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Laryngoscope Investigative... Jun 2022Mucoepidermoid carcinoma (MEC) is the most common malignancy of the parotid gland, but the outcome depends on the histological grade. Therefore, the aim of this study...
OBJECTIVE
Mucoepidermoid carcinoma (MEC) is the most common malignancy of the parotid gland, but the outcome depends on the histological grade. Therefore, the aim of this study was to evaluate MEC on the basis of histological grade.
STUDY DESIGN
Retrospective analysis.
METHODS
We performed a retrospective analysis of data from patients whose initial treatment for MEC of the parotid gland was performed at our department between 1999 and 2021. We examined the association between the Armed Forces Institute of Pathology (AFIP) grade and outcome.
RESULTS
The AFIP grades were as follows: low, 26 cases; intermediate, 9 cases; and high, 31 cases. About 50% of cases were correctly diagnosed as malignant, and both grade and histology were accurately determined by fine-needle aspiration cytology in 20% of cases. The 5-year disease-free survival rate was 95.5% and 53.8% in the low-/intermediate- and high-grade cases, respectively. In the high-grade group, cases with recurrence were found to have a higher rate of lymph nodes metastasis than cases without recurrence. Furthermore, in this high-grade group, total sacrifice of the facial nerve did not reduce local recurrence. However, radical resection in the cases without tumor invasion to the nerve has decreased the local recurrence rate. The CRTC1-MAML2 fusion gene was expressed in 42.3% of low-/intermediate- and 14.3% of high-grade cases.
CONCLUSIONS
The survival rate in MEC was quite different between the low-/intermediate- and high-grade cases. However, the rate of correct assessment of the grade by fine-needle aspiration cytology was poor. In high-grade cases, total sacrifice of the facial nerve may improve the rate of local recurrence in cases without invasion of the main trunk of the nerve. Expression of the CRTC1-MAML2 fusion gene could be helpful in not only the assessment of grade but the prediction of recurrence.
LEVEL OF EVIDENCE
4.
PubMed: 35734046
DOI: 10.1002/lio2.809 -
Journal of Dentistry (Shiraz, Iran) Jun 2023Mast cells are round to elliptical cells that originate from bone marrow stem cells and enter the peripheral blood. By releasing inflammatory mediators, these cells are...
STATEMENT OF THE PROBLEM
Mast cells are round to elliptical cells that originate from bone marrow stem cells and enter the peripheral blood. By releasing inflammatory mediators, these cells are involved in type I hypersensitivity, wound healing, defense against pathogens, increased blood vessel formation, and destruction of the extracellular matrix. There are contradictory results regarding the role of mast cells in tumor lesions.
PURPOSE
Considering the contradictory results and few studies on the density of mast cells in salivary tumors, the present study investigated and compared the density of mast cells in two common salivary gland tumors.
MATERIALS AND METHOD
In the cross-sectional study after reviewing the records of patients referred to the Pathology Department of the School of Dentistry and Shahid Sadoughi Hospital in Yazd, 15 blocks of each of the mucoepidermoid carcinoma and pleomorphic adenoma tumors were taken. After Giemsa staining of the samples, the average of stained cells in 10 random fields under 400× magnification was counted. The results were analyzed using statistical tests of t-test, ANOVA, Chi-square, and Mann-Whitney in SPSS ver. 22.
RESULTS
The average mast cell counts in pleomorphic adenoma (4.2) was higher than muco-epidermoid carcinoma (1.7) but there was no significant relationship (= 0.305). In mucoepidermoid carcinoma, the numbers of mast cells increased with increasing tumor grade (low: 0/467 moderate: 1/567 high: 2/983) and there was a significant relationship (= 0.009).
CONCLUSION
According to the results of the present study, it seems that the mast cells accumulation may be secondarily associated with inflammatory responses due to cell accumulation and tissue destruction by tumor cells.
PubMed: 37388197
DOI: 10.30476/dentjods.2022.93712.1730 -
Hua Xi Kou Qiang Yi Xue Za Zhi = Huaxi... Jan 2022Warthin-like mucoepidermoid carcinoma (MEC) is a recently identified MEC variant of the salivary gland. MEC morphologically mimics Warthin tumor (WT) but harbors the...
Warthin-like mucoepidermoid carcinoma (MEC) is a recently identified MEC variant of the salivary gland. MEC morphologically mimics Warthin tumor (WT) but harbors the same chromosomal translocation t (11; 19) (q21; p13) as MEC. Thus, differential diagnosis is crucial. MEC involving WT is extremely rare in salivary glands. In this study, we reported a case of Warthin-like MEC, a case of MEC co-existing with WT, and a case of mucinous metaplasia in WT. We also discussed the possible link between WT and MEC.
PubMed: 38597001
DOI: 10.7518/hxkq.2022.01.016 -
Indian Journal of Otolaryngology and... Oct 2022Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for 54-76% of all salivary gland neoplasms. Extensive squamous metaplasia in PA can be...
Pleomorphic adenoma (PA) is the most common salivary gland tumor, accounting for 54-76% of all salivary gland neoplasms. Extensive squamous metaplasia in PA can be mistaken for malignancy, including low grade mucoepidermoid carcinoma and squamous cell carcinoma. Here, we present an unusual case of PA with extensive squamous metaplasia and keratin cyst formations in a minor salivary gland, and discuss its microscopic features, including the immunohistochemical characteristics, and differential diagnosis of this uncommon presentation.
PubMed: 36452717
DOI: 10.1007/s12070-020-02039-w -
Signal Transduction and Targeted Therapy Jan 2021Mucoepidermoid carcinoma (MEC) is the most common type of salivary gland cancers and patients with advanced, metastatic, and recurrent MECs have limited therapeutic...
Mucoepidermoid carcinoma (MEC) is the most common type of salivary gland cancers and patients with advanced, metastatic, and recurrent MECs have limited therapeutic options and poor treatment outcomes. MEC is commonly associated with a chromosomal translocation t(11;19) (q14-21;p12-13) that encodes the CRTC1-MAML2 oncogenic fusion. The CRTC1-MAML2 fusion is required for MEC growth in part through inducing autocrine AREG-EGFR signaling. Growing evidence suggests that MEC malignancy is maintained by cancer stem-like cells. In this study, we aimed to determine critical signaling for maintaining MEC stem-like cells and the effect of combined targeting of stem cell signaling and CRTC1-MAML2-induced EGFR signaling on blocking MEC growth. First, we evaluated the significance of Notch signaling in regulating MEC stem-like cells. Aberrantly activated Notch signaling was detected in human fusion-positive MEC cells. The inhibition of Notch signaling with genetic or pharmacological inhibitors reduced oncosphere formation and ALDH-bright population in vitro and blocked the growth of MEC xenografts in vivo. Next, we investigated the effect of co-targeting Notch signaling and EGFR signaling, and observed enhanced inhibition on MEC growth in vivo. Collectively, this study identified a critical role of Notch signaling in maintaining MEC stem-like cells and tumor growth, and revealed a novel approach of co-targeting Notch and EGFR signaling as a potential effective anti-MEC treatment.
Topics: Animals; Carcinoma, Mucoepidermoid; Cell Proliferation; ErbB Receptors; Erlotinib Hydrochloride; Heterografts; Humans; Mice; Molecular Targeted Therapy; Neoplastic Stem Cells; Oncogene Proteins, Fusion; Receptors, Notch; Salivary Gland Neoplasms; Signal Transduction; Trans-Activators; Transcription Factors; Translocation, Genetic
PubMed: 33473104
DOI: 10.1038/s41392-020-00388-0 -
Zhongguo Yi Xue Ke Xue Yuan Xue Bao.... Jun 2022Objective To improve the understanding and diagnostic accuracy of pulmonary mucoepidermoid carcinoma(PMEC) by analyzing the imaging and clinical characteristics.Methods...
Objective To improve the understanding and diagnostic accuracy of pulmonary mucoepidermoid carcinoma(PMEC) by analyzing the imaging and clinical characteristics.Methods The clinical and CT data of 27 cases of PMEC confirmed by histopathology in the First Medical Center of Chinese PLA General Hospital from January 2016 to December 2020 were retrospectively analyzed,including the location,size,margin,density,enhancement characteristics,accompanying signs,and pathological grade.Results The 27 cases included 6(6/27,22.2%) of large airway type,14(14/27,51.9%) of hilar type,and 7(7/27,26.9%) of peripheral type.The CT manifestations of 20 cases of large airway and hilar PMEC were soft-tissue nodules or mass with clear boundary in the lumen of the trachea and main bronchi,including 6 cases of mild enhancement,4 cases of moderate enhancement,5 cases of marked enhancement,and 5 cases of uneven enhancement.Three of the 20 cases showed calcification.The 7 cases of peripheral PMEC showed soft-tissue nodules or masses in the lungs,including 3 cases of mild enhancement,1 case of moderate enhancement,and 3 cases of marked enhancement. Obstructive pneumonia or atelectasis and bronchiectasis with mucus plug formation occurred in 16(16/27,59.3%) cases,lymph node metastasis in 9(9/27,33.3%) cases,and multiple organ metastasis in 8(8/27,29.6%) cases.Age(=-3.132,=0.005),enlarged lymph node (=9.281,=0.003),and distant metastasis(=7.816,=0.008) were statistically significant in the low-grade group and high-grade group. Conclusion PMEC have some unique imaging features,and recognizing these signs is conducive to the differential diagnosis and the improvement of the diagnostic accuracy.
Topics: Carcinoma, Mucoepidermoid; Child, Preschool; Humans; Lung Neoplasms; Lymphatic Metastasis; Retrospective Studies; Tomography, X-Ray Computed
PubMed: 35791941
DOI: 10.3881/j.issn.1000-503X.14939 -
Thoracic Cancer Aug 2022Pulmonary mucoepidermoid carcinoma (PMEC) is uncommon. The purpose of this study was to evaluate the clinicopathological features, diagnostic criteria, treatment...
Pulmonary mucoepidermoid carcinoma (PMEC) is uncommon. The purpose of this study was to evaluate the clinicopathological features, diagnostic criteria, treatment options, and prognostic factors relating to primary PMEC. Clinical data on 45 patients with primary PMEC were collected and analyzed retrospectively at Tianjin Medical University General Hospital and the First People' Hospital of Longquanyi District Chengdu from January 2008 to December 2020. The 45 patients (25 males and 20 females) ranged in age from 22 to 72 years, with a median age of 49 and an average age of 47.7. All the patients underwent surgery, with 32 receiving only surgery and 13 receiving both surgery and postoperative chemotherapy. A total of 34 instances of low-grade tumors and 11 cases of high-grade tumors were discovered during postoperative pathological diagnosis. Forty-five patients were followed for 13 to 78 months, and four died during this period. In all four instances, a lung infection unrelated to the tumor was determined to be the cause of death. The MAML2 gene translocation was detected in 40 of 45 patients, with 34 of them testing positive. Radical surgery with lymph node dissection is an efficient treatment for PMEC. The prognosis is poor for patients with advanced disease, a negative MAML2 gene translocation, lymph node metastases, and high-grade tumors.
Topics: Adult; Aged; Carcinoma, Mucoepidermoid; Female; Humans; Lung Neoplasms; Male; Middle Aged; Neoplasm Staging; Prognosis; Retrospective Studies; Transcription Factors; Translocation, Genetic; Young Adult
PubMed: 35747926
DOI: 10.1111/1759-7714.14536 -
Indian Journal of Otolaryngology and... Dec 2022Salivary gland tumours constitute an uncommon and diverse group of neoplasms that vary considerably in their histology and biologic behaviour. As per Globocon 2018,...
Salivary gland tumours constitute an uncommon and diverse group of neoplasms that vary considerably in their histology and biologic behaviour. As per Globocon 2018, salivary gland malignancy account for 0.3% of all cancer cases and 0.2% of all cancer deaths worldwide, reflecting the rarity of these neoplasms. Mucoepidermoid carcinoma (MEC) is a common malignant tumour of major and minor salivary gland, which comprises about 10% of all salivary gland neoplasms and approximately 35% of malignant salivary gland neoplasms. While three fourth of cases of MEC arise in the parotid, they account for a large proportion of salivary gland neoplasms occurring in minor salivary glands. Appending to the uncommonness, unusual presentations like MEC arising in heterotopic rests of salivary gland tissue in intraparotid or extraparotid lymph nodes, and MEC arising in lingual tonsils have been reported. Such diversity of clinical presentation may present a diagnostic challenge. In this continuum, we report a rare and unique case of low grade mucoepidermoid carcinoma of minor salivary gland, which primarily presented as cervical lymph node metastasis, three years before the primary intraoral lesion occurred.
PubMed: 36742659
DOI: 10.1007/s12070-021-02513-z -
Head and Neck Pathology Jun 2023Sinonasal adenosquamous carcinoma is rare, and there are almost no studies detailing morphology or characterizing their genetic driver events. Further, many authors have...
BACKGROUND
Sinonasal adenosquamous carcinoma is rare, and there are almost no studies detailing morphology or characterizing their genetic driver events. Further, many authors have termed sinonasal tumors with combined squamous carcinoma and glands as mucoepidermoid carcinoma but none have analyzed for the presence of MAML2 rearrangement.
METHODS
Cases from 2014 to 2020 were collected and diagnosed using World Health Organization criteria. They were tested for p16 expression by immunohistochemistry (70% cut-off), DEK::AFF2 fusion by fluorescence in situ hybridization (FISH) and AFF2 immunohistochemistry, MAML2 rearrangement by FISH, and low- and high-risk HPV by RNA ISH and reverse transcription PCR, respectively. Detailed morphology and clinical features were reviewed.
RESULTS
There were 7 male (64%) and 4 female (36%) patients with a median age of 69 years, most Caucasian (10 of 11 or 91%). Most had tobacco exposure (8/11, 73%) and most presented with epistaxis, a visible nasal mass, and/or facial pain. Several had a precursor papillomas (3 of 11, 27%). The squamous component had variable keratinization, 5 of 11 (46%) of which would be described as keratinizing, 3 non-keratinizing, and 2 with mixed features. All had gland formation, by definition, and 2 of 11 (18%) had ciliated tumor cells. None of the 11 cases had MAML2 rearrangement and one had DEK::AFF2 fusion with associated positive nuclear AFF2 protein immunostaining. Most were p16 positive (7 of 11, 64%) and all 7 of these were hrHPV positive either by RNA ISH or RT-PCR. Two of the p16-negative tumors were positive for lrHPV by RNA ISH. Treatment included surgery alone (4 of 11, 36%), surgery with adjuvant radiation (5 of 11, 45%), and surgery with radiation and chemotherapy (2 of 11, 18%). Four of 11 patients (36%) suffered disease recurrence, two requiring re-operation and who were disease free at last follow-up, one receiving additional chemotherapy and who was alive with disease. The other elected to undergo palliative therapy and died of disease.
CONCLUSION
Sinonasal adenosquamous carcinoma is a somewhat heterogeneous tumor not infrequently arising ex papilloma and having various drivers including high- and low-risk HPV and rarely DEK::AFF2 fusion. The prognosis appears favorable when proper treatment is possible.
Topics: Humans; Male; Female; Aged; Carcinoma, Adenosquamous; Human Papillomavirus Viruses; RNA, Messenger; In Situ Hybridization, Fluorescence; Papillomavirus Infections; Transcription Factors; Nuclear Proteins; Paranasal Sinus Neoplasms; Carcinoma, Mucoepidermoid; Trans-Activators
PubMed: 36849671
DOI: 10.1007/s12105-023-01538-w -
Oral Oncology Dec 2021Mucoepidermoid carcinoma (MEC) is one of the most common salivary gland malignancies. Our aim was to evaluate the prognostic impact of primary tumor site in patients...
UNLABELLED
Mucoepidermoid carcinoma (MEC) is one of the most common salivary gland malignancies. Our aim was to evaluate the prognostic impact of primary tumor site in patients with MEC.
MATERIAL AND METHODS
This cohort identified 308 patients with MEC who underwent primary surgery between 1985 and 2015. Survival outcomes were determined using the Kaplan-Meier method. Hazard ratios for primary site were determined using the Cox proportional-hazards model.
RESULTS
One hundred eighty (58%) patients were diagnosed with minor and 128 (42%) with major salivary gland cancer. Primary site in the minor salivary gland group included 137 (44%) oral cavity, 38 (12%) pharynx, 3 (0.9%) nasal cavity, and 2 (0.6%) trachea and larynx. The major salivary gland group included 118 (38%) parotid, 8 (3%) submandibular, and 2 (0.6%) sublingual. With a median follow-up of 73 months, 5-year overall survival and disease-specific survival were 84% and 91%, respectively. Patients with tumors located in the hard palate and retromolar trigone had the best survival, while patients with tumors located in the paranasal sinuses and submandibular gland had the poorest survival. After controlling for tumor grade and stage, MEC primary site was not predictive of survival or recurrence. On multivariate analysis, worse DSS was associated with stage III-IV tumors (HR: 7,11; 95% CI: 1.19-26.43; p = 0.0034) and high-grade tumors (HR: 19.12; 95% CI: 2.26-162.77; p = 0.0068).
CONCLUSIONS
While high grade and advanced overall stage were found to be independent predictors of worse survival, primary tumor site was not predictive of poor outcome.
Topics: Carcinoma, Mucoepidermoid; Humans; Neoplasm Staging; Prognosis; Retrospective Studies; Salivary Gland Neoplasms; Survival Rate
PubMed: 34768210
DOI: 10.1016/j.oraloncology.2021.105602