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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 -
European Archives of... Mar 2022To describe the clinicopathological characteristics and determinants of survival of patients with mucoepidermoid carcinoma (MEC) of the tongue.
OBJECTIVES
To describe the clinicopathological characteristics and determinants of survival of patients with mucoepidermoid carcinoma (MEC) of the tongue.
METHOD
Retrospective population-based study was conducted using the data of patients diagnosed with MEC of the tongue from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2016.
RESULTS
A total of 200 cases of MEC of the tongue were identified. The cohort was composed of 56.5% females. The mean age at diagnosis was 58.8 years. The base of the tongue was the most common primary site (72.5%). Most cases (80.9%) presented with T1 and T2. Lymph node metastases was present in 40.9% of cases, while distant metastases only observed in 2.2% of cases. Overall survival (OS) at 2, 5, and 10 years was 80.2%, 69.8%, and 52.4%, respectively. 77.5 percent of cases (155/200) underwent surgery, and 66 cases received both surgery and radiation therapy. Patients with post-operative radiation had much longer disease-specific survival (DSS). Advanced T stage, distant metastasis contributed independently to shorter OS, while the use of surgery is an independently favorable prognostic factor for OS. In addition, an OS-specific nomogram was established, and the C-index for OS prediction was 0.74 (95% CI 0.67-0.81).
CONCLUSION
This rare malignancy is associated with a generally favorable prognosis, and T stage, distant metastasis as well as surgical therapy are independent predictors of OS.
Topics: Carcinoma, Mucoepidermoid; Female; Humans; Male; Nomograms; Prognosis; Retrospective Studies; SEER Program; Tongue
PubMed: 34152476
DOI: 10.1007/s00405-021-06919-x -
Journal of the American Society of... 2020Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a... (Review)
Review
Diagnosis of salivary gland tumors on small biopsy can be difficult because of overlapping morphology, limited tissue availability, and technical artifact. Although a specific diagnosis is not feasible in all cases, a cautious and thoughtful approach to the differential diagnosis and a keen awareness of clinical consequences can facilitate the most complete and useful classification possible. In this review, we present a general strategy for the evaluation of small salivary biopsies, including consideration of clinical and radiographic information, systematic assessment of histologic patterns, and judicious use of immunohistochemistry and molecular studies. We then focus on the distinctive differential diagnoses raised by 6 specific histologic patterns: tubular and cribriform architecture, squamous differentiation, mucin and other secretions, high-grade cytology, epithelial and lymphoid elements, and oncocytic features. Throughout this systematic and pattern-based approach, we focus on practical and cost-effective strategies to overcome the most common diagnostic challenges in limited material.
Topics: Artifacts; Biomarkers, Tumor; Biopsy; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Carcinoma, Squamous Cell; Diagnosis, Differential; Humans; Immunohistochemistry; Mucins; Salivary Gland Neoplasms
PubMed: 32660844
DOI: 10.1016/j.jasc.2020.06.004 -
ORL; Journal For Oto-rhino-laryngology... 2020Mucoepidermoid carcinoma (MEC) of the upper aerodigestive tract (UADT) is an uncommon malignancy, with limited literature available on its clinical and pathologic...
INTRODUCTION
Mucoepidermoid carcinoma (MEC) of the upper aerodigestive tract (UADT) is an uncommon malignancy, with limited literature available on its clinical and pathologic characteristics. Here, we describe the behavior of MEC of the UADT including pathologic characteristics and predictors of nodal metastasis.
METHODS
Retrospective cohort study of patients with MEC of the UADT treated at an academic medical center from January 2008 to May 2018. Data was collected about demographics and tumor characteristics including clinical and histological data. The two-tailed Student t test and χ2 analysis were performed to assess for predictors of nodal metastasis.
RESULTS
We identified 44 patients with minor salivary gland MEC of the oral cavity (OC) and oropharynx (OP). All patients were treated with primary site surgery. The primary site was the OC in 25 patients (57%) and OP in 19 (43%). Low-grade histology was seen in 27 specimens (61.4%), intermediate histology in 9 specimens (20.5%), and high-grade histology in 8 specimens (18.2%). Perineural invasion was noted in 10 specimens (22.7%). Neck dissection was performed in 17 patients (39%), with pathologically positive nodes found in 9 (20.5%). Notably, 5 of the 9 positive nodal specimens were found in clinically node-negative necks. Pathologically positive cervical lymph nodes were significantly associated with the OP as the primary site (p = 0.0005), perineural invasion (p = 0.012), lymphovascular invasion (p < 0.001), and high-grade histology (p = 0.004) in the primary specimen.
DISCUSSION
MEC of the UADT is an uncommon malignancy. Our findings suggest elective neck dissection should be considered with perineural and lymphovascular invasion, high-grade tumor, and the OP as the primary site.
Topics: Adenocarcinoma; Adult; Aged; Aged, 80 and over; Carcinoma, Mucoepidermoid; Female; Humans; Laryngeal Neoplasms; Lymphatic Metastasis; Male; Middle Aged; Mouth Neoplasms; Neoplasm Staging; Oropharynx; Pharyngeal Neoplasms; Prognosis; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands, Minor; Tumor Burden
PubMed: 32810854
DOI: 10.1159/000509142 -
European Journal of Surgical Oncology :... Jun 2021To describe the characteristics of the largest European study of MEC of salivary glands and to determine the prognostic factors for overall and disease free survival.
BACKGROUND
To describe the characteristics of the largest European study of MEC of salivary glands and to determine the prognostic factors for overall and disease free survival.
PATIENTS AND METHODS
Patients with MEC were prospectively included in the Réseau d'Expertise Français sur les Cancers ORL Rares (REFCOR, French Network of Rare Head and Neck Tumors) database between 2009 and 2015.
RESULTS
A total of 292 patients were included. Tumors were classified as low grade in 175 cases (60%), intermediate in 39 (13%) and high grade in 78 (27%). Median follow-up was 26 months. The 5-year OS and DFS rates were respectively 83% and 69%. In multivariate analysis, age (p = 0.004), diabetes (p = 0.02) and advanced stage (p = 0.03) were found to have a significant negative impact on OS. Diabetes (p = 0.001), alcohol consumption (p = 0.003) and advanced stage (p = 0.001) were found to have a significant negative impact on DFS. Compare to low grade, high grade tended to have a negative impact on OS (p = 0.05) and had a significant effect on DFS (0.002) while intermediate grade had no significant influence on survival. The surgical treatment had a positive impact on both OS (p = 0.00005) and DFS (p = 0.0005). Postoperative radiotherapy had no impact in multivariate analysis.
CONCLUSION
Advanced clinical stage, high grade tumor, high age, the impossibility of carrying out a complete surgical resection, and diabetes are the main prognostic factors in this prospective series of patients with MEC. Such findings open new research perspectives on the influence of these components on initial patient care.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Alcohol Drinking; Carcinoma, Mucoepidermoid; Chemoradiotherapy, Adjuvant; Databases, Factual; Diabetes Complications; Disease-Free Survival; Follow-Up Studies; France; Humans; Lymphatic Metastasis; Middle Aged; Neck Dissection; Neoplasm Grading; Neoplasm Recurrence, Local; Neoplasm Staging; Prospective Studies; Radiotherapy, Adjuvant; Salivary Gland Neoplasms; Survival Rate; Young Adult
PubMed: 33248902
DOI: 10.1016/j.ejso.2020.11.123 -
Japanese Journal of Clinical Oncology Mar 2024Salivary gland-type tumors of the lung are thought to originate from the submucosal exocrine glands of the large airways. Due to their rare occurrence, reports of their... (Review)
Review
Salivary gland-type tumors of the lung are thought to originate from the submucosal exocrine glands of the large airways. Due to their rare occurrence, reports of their study are limited to small-scale or case reports. Therefore, daily clinical practices often require a search for previous reports. In the last 20 years, several genetic rearrangements have been identified, such as MYB::NF1B rearrangements in adenoid cystic carcinoma, CRTC1::MAML2 rearrangements in mucoepidermoid carcinoma, EWSR1::ATF1 rearrangements in hyalinizing clear cell carcinoma and rearrangements of the EWSR1 locus or FUS (TLS) locus in myoepithelioma and myoepithelial carcinoma. These molecular alterations have been useful in diagnosing these tumors, although they have not yet been linked to molecularly targeted therapies. The morphologic, immunophenotypic, and molecular characteristics of these tumors are similar to those of their counterparts of extrapulmonary origin, so clinical and radiologic differential diagnosis is required to distinguish between primary and metastatic disease of other primary sites. However, these molecular alterations can be useful in differentiating them from other primary lung cancer histologic types. The management of these tumors requires broad knowledge of the latest diagnostics, surgery, radiotherapy, bronchoscopic interventions, chemotherapy, immunotherapy as well as therapeutic agents in development, including molecularly targeted agents. This review provides a comprehensive overview of the current diagnosis and treatment of pulmonary salivary gland tumors, with a focus on adenoid cystic carcinoma and mucoepidermoid carcinoma, which are the two most common subtypes.
Topics: Humans; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Salivary Gland Neoplasms; Carcinoma; Myoepithelioma; Salivary Glands; Lung Neoplasms
PubMed: 38018262
DOI: 10.1093/jjco/hyad160 -
Journal of Cancer Research and... 2022Mucoepidermoid carcinoma (MEC) is a rare malignant thyroid neoplasm. Cases of MEC with papillary, insular, and anaplastic thyroid carcinoma have been reported. Here, we...
Mucoepidermoid carcinoma (MEC) is a rare malignant thyroid neoplasm. Cases of MEC with papillary, insular, and anaplastic thyroid carcinoma have been reported. Here, we present a case of follicular carcinoma with extensive MEC-like differentiation. A 62-year-old female presented with complaint of thyroid swelling for 10 years. Cytological features were suggestive of follicular neoplasm. Contrast-enhanced computed tomography showed metastasis to lung and vertebrae. Salivary glands and breasts were normal on examination and imaging. Subtotal thyroidectomy with bilateral neck dissection surgery was performed. The specimen was submitted for histopathological examination. Microscopy showed features of follicular carcinoma with capsular and vascular invasion along with an additional MEC-like morphology. Follicular carcinoma with extensive MEC-like differentiation is a rare observation. Since the tumor was sparing salivary glands and breasts, we considered it as mucoepidermoid differentiation over a collision tumor. However, immunohistochemistry and molecular analysis were the limitations.
Topics: Adenocarcinoma, Follicular; Carcinoma, Mucoepidermoid; Female; Humans; Middle Aged; Thyroid Neoplasms; Thyroidectomy
PubMed: 35900576
DOI: 10.4103/jcrt.JCRT_1422_20 -
Journal of Oral Pathology & Medicine :... Apr 2022Mucoepidermoid carcinoma and adenoid cystic carcinoma are the two most common malignancies of salivary gland. Our study aims to explore the role of human endogenous...
BACKGROUND
Mucoepidermoid carcinoma and adenoid cystic carcinoma are the two most common malignancies of salivary gland. Our study aims to explore the role of human endogenous Retrovirus-H long terminal repeat-associating protein 2, transmembrane and immunoglobulin domain-containing 2, and glucocorticoid-induced tumor necrosis factor receptor in adenoid cystic carcinoma and mucoepidermoid carcinoma, and the relationship between human endogenous Retrovirus-H long terminal repeat-associating protein 2, transmembrane and immunoglobulin domain-containing 2, glucocorticoid-induced TNF receptor, oncogenic signaling molecules, and cluster of differentiation 8.
METHODS
Custom-made human salivary gland tissue microarrays included 81 Adenoid cystic carcinoma, 52 mucoepidermoid carcinoma, 76 normal salivary gland, and 14 pleomorphic adenoma samples. Immunohistochemical analysis of human endogenous Retrovirus-H long terminal repeat-associating protein 2, transmembrane and immunoglobulin domain-containing 2, and glucocorticoid-induced TNF receptor, oncogenic phosphorylated Erk , the epithelial-mesenchymal transition (EMT) molecule transforming growth factor β1, and cluster of differentiation 8 was performed with salivary gland tissue microarray of human samples.
RESULTS
According to a digital pathological system, we analyzed the correlation of immunostaining. The expression levels of human endogenous Retrovirus-H long terminal repeat-associating protein 2, transmembrane and immunoglobulin domain-containing 2, and glucocorticoid-induced TNF receptor were significantly enhanced in the adenoid cystic carcinoma and mucoepidermoid carcinoma, compared with those of pleomorphic adenoma and NSG samples. However, the expression levels of human endogenous Retrovirus-H long terminal repeat-associating protein 2, transmembrane and immunoglobulin domain-containing 2, and glucocorticoid-induced TNF receptor were independent of the pathological grade of malignancy of mucoepidermoid carcinoma and histological pattern of adenoid cystic carcinoma. They were closely related to phosphorylated Erk1/2 and transforming growth factor β1, but negligibly related to cluster of differentiation 8.
CONCLUSIONS
These results described that certain immune checkpoint molecules, namely, human endogenous Retrovirus-H long terminal repeat-associating protein 2, transmembrane and immunoglobulin domain-containing 2, and glucocorticoid-induced TNF receptor were overexpressed in Adenoid cystic carcinoma and mucoepidermoid carcinoma, but were independent of pathological grade, and may relate to transforming growth factor β1, phosphorylated Erk1/2, and cluster of differentiation 8.
Topics: Adenoma, Pleomorphic; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Carcinoma, Mucoepidermoid; Glucocorticoids; Humans; Immunoglobulins; Salivary Gland Neoplasms; Salivary Glands; Transforming Growth Factor beta1
PubMed: 35226778
DOI: 10.1111/jop.13289 -
Journal of Oral and Maxillofacial... 2021Salivary gland tumors are rare and clinically represent a diverse group of neoplasms among which mucoepidermoid carcinoma (MEC) is a relatively common salivary gland...
BACKGROUND
Salivary gland tumors are rare and clinically represent a diverse group of neoplasms among which mucoepidermoid carcinoma (MEC) is a relatively common salivary gland tumor with varying potential for aggressive behavior. The purpose of the study was aimed at to analyze the relative frequency and correlate with age, sex, anatomical site and histological grade of MEC and compare the findings with epidemiological data from different geographic locations.
MATERIALS AND METHODS
Twenty-five cases diagnosed with MEC during the period June 1985 to June 2004 (19 years) were retrieved from the Department of Pathology, Government Medical College and Hospital, Ambajogai, and clinical data were recorded and reviewed histopathologically.
RESULTS
The relative frequency of MEC was 13.15%. Low-grade MEC (44%) was the most common, followed by intermediate-grade MEC (36%) and high-grade MEC (20%). The mean age for occurrence of MEC was 44.28 ± 13.29 years. MEC was predominant in females (60%) than males (40%). Thus, the overall female-male ratio was 1.5:1. Among minor salivary glands, palate (48%) was the most common site, and among major salivary glands, parotid gland (16%) was the common site.
CONCLUSION
Comparing the present data with previous studies on MEC, one may infer that some demographic characteristics and the predominance vary in different geographic regions. Analysis of the distribution and particular features of MEC in a specific population helps in establishment of appropriate treatment.
PubMed: 35281140
DOI: 10.4103/jomfp.jomfp_67_21 -
Diagnostic Pathology Jan 2024Mammary mucoepidermoid carcinoma (MEC) is a rare entity. The molecular characteristics of breast MEC have not been fully investigated due to its rarity. We performed a...
Mammary mucoepidermoid carcinoma (MEC) is a rare entity. The molecular characteristics of breast MEC have not been fully investigated due to its rarity. We performed a retrospective study among 1000 patients with breast carcinomas and identified four cases of breast MEC. Clinical and demographic data were collected. Immunohistochemistry panels which were used to diagnose salivary gland MEC and breast carcinomas were also performed. MAML2 rearrangements were detected by FISH and fusion partners were identified by RNA sequencing. Whole-exome sequencing (WES) was used to reveal the genomes of these four breast MEC. Then, the biological functions and features of breast MEC were further compared with those of invasive breast carcinomas and salivary gland MEC.According to Ellis and Auclair's methods, these four breast MEC could be classified as low-grade breast MEC. All the patients were alive, and disease-free survival (PFS) ranged from 20 months to 67 months. Among these four breast MEC, two cases were triple-negative, and the other two cases were found to be ER positive, with one also showing HER2 equivocal by immunohistochemical staining, but no amplification in FISH. FISH analysis confirmed the presence of the MAML2 translocation in three of four tumors, and CRTC1-MAML2 fusion was confirmed in two of them by RNA-sequencing. The average coverage size of WES for the tumor mutation burden estimation was 32 Mb. MUC4, RP1L1 and QRICH2 mutations were identified in at least three tumors, and these mutation also existed in breast invasive carcinoma databases (TCGA, Cell 2015; TCGA, Nature 2012). The results showed that there were many genes in breast MEC overlapping with the breast invasive carcinoma databases mentioned above, range from 5 to 63 genes (median:21 genes). Next, we assessed immune cell infiltration levels in these tumors. In all these tumors, M2 macrophages and plasma cell were in the high infiltration group. Our breast MEC showed different results from the salivary gland MEC, whose plasma cells were in the low infiltration group. Overall, we first analyzed the genomics and tumor microenvironment of breast mucoepidermoid carcinoma and proposed our hypothesis that although MECs arising in the breast resemble their salivary gland counterparts phenotypically, our findings indicate that breast MECs probably resemble invasive breast carcinomas at the genetic level and immune cell infiltration levels. More cases and in deep research need to be done to further understand this rare carcinoma.
Topics: Humans; Female; DNA-Binding Proteins; Trans-Activators; Retrospective Studies; Carcinoma, Mucoepidermoid; Exome; Exome Sequencing; Tumor Microenvironment; Transcription Factors; Breast Neoplasms; Salivary Gland Neoplasms; Genomics; Sequence Analysis, RNA; Eye Proteins
PubMed: 38243319
DOI: 10.1186/s13000-024-01439-8