoid cystic carcinoma of the lacrimal gland, 371 an ameloblastoma, 372 a thymoma, 373 an adrenal carcinoma, 374,375 a pheochromocytoma, 376 and carcinomas of the. Malignant myoepithelioma of the parotid gland wiley online library. However, unlike cellular pa, the stroma in a bca does not blend into the. Losito nsbotti gionna fpasquinelli gminenna pbisceglia m clearcell myoepithelial carcinoma of the salivary glands. Myoepithelioma is a rare but wellcharacterized group of tumours, among which myoepithelioma of the salivary glands is the best known. Mc usually presents as a slowgrowing painless mass arising in the parotid gland, but may involve other salivary glands.
Classically, they are found in the parotid gland or palate. Myoepithelioma, salivary glands, mouse springerlink. Myoepithelioma me is a benign salivary gland tumor composed almost exclusively of sheets, islands, or cords of cells with myoepitheliomal differentiation. Original article, clinical report by ear, nose and throat journal.
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