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Head and Neck Pathology Jun 2021Myoepithelial neoplasms are rare tumors of the salivary glands with predominant myoepithelial differentiation and a broad histologic spectrum. Their histological...
Myoepithelial neoplasms are rare tumors of the salivary glands with predominant myoepithelial differentiation and a broad histologic spectrum. Their histological features, immunohistochemical profile and biological behavior are not well characterized and pose a diagnostic challenge. A total of 15 myoepithelial tumors, diagnosed during 2012 and 2019 were subcategorized and correlated with MIB-1 labeling index (LI) and various histological parameters. Immunohistochemical stains for MIB-1 and other antibodies were performed. Statistical analysis was done by chi-square test, Fisher's exact test and Kaplan Meier curve. Nine patients were male and six were female with the median age of 44 years (range 21-83 years). Of the 15 patients, 6 cases were classified as myoepithelioma (ME) and 9 cases as myoepithelial carcinoma (MECA). Parotid gland was the most common site (46.7%) followed by the palate. MEs showed well circumscribed tumor borders whereas MECAs exhibited focal capsular to extensive invasion into adjacent tissues. Epithelioid cell morphology was most common followed by mixed cell morphology. MIB-1 LI was significantly associated with invasive tumor borders, necrosis and high mitosis. Increased frequency of recurrence was noted with high MIB-1 LI, though it was not statistically significant. MIB-1 LI was high in nearly all MECAs with focal capsular to extensive invasion while low in MEs. Myoepithelial tumor with multinodular growth pattern and focal capsular invasion may have an indolent behavior if mitotic activity and MIB-1 LI is low. Early diagnosis and treatment of MECAs significantly improves the patient's survival and prognosis.
Topics: Adult; Aged; Aged, 80 and over; Antibodies, Antinuclear; Antibodies, Monoclonal; Biomarkers, Tumor; Carcinoma; Female; Humans; Immunohistochemistry; Ki-67 Antigen; Male; Middle Aged; Mitotic Index; Myoepithelioma; Neoplasm Recurrence, Local; Prognosis; Retrospective Studies; Salivary Gland Neoplasms
PubMed: 32959208
DOI: 10.1007/s12105-020-01225-0 -
Hand Surgery & Rehabilitation Dec 2023Cutaneous myoepithelioma is a rare neoplasm of the skin that has become more widely recognized in recent years despite significant diagnostic pitfalls. It is a benign...
Cutaneous myoepithelioma is a rare neoplasm of the skin that has become more widely recognized in recent years despite significant diagnostic pitfalls. It is a benign neoplasm with a high recurrence rate if not excised radically, and must be distinguished from its malignant counterpart. Few cases have been described so far and, to our knowledge, no cases in the finger of a child exist in the literature. We report the case of a 15 year-old boy affected by a rare form of locally aggressive spindle-cell myoepithelioma, and suggest a new multidisciplinary approach combining surgical excision and custom brachytherapy.
Topics: Male; Child; Humans; Adolescent; Myoepithelioma; Skin Neoplasms; Fingers; Upper Extremity
PubMed: 37714516
DOI: 10.1016/j.hansur.2023.09.001 -
Head and Neck Pathology Mar 2020Primary myoepithelial neoplasms of soft tissue have been shown to be related to their salivary gland counterparts, with which they often share morphologic,... (Review)
Review
Primary myoepithelial neoplasms of soft tissue have been shown to be related to their salivary gland counterparts, with which they often share morphologic, immunophenotypic, and molecular genetic features, such as the presence of PLAG1 rearrangement in both soft tissue mixed tumor and salivary pleomorphic adenoma. However, important distinctions remain between soft tissue and salivary myoepithelial neoplasms, namely differing criteria for malignancy. This review provides an overview of the current understanding of the clinicopathologic and molecular features of soft tissue myoepithelial neoplasms, including discussion of the similarities and differences between soft tissue and salivary counterparts and relevant diagnostic issues specific to head and neck pathology practice.
Topics: Diagnosis, Differential; Head and Neck Neoplasms; Humans; Myoepithelioma; Salivary Gland Neoplasms; Soft Tissue Neoplasms
PubMed: 31950472
DOI: 10.1007/s12105-019-01109-y -
The American Journal of Surgical... Jan 2018We hypothesized that there is a relationship between the preexisting pleomorphic adenoma [PA]), histologic grade of epithelial-myoepithelial carcinomas (EMCAs), and...
Epithelial-Myoepithelial Carcinoma: Frequent Morphologic and Molecular Evidence of Preexisting Pleomorphic Adenoma, Common HRAS Mutations in PLAG1-intact and HMGA2-intact Cases, and Occasional TP53, FBXW7, and SMARCB1 Alterations in High-grade Cases.
We hypothesized that there is a relationship between the preexisting pleomorphic adenoma [PA]), histologic grade of epithelial-myoepithelial carcinomas (EMCAs), and genetic alterations. EMCAs (n=39) were analyzed for morphologic and molecular evidence of preexisting PA (PLAG1, HMGA2 status by fluorescence in situ hybridization, FISH, and FGFR1-PLAG1 fusion by next-generation sequencing, NGS). Twenty-three EMCAs were further analyzed by NGS for mutations and copy number variation in 50 cancer-related genes. On the basis of combined morphologic and molecular evidence of PA, the following subsets of EMCA emerged: (a) EMCAs with morphologic evidence of preexisting PA, but intact PLAG1 and HMGA2 (12/39, 31%), (b) Carcinomas with PLAG1 alterations (9/39, 23%), or (c) HMGA2 alterations (10/39, 26%), and (d) de novo carcinomas, without morphologic or molecular evidence of PA (8/39, 21%). Twelve high-grade EMCAs (12/39, 31%) occurred across all subsets. The median disease-free survival was 80 months (95% confidence interval, 77-84 mo). Disease-free survival and other clinicopathologic parameters did not differ by the above defined subsets. HRAS mutations were more common in EMCAs with intact PLAG1 and HMGA2 (7/9 vs. 1/14, P<0.001). Other genetic abnormalities (TP53 [n=2], FBXW7 [n=1], SMARCB1 deletion [n=1]) were seen only in high-grade EMCAs with intact PLAG1 and HMGA2. We conclude that most EMCAs arose ex PA (31/39, 80%) and the genetic profile of EMCA varies with the absence or presence of preexisting PA and its cytogenetic signature. Progression to higher grade EMCA with intact PLAG1 and HMGA2 correlates with the presence of TP53, FBXW7 mutations, or SMARCB1 deletion.
Topics: Adenoma, Pleomorphic; Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; DNA-Binding Proteins; Disease-Free Survival; F-Box-WD Repeat-Containing Protein 7; Female; Follow-Up Studies; HMGA2 Protein; Humans; In Situ Hybridization, Fluorescence; Male; Middle Aged; Mutation; Myoepithelioma; Neoplasm Grading; Neoplasms, Glandular and Epithelial; Proto-Oncogene Proteins p21(ras); SMARCB1 Protein; Salivary Gland Neoplasms; Sequence Analysis, DNA; Tumor Suppressor Protein p53
PubMed: 29135520
DOI: 10.1097/PAS.0000000000000933 -
Molecular and Clinical Oncology Jul 2018Following breast and lung cancers, renal cell carcinoma (RCC) is the third most frequent cancer to metastasize to the head and neck region, though such cases are rarely...
Following breast and lung cancers, renal cell carcinoma (RCC) is the third most frequent cancer to metastasize to the head and neck region, though such cases are rarely reported. Distinguishing between malignant tumors of salivary gland origin and metastatic RCC is very important. The case of a 75-year-old man with an oral cavity lesion in the left buccal submucosa measuring 40×30 mm that had grown substantially over several weeks is presented. His medical history included left kidney cancer 26 years earlier and a malignant myoepithelioma of the left buccal region 7 years earlier. It was suspected that this lesion was a recurrent malignant myoepithelioma as it appeared at the same site as the previous operation. Surgery was performed, and metastatic RCC was confirmed upon pathological examination. The diagnosis of metastatic RCC was made by immunohistochemical examination, which also excluded malignant myoepithelioma and other clear cell carcinomas of salivary gland origin. Metastatic RCC must be considered in the differential diagnosis of a new oral cavity lesion presenting in a patient with a past history of kidney cancer. Thus, immunohistochemical staining is required to distinguish malignancies of salivary gland origin, including malignant myoepithelioma, from metastatic RCC.
PubMed: 29896402
DOI: 10.3892/mco.2018.1630 -
The American Journal of Case Reports Apr 2022BACKGROUND Breast adenomyoepithelioma is a rare benign breast tumor characterized by a biphasic proliferation of epithelial and myoepithelial cells with variable...
BACKGROUND Breast adenomyoepithelioma is a rare benign breast tumor characterized by a biphasic proliferation of epithelial and myoepithelial cells with variable clinical and diagnostic features. Establishing the diagnosis, determining optimal therapy, and predicting outcome are problematic because of the rarity of this entity. There have been only 2 large series of adenomyoepitheliomas of the breast, reported by Tavassoli and Rosen, which included 27 and 18 patients, respectively. In this report, we present 3 cases of breast adenomyoepithelioma. CASE REPORT Herein, we report 3 cases of breast adenomyoepithelioma. The first case is of a 64-year-old woman who was found to have right breast microcalcification on a screening mammogram. The second case is of a 74-year-old woman who had a right breast mass. These 2 patients were managed by wide local excision. Postoperative microscopic examination revealed adenomyoepithelioma. The third case is of a 49-year-old woman with bilateral saline breast implants who presented with a left breast mass. A core needle biopsy was done and revealed adenomyoepithelioma associated with usual ductal hyperplasia and ductal carcinoma in situ. CONCLUSIONS Breast adenomyoepithelioma is a rare condition that can pose diagnostic challenges due to variable imaging presentations, necessitating percutaneous core biopsy for initial diagnosis. Correct diagnosis is usually possible only on excisional biopsy and confirmed by demonstrating the biphasic nature of the tumor by IHC. Clinical suspicion coupled with utilizing both radiological and histopathological facilities can aid in the accurate diagnosis and management. For the most part, they are considered to be benign, but they can locally recur.
Topics: Adenomyoepithelioma; Aged; Breast; Breast Neoplasms; Carcinoma, Intraductal, Noninfiltrating; Female; Humans; Middle Aged; Myoepithelioma; Neoplasm Recurrence, Local
PubMed: 35400730
DOI: 10.12659/AJCR.936070 -
BMJ Case Reports Jan 2021Myoepithelial tumours are a rare form of salivary gland neoplasm, and their occurrence in the central nervous system is exceedingly rare. The authors report the case of... (Review)
Review
Myoepithelial tumours are a rare form of salivary gland neoplasm, and their occurrence in the central nervous system is exceedingly rare. The authors report the case of an 18-year-old Filipino man presenting with headache and weakness, and on imaging showing an extensive parasagittal tumour at the left posterior parietal area with extracalvarial extension. There was no systemic disease. The patient underwent surgery to excise the tumour, with histopathology showing findings consistent with myoepithelioma. There was no further treatment, given the benign histology of the lesion, but there was recurrence after 8 months. Repeat surgery was done for the patient and he is for adjuvant radiotherapy. This appears to be the 10th reported case of a central nervous myoepithelioma, and the first case in the Philippines of a primary parasagittal myoepithelioma in a paediatric patient. Further information is needed to provide diagnostic and therapeutic recommendations.
Topics: Adolescent; Brain Neoplasms; Cerebral Angiography; Humans; Male; Myoepithelioma; Neoplasm Recurrence, Local; Parietal Lobe; Philippines; Radiotherapy, Adjuvant
PubMed: 33504518
DOI: 10.1136/bcr-2020-236479 -
Indian Journal of Otolaryngology and... Nov 2019Myoepithelioma is a rare tumour of the salivary glands. Only 3 cases of myoepithelioma in the nasal cavity have been reported. A 29 year old male presented to us with...
Myoepithelioma is a rare tumour of the salivary glands. Only 3 cases of myoepithelioma in the nasal cavity have been reported. A 29 year old male presented to us with epistaxis and nasal obstruction. There was a fleshy mass occupying the right middle meatus. Biopsy showed evidence of myoepithelioma and an endoscopic excision of the tumour was done. Histopathological examination of the resected tumour was consistent with myoepithelioma. Due to its rarity, the nature of the tumour is not known and regular follow-ups are needed for early detection of recurrence and malignancy.
PubMed: 31763237
DOI: 10.1007/s12070-017-1093-6 -
The Tohoku Journal of Experimental... Feb 2024Parotid tumors present a wide range of histological features, from benign to malignant. Periostin, an extracellular matrix protein specifically expressed in the...
Parotid tumors present a wide range of histological features, from benign to malignant. Periostin, an extracellular matrix protein specifically expressed in the periosteum and periodontal ligament, is isolated from osteoblast cell lines. It regulates fibrosis and collagen deposition and plays an important role in myocardial repair after myocardial infarction. It is also known to be involved in otorhinolaryngological-diseases. This study included 36 patients [38 specimens; 16 men and 20 women, mean age 59.2 (range 26-82) years] who underwent parotid tumor resection at the Division of Otorhinolaryngology, Tohoku Medical and Pharmaceutical University, between April 2017 and March 2022 and were clinically and pathologically diagnosed as having benign parotid tumors. Formalin-fixed, paraffin-embedded sections from the surgical specimens were autoclaved and immunostained with anti-periostin antibodies to evaluate the expression and distribution of periostin. Histologically, the tumors were diagnosed as pleomorphic adenomas in 15 cases (15 specimens), Warthin's tumors in 13 cases (15 specimens), basal cell adenomas in 2 cases (2 specimens), oncocytomas in 4 cases (4 specimens), and myoepitheliomas in 2 cases (2 specimens). An increased expression of periostin was found in 32 of 38 samples (84.2%) in the stroma of benign parotid tumors. Four distinct patterns of periostin expression were observed in benign parotid gland tumors: negative, superficial, infiltrative, and diffuse. Statistically significant differences were found between periostin expression patterns and histological classification of the tumors. Our results suggest that periostin may be involved in the pathogenesis of benign parotid tumors and could serve as a new biomarker for these tumors.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Adenoma; Adenoma, Pleomorphic; Parotid Neoplasms; Periostin; Salivary Gland Neoplasms
PubMed: 38092409
DOI: 10.1620/tjem.2023.J099 -
World Journal of Surgical Oncology Jan 2024A malignant myoepithelioma is a rare tumor, mostly arising from the salivary glands. Myoepitheliomas of the ear have rarely been reported. The manuscript reports... (Review)
Review
BACKGROUND
A malignant myoepithelioma is a rare tumor, mostly arising from the salivary glands. Myoepitheliomas of the ear have rarely been reported. The manuscript reports myoepithelial carcinoma of the external auditory canal (EAC) spreading to the infratemporal fossa. A clinician must be aware of anatomical variation of the bony EAC wall, such as the foramen of Huschke. This rare defect may be a pathway for spreading pathologies between these two anatomical regions.
CASE REPORT
We present a case of osteoma-like stenosis of the EAC, which turned out to be an extremely rare malignant tumor. The preoperative MRI and PET/CT revealed that two parts of the tumor communicated through a defect in the antero-inferior portion of the bony ear canal. No distant metastases were detected. Subsequently, the tumor was resected from the ear canal and the infratemporal fossa en bloc. Perioperatively the defect in the EAC wall was suspected of the foramen of Huschke. After the surgery, the older scans of the patient from the past showed no presence of a congenital EAC wall defect. Therefore, the authors concluded that the tumor aggressively grew through the bone due to its biological nature.
CONCLUSION
Malignant myoepithelioma of the external auditory canal is an extremely rare condition and could be misdiagnosed as other benign lesions. In cases of suspicious lesions, it is advisable to do a probatory biopsy from the EAC. Surgery is the treatment of choice in malignant myoepitheliomas, and regular follow-ups are essential to monitor for recurrence or metastatic disease. Any mass located at the antero-inferior portion of the EAC wall warrants close evaluation due to its potential for expansion from the EAC.
Topics: Humans; Ear Canal; Myoepithelioma; Clinical Relevance; Positron Emission Tomography Computed Tomography; Carcinoma
PubMed: 38268020
DOI: 10.1186/s12957-024-03317-5