1: Am J Otolaryngol. 2006 Jan-Feb;27(1):58-60.
Epithelial-myoepithelial carcinoma in the base of the tongue: a case report.
Kumai Y, Ogata N, Yumoto E.
Department of Otolaryngology, Head, and Neck Surgery, Graduate School of
Medicine, Kumamoto University, Kumamoto, Japan.
035r5120@med.stud.kumamoto-u.ac.jp
OBJECTIVES: To report a rare case of epithelial-myoepithelial carcinoma (EMC) of
a minor salivary gland originating in the base of the tongue, which is a highly
unusual location. STUDY DESIGN: This is a case report and a review of
literature. METHODS: A 76-year-old man was referred to our outpatient clinic
with a 6-month history of a sensation of a foreign body in the pharynx.
Endoscopic examination revealed a tumorous lesion 40 x 20 mm in the base of the
tongue on the left side. A biopsy was performed, and the lesion was
histologically identified as squamous cell carcinoma. RESULTS: The patient
underwent subtotal glossectomy, bilateral neck dissection, and reconstruction
with a microvascularized rectus abdominis myocutaneous flap. The final diagnosis
based on the histological and immunohistochemical findings was EMC. Because
neither histological evidence of residual tumor in the surgical margin nor neck
metastases were found, radiotherapy was not performed. No local recurrence or
distant metastases have been found 19 months post-surgery. CONCLUSION: We
believe this report is the first description of EMC originating in the base of
the tongue. We conclude that a wide surgical excision with a clear margin and
close, prolonged follow-up are recommended for the treatment of EMC.
2: Oral Oncol. 2006 Jan;42(1):57-65. Epub 2005 Sep 2.
Detection of C-KIT (CD117) molecule in benign and malignant salivary gland
tumours.
Andreadis D, Epivatianos A, Poulopoulos A, Nomikos A, Papazoglou G, Antoniades
D, Barbatis C.
Department of Oral Medicine and Maxillofacial Pathology, Dental School,
Aristotle University of Thessaloniki, Greece.
C-KIT (CD117), a tyrosine kinase receptor, is involved in the growth and
development of normal tissues and some types of neoplasms. In the present study
we analysed the expression of this molecule in salivary gland tumours. Archival
formalin-fixed, paraffin-embedded sections of 40 benign and 57 malignant
salivary gland tumours were retrieved and retrospectively studied
immunohistochemically using a polyclonal C-KIT antibody in an Envision/HRP
technique. In addition five samples of chronic submandibular sialadenitis, five
normal minor salivary glands and parotid or submandibular gland tissue adjacent
to benign tumour were also studied. C-KIT expression was observed in cases of
adenoid cystic, acinic cell polymorphous low grade, epithelial-myoepithelial,
carcinosarcoma and basal cell adenocarcinomas, as in luminal cells of
pleomorphic adenomas, in serous acinar and only in intercalated and a small
number of striated ductal cells of inflammatory salivary gland tissue, whereas
normal salivary lobules were generally negative except a weak positivity of
intercalated cells. Contrary to other reports, this study suggests that, C-KIT
protein does not appear to be an exclusively specific marker for benign or
malignant salivary gland neoplasms, but may be useful in differential diagnosis
of adenoid cystic carcinoma from polymorphous low grade adenocarcinoma.
Furthermore its expression in serous acinar cells in sialadenitis and
intercalated ductal cells in normal and inflammatory lesions may indicate a
possible participation in pathogenesis of both neoplastic and non-neoplastic
salivary gland diseases.
3: Int J Surg Pathol. 2005 Jan;13(1):57-65.
Myoepithelial cell markers in salivary gland neoplasms.
Furuse C, Sousa SO, Nunes FD, Magalhaes MH, Araujo VC.
Department of Oral Pathology, Sao Leopoldo Mandic Dental Research Institute,
Campinas, Brazil.
We compared the immunoexpression of 5 myoepithelial cell (MEC) markers
(alpha-smooth-muscle actin, calponin, h-caldesmon, vimentin, and S-100-protein)
using 16 pleomorphic adenomas (PA), 15 adenoid cystic carcinomas (ACC), and 3
epithelial-myoepithelial carcinomas (EMC) of salivary glands. The
alpha-smooth-muscle actin was useful for identification of MECs, especially in
cribriform and tubular ACC, followed by EMC. Calponin was similar to
alpha-smooth-muscle actin, except for polygonal and plasmacytoid cells of PA and
for solid ACC, which showed alpha-smooth-muscle actin negative and calponin
positive. H-caldesmon was negative. Vimentin immunostained all MEC types, and
was negative in luminal cells. S-100 protein was expressed both in the nuclei
and cytoplasm of MECs and luminal cells, especially in PA. The best way to
identify MEC is using alpha-smooth-muscle actin or calponin, plus vimentin,
since in tumors MECs are hardly ever fully differentiated.
4: J Korean Med Sci. 2004 Jun;19(3):462-5.
A hybrid carcinoma of epithelial-myoepithelial carcinoma and adenoid cystic
carcinoma in maxillary sinus.
Woo JS, Kwon SY, Jung KY, Kim I.
Department of Otolaryngology-Head and Neck Surgery, Anam Hospital, Korea
University College of Medicine, Seoul, Korea.
Hybrid carcinoma of the salivary gland is a very rare entity that has been
described only in the parotid and palate. The occurrence of a hybrid carcinoma
of maxillary sinus has not been reported. The diagnosis of hybrid carcinoma is
important particularly when the components of tumor have different biologic
behaviors. Diagnosis and treatment require a high index of suspicion, especially
when the tumor is an epithelial-myoepithelial carcinoma, pathological effort to
look for a more aggressive accompanying tumor, and proper oncologic treatment.
We describe a case of 26-yr-old woman with a hybrid carcinoma composed of
epithelial-myoepithelial carcinoma with an adenoid cystic carcinoma component
(cribriform pattern) in the right maxillary sinus with a brief review of the
relevant literature.
5: Diagn Cytopathol. 2004 Apr;30(4):280-3.
Cytopathological features of an epithelial-myoepithelial carcinoma with
predominant clear myoepithelial cells in the parotid gland.
Kawahara A, Harada H, Yokoyama T, Kage M.
Department of Pathology, Kurume University Hospital, Kurume, Japan.
Epithelial-myoepithelial carcinoma (EMC) is a rare low-grade carcinoma occurring
most frequently in the parotid gland. Most EMCs consist of two cell types that
typically form double-layered ductal structures. However, occasionally EMC
presents predominantly clear myoepithelial cells. A 34-year-old man visited in
August 1993 and was diagnosed as having clear-cell carcinoma. The tumor was
curatively resected. However, in the following 5 years, recurrence developed a
total of five times. The imprint cytological feature of the recurrence at the
third time showed monophasic clear cells in sheet clusters with overlapping.
Most of the clear tumor cells presented an expression to alpha-smooth muscle
actin (SMA). The imprint cytological feature of the recurrence at the fifth time
showed increase of nuclear atypia with coarse chromatin patterns and large
nucleoli. In addition to cytological findings, the cytological diagnosis of EMC
with predominant clear myoepithelial cells requires a definite expression to
SMA. Copyright 2004 Wiley-Liss, Inc.
6: Pathologe. 2004 Feb;25(1):46-55.
[Differential diagnosis of basaloid salivary gland tumors]
[Article in German]
Jakel KT, Loning T.
Institut fur Oralpathologie, Zentrum Klinisch-theoretische Medizin I,
Universitatsklinikum Eppendorf, Hamburg. jaekel@uke.uni-hamburg.de
The diagnosis of basaloid tumors of the salivary glands can be challenging. In
most cases, conventional histologic examination, if carried out meticulously,
will be sufficient. Yet, immunohistochemistry will be of help for the definition
of purely myoepithelial tumors, basaloid squamous cell carcinomas, and
canalicular adenomas. The differential diagnosis of canalicular adenoma, basal
cell adenoma and basal cell adenocarcinoma, adenoid cystic carcinoma,
polymorphous low-grade adenocarcinoma, myoepithelial tumors,
epithelial-myoepithelial carcinoma, and basaloid squamous cell carcinoma is
discussed.
7: Arch Pathol Lab Med. 2004 Jan;128(1):92-4.
Bronchial epithelial-myoepithelial carcinoma.
Ru K, Srivastava A, Tischler AS.
Department of Pathology, New England Medical Center, Tufts University School of
Medicine, Boston, MA 02111, USA. kru@tufts-nemc.org
Epithelial-myoepithelial tumor is extremely rare as a pulmonary neoplasm. Only
20 cases have been reported to date, of which 14 were malignant. We report a
case of intrabronchial epithelial-myoepithelial carcinoma in a 73-year-old man
with a history of heavy smoking. The tumor was well-circumscribed and caused
distal airway obstruction. Histologically, the tumor showed glandular and solid
architecture. The glands were composed of an inner layer of epithelial cells and
an outer layer of myoepithelial cells. The solid areas consisted of
spindle-shaped myoepithelial cells. Immunohistochemical staining was positive
for p53 and c-Kit (CD117). Focal atypia and increased mitotic activity were
present, but no vascular invasion or nodal metastasis was identified.
8: Eur Arch Otorhinolaryngol. 2003 Jul;260(6):312-5. Epub 2003 Feb 12.
Hybrid tumours of the salivary glands. A report of two cases involving the
palate and a review of the literature.
Ruiz-Godoy LM, Mosqueda-Taylor A, Suarez-Roa L, Poitevin A, Bandala-Sanchez E,
Meneses-Garcia A.
Department of Pathology, National Cancer Institute, Ave. San Fernando 22, CP
14000, Tlalpan, Mexico. lmgodoy@salud.gob.mx
Hybrid tumours are very rare salivary gland lesions composed of two or more
different tumoural entities in a single neoplasm that arise within a definite
topographical region. In most cases adenoid cystic carcinoma has been the
predominant component in these lesions. In this study we describe two patients
with hybrid tumours located in the palate, one in a 49-year-old woman and one in
a 71-year-old man. The first case involved adenoid cystic carcinoma and
mucoepidermoid carcinoma, and the patient in the second case exhibited adenoid
cystic carcinoma and epithelial-myoepithelial carcinoma. Both patients were
treated with surgery and radiotherapy, and there has been no evidence of
recurrence after 13 and 36 months of follow-up, respectively. The recognition of
the histologic component with the higher grade of malignancy in every case of
hybrid tumour of the salivary glands is a necessary step to determine the
biological behaviour and, consequently, to determine the proper therapeutic
approach.
9: Auris Nasus Larynx. 2003 May;30(2):201-3.
Epithelial-myoepithelial carcinoma of the parotid gland.
Kumagai M, Suzuki H, Matsuura K, Takahashi E, Hashimoto S, Suzuki H, Tezuka F.
Department of Otolaryngology, Sendai National Hospital, 2-8-8 Miyagino,
Miyagino-ku, Japan.
We report a rare case of epithelial-myoepithelial carcinoma (EMC) of the parotid
gland. A 70-year-old man presented with a 4-months-history of right-sided
subauricular swelling. Computed tomographic scans revealed a well-defined mass
with cystic lesion, measuring about 40 mm in diameter, in the right parotid
gland. Because the tumor occupied superficial lobe, he underwent superficial
parotidectomy with preservation of the facial nerve. On the basis of the
histological and immunohistochemical findings, the tumor was diagnosed as EMC.
His post-operative course was uneventful, and he is currently free from disease
6 months after surgery. Diagnosis, clinical behavior and treatment of EMC are
reviewed from perusal of the literature.
10: Med Oral. 2002 Nov-Dec;7(5):391-5.
Salivary Gland Epithelial- Myoepithelial Carcinoma: behaviour, diagnosis and
treatment.
[Article in English, Spanish]
Senis-Segarra L, Sahuquillo-Arce E, Davo R, Hamad-Arcis P, Floria-Garcia LM,
Baquero MC.
Servicio de Cirugia Oral y Maxilofacial, Hospital Universitario la Fe, Valencia,
Spain. Senis@mixmail.com
Across the whole spectrum of the tumoral pathology in the maxillo-facial and
cervical areas, we can find those tumours where the aetieology is in the
salivary glands. The tumours in the salivary glands are subdivided in benign and
malignant tumours whenever this theorical subdivision is possible. The
Epithelial-Myoepithelial Carcinoma represents about the 1% of the malignant
neoplasms in the salivary glands and also affect other anatomical areas where
there are glands: lung, kidney, uterus and so on. We start from a clinical case
of a Epithelial-Myoepithelial of salivary minor gland carcinoma doing a
bibliographic review of this unusual histological lineage. So we present a case
of Epithelial-Myoepithelial Carcinoma of a minor salivary gland in the right
cheek. We'll review the clinical and histological features of this uncommon
tumour. And we'll discuss about the best way for diagnosis, treatment and the
differential diagnosis to similar clinical injuries.
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