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Journal of Stomatology, Oral and... Dec 2020Mucoepidermoid Carcinoma (MEC) is the most common malignant salivary gland neoplasm, representing 10 to 15% of all salivary neoplasms. A review of the literature was... (Review)
Review
OBJECTIVE
Mucoepidermoid Carcinoma (MEC) is the most common malignant salivary gland neoplasm, representing 10 to 15% of all salivary neoplasms. A review of the literature was conducted in order to determine trends in presentation, diagnostic features, treatment, and outcomes.
METHODS
A PubMed, Embase, and Scopus search was carried out. The search process was performed by 2 independent reviewing authors and inclusion criteria included systematic reviews, meta-analyses, case-controls studies, cohort studies, comparative studies, clinical trials, cross-sectional studies, descriptive studies, experimental studies, case reports, case series studies, and human studies evaluating MEC.
RESULTS
Females were more affected (54.5%) and the average age was 48.8 years. The most common location of MEC was the parotid glands (56.8%) followed by hard palate (18%). The most frequent clinical presentation was mass (65.2%) followed by ulcer (29.4%) with pressure as their main symptom (64.4%). The most frequent histologic presentation was Low grade (46.7%) followed by Intermediate grade (27.3%) and the most used treatment was surgery (76.2%). The average follow up was 138.5months, and recurrence was reported at 8.5%.
CONCLUSION
MEC showed a strong predilection for the parotid glands is frequently painful, most frequently presents as a mass and most commonly has a low-grade histologic presentation.
Topics: Carcinoma, Mucoepidermoid; Cross-Sectional Studies; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Parotid Gland; Salivary Gland Neoplasms
PubMed: 32565266
DOI: 10.1016/j.jormas.2020.06.003 -
Molecular Pathology of Salivary Gland Neoplasms: Diagnostic, Prognostic, and Predictive Perspective.Advances in Anatomic Pathology Mar 2021Salivary gland neoplasms are an uncommon and widely heterogeneous group of tumors. In recent years, there has been considerable progress in efforts to reveal the... (Review)
Review
Salivary gland neoplasms are an uncommon and widely heterogeneous group of tumors. In recent years, there has been considerable progress in efforts to reveal the molecular landscape of these tumors, although it is still limited and appears to be only the tip of the iceberg. Genomic aberrations, especially specific chromosomal rearrangements including CRTC1-MAML2 and CRTC3-MAML2 in mucoepidermoid carcinoma, MYB-NFIB and MYBL1-NFIB fusions in adenoid cystic carcinoma, PLAG1 and HMGA2 alterations in pleomorphic adenoma and carcinoma ex pleomorphic adenoma, ETV6-NTRK3 and ETV6-RET in secretory carcinoma, EWSR1-ATF1 and EWSR1-CREM in clear cell carcinoma, provide new insights into the molecular pathogenesis of various salivary gland neoplasms and help to better classify them. These genetic aberrations primarily serve as diagnostic tools in salivary gland tumor diagnosis; however, some also have promise as prognostic or predictive biomarkers. This review summarizes the latest developments in molecular pathology of salivary gland tumors with a focus on distinctive molecular characteristics.
Topics: Adenoma, Pleomorphic; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Gene Expression Regulation, Neoplastic; Humans; Pathology, Molecular; Prognosis; Salivary Gland Neoplasms
PubMed: 33405400
DOI: 10.1097/PAP.0000000000000291 -
Mayo Clinic Proceedings Sep 2023
Topics: Humans; Carcinoma, Mucoepidermoid
PubMed: 37661153
DOI: 10.1016/j.mayocp.2023.07.018 -
BMJ Case Reports Aug 2014Salivary gland tumours comprise almost 5% of head and neck malignancies. Minor salivary gland tumours account for 10-15% of all salivary gland neoplasms and are usually... (Review)
Review
Salivary gland tumours comprise almost 5% of head and neck malignancies. Minor salivary gland tumours account for 10-15% of all salivary gland neoplasms and are usually malignant. The second most common minor salivary gland tumour (12-40% globally) is mucoepidermoid carcinoma. Mucoepidermoid carcinoma is more frequent in females, occurs in the fifth decade of life and is usually found in the parotid gland. However, the palate is a frequent site when it occurs in the minor glands. We report a case of a high-grade variant of mucoepidermoid carcinoma in the right retromolar trigone of a 21-year man which was treated with wide excision of the tumour with a 1.5 cm margin. Reconstruction was done with a buccal fat pad posteriorly with a pedicled lateral tongue flap. Temporal stripping and right coronoidectomy was carried out in case of post-surgical wound contraction. The patient is currently under periodic review.
Topics: Biopsy; Carcinoma, Mucoepidermoid; Diagnosis, Differential; Humans; Male; Radiography, Panoramic; Salivary Gland Neoplasms; Salivary Glands, Minor; Tomography, X-Ray Computed; Young Adult
PubMed: 25085946
DOI: 10.1136/bcr-2013-202776 -
Expert Review of Respiratory Medicine Mar 2018Primary mucoepidermoid carcinomas (MEC) of the lung are rare and represent a diagnostic challenge. MEC in the lung is under the umbrella of primary salivary gland type... (Review)
Review
Primary mucoepidermoid carcinomas (MEC) of the lung are rare and represent a diagnostic challenge. MEC in the lung is under the umbrella of primary salivary gland type tumors of the lung. Areas covered: In general, salivary gland type tumors are represented by malignant neoplasms that may range from low to intermediate to high-grade type of malignancy sharing similar histopathological features as those in salivary glands. The focus in this review will be on one tumor in particular - mucoepidermoid carcinoma. Clinical, radiological, histopathological, and molecular diagnostic features will be highlighted in order to provide an insight on this unusual tumor in the lung. In addition, the treatment of these tumors will be discussed. Expert commentary: It is important to stress that in the majority of cases, the proper use of histopathological assessment is the most important step in arriving at an accurate diagnosis. It is also important to recognized that there are other unusual primary tumoral conditions of the lung, which may pose a significant challenge in the differential diagnosis. The importance of proper recognition of mucoepidermoid carcinoma and its grading will be highlighted in order to assess clinical outcome.
Topics: Carcinoma, Mucoepidermoid; Diagnosis, Differential; Humans; Lung Neoplasms
PubMed: 29338644
DOI: 10.1080/17476348.2018.1428563 -
European Archives of... Apr 2015Clinicopathological features, prognosis and therapeutic strategies for mucoepidermoid carcinoma originating in salivary and salivary-type glands of the head and neck are... (Review)
Review
Clinicopathological features, prognosis and therapeutic strategies for mucoepidermoid carcinoma originating in salivary and salivary-type glands of the head and neck are reviewed. We emphasise histopathological aspects, appraise the value of histochemistry, electron microscopy, immunohistochemistry and cytophotometry, and discuss histogenesis and characteristic gene translocations. We additionally consider possible diagnostic difficulties, problems related to histological grading and accuracy of existing literature, and areas of controversy or uncertainty which may benefit from further investigations.
Topics: Biopsy, Fine-Needle; Carcinoma, Mucoepidermoid; Disease Management; Head and Neck Neoplasms; Humans; Immunohistochemistry; Neoplasm Grading; Neoplasm Invasiveness; Neoplasm Staging; Prognosis; Salivary Gland Neoplasms
PubMed: 24771140
DOI: 10.1007/s00405-014-3053-z -
Mucoepidermoid carcinoma of the head and neck: CRTC1/3 MAML 2 translocation and its prognosticators.European Archives of... May 2022Mucoepidermoid carcinoma (MEC) of the head and neck is a prevalent malignant salivary gland tumour with a reported good outcome. The aim of this study was to report the...
PURPOSE
Mucoepidermoid carcinoma (MEC) of the head and neck is a prevalent malignant salivary gland tumour with a reported good outcome. The aim of this study was to report the outcome in our centre.
METHODS
A retrospective chart analysis with survival analyses was performed combined with fluorescence in situ hybridization (FISH) analysis to assess CRTC1/3 MAML 2 fusion gene presence.
RESULTS
Sixty-four cases of MEC were identified. Median age at presentation was 51.4 years with a predominance for parotid gland involvement. Five, 10- and 20- year disease-free survival was 98%, 90% and 68%, respectively. Overall survival was 94%, 90% and 64%, respectively. Local recurrence was seen up to 14 years after primary diagnosis; distant metastases were diagnosed up to 17 years later. The overall recurrence rate was less than 20 per cent. CRTC1/3 MAML 2 fusion gene presence showed no survival benefit.
CONCLUSION
MEC of the head and neck has a favorable outcome with the exception of high-grade MEC. PNI and nodal involvement are not rare. CRTC1/3 MAML 2 fusion gene presence showed no survival benefit. The tendency for late onset of loco-regional and distant recurrence should not be underestimated.
Topics: Carcinoma, Mucoepidermoid; DNA-Binding Proteins; Humans; In Situ Hybridization, Fluorescence; Nuclear Proteins; Retrospective Studies; Salivary Gland Neoplasms; Trans-Activators; Transcription Factors; Translocation, Genetic
PubMed: 34405264
DOI: 10.1007/s00405-021-07039-2 -
Cancer Medicine May 2023Mucoepidermoid carcinoma (MEC) of the breast is an extremely rare salivary gland-type tumor characterized by epidermoid, basaloid, intermediate, and/or mucinous cells...
Mucoepidermoid carcinoma (MEC) of the breast is an extremely rare salivary gland-type tumor characterized by epidermoid, basaloid, intermediate, and/or mucinous cells arranged in solid and cystic patterns. Despite their triple-negative phenotype, breast MECs are generally considered low-risk malignancies but their biology is largely unexplored; therefore, guidelines for clinical management are lacking. Here, we sought to characterize the molecular landscape of breast MECs. Thirteen cases were histologically reviewed, characterized for tumor-infiltrating lymphocytes (TILs), and were subjected to immunohistochemistry for programmed death-ligand 1 (PD-L1, clone 22C3), EGFR, and amphiregulin (AREG). Rearrangements in MAML2 and EWSR1 were investigated by fluorescent in situ hybridization. Targeted next-generation sequencing of 161 genes was performed on eight cases. Most MECs had low histological grade (n = 10, 77%), with the presence of TILs (n = 9/12; 75%) and PD-L1 combined positive score ranging from 10 to 20 (n = 4/6; 67%). All cases showed EGFR and AREG overexpression and were fusion negative. Enrichment of genetic alterations was observed in PI3K/AKT/mTOR and cell cycle regulation pathways, while only one case harbored TP53 mutations. This is the first study providing extensive molecular data on breast MECs and the largest collection of cases available to date in the literature. Breast MECs lack TP53 mutations found in high-grade forms of triple-negative breast cancers and MAML2 or EWSR1 rearrangements pathognomonic of salivary MECs. Triple-negativity and PD-L1 positivity suggest a window of opportunity for immunotherapy in these patients. The EGFR/AREG axis activation, coupled with the mutational patterns in PI3K/AKT/mTOR and cell cycle pathways warrants caution in considering MECs as low-risk neoplasms.
Topics: Humans; DNA-Binding Proteins; Trans-Activators; B7-H1 Antigen; In Situ Hybridization, Fluorescence; Carcinoma, Mucoepidermoid; Phosphatidylinositol 3-Kinases; Proto-Oncogene Proteins c-akt; Nuclear Proteins; Transcription Factors; Salivary Gland Neoplasms; ErbB Receptors; TOR Serine-Threonine Kinases; Biomarkers, Tumor
PubMed: 36916425
DOI: 10.1002/cam4.5754 -
Radiology Oct 2022
Topics: Breast; Carcinoma, Mucoepidermoid; Humans
PubMed: 35787204
DOI: 10.1148/radiol.220128 -
The Annals of Otology, Rhinology, and... Dec 2022Discussions regarding the specific management and outcomes for laryngeal MEC are limited to very small, single-institution case series. To look further into the...
OBJECTIVES
Discussions regarding the specific management and outcomes for laryngeal MEC are limited to very small, single-institution case series. To look further into the diagnosis and management of these uncommon non-squamous cell carcinomas of the larynx, we present 3 recent cases of laryngeal MEC treated at our institution.
METHODS
Patients at a tertiary hospital treated for MEC between October 2019 and December 2020 were retrospectively identified. Chart review, imaging analysis, and histologic slide creation were completed for all patients.
RESULTS
We identified and treated 2 patients with high-grade supraglottic and 1 patient with intermediate-grade glottic MEC. These patients presented to our clinic with a primary complaint of either gradual, worsening dysphonia, dysphagia, or both. All patients underwent laryngovideostroboscopy as well as panendoscopy with directed submucosal biopsy, which was consistent with MEC. MRI was performed in 2 of the cases further elucidating the extent of submucosal spread. PET-CT was performed in all 3 cases, and none demonstrated evidence of regional or distal metastases. Surgically, high-grade MEC lesions were treated with a total laryngectomy. The intermediate MEC lesion was managed with a supracricoid partial laryngectomy (SCPL). Surgical margins were free of tumor in all cases with no nodal metastases by modified radical neck dissection. Radiation therapy was offered to both high-grade MEC patients and declined by one. Radiation was not recommended to the patient with intermediate-grade MEC as we believed that the risk of additional treatment outweighed the benefit.
CONCLUSION
We believe that MEC of the larynx should be considered in patients with atypical submucosal laryngeal masses. Laryngovideostroboscopy, MRI, and PET imaging may be valuable in determining the extent of the lesions and planning appropriate surgery. Postoperative radiation therapy should be considered a per tumor grade in other more studied sites, as there is no data on efficacy in laryngeal MEC.
Topics: Carcinoma, Mucoepidermoid; Humans; Laryngeal Neoplasms; Laryngectomy; Larynx; Positron Emission Tomography Computed Tomography; Retrospective Studies
PubMed: 34991344
DOI: 10.1177/00034894211069459