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Journal of Oral and Maxillofacial... 2024Oncocytic mucoepidermoid carcinoma (OMEC) is an uncommon variant of mucoepidermoid carcinoma. Histopathologically, it is characterised by the predominance of cells with...
Oncocytic mucoepidermoid carcinoma (OMEC) is an uncommon variant of mucoepidermoid carcinoma. Histopathologically, it is characterised by the predominance of cells with large polygonal morphology and with an abundance of eosinophilic granules. We present a rare case of OMEC manifested as painless palatal swelling in a 25-year-old young male. The overlying mucosa was normal in appearance, with no evidence of ulceration or discharge. Histopathology examination showed the presence of sheets of mucous and intermediate cells along with cystic areas of variable sizes and shapes. On high power magnification, oncocytes were evident, showing abundant granular eosinophilic cytoplasm with central dark round nuclei. Around 75-80% tumour cell population was composed of oncocytic cells. The predominant presence of oncocytes can present diagnostic difficulties to pathologists due to overlapping features with adenoid cystic carcinoma, oncocytoma, acinic cell carcinoma, Warthin's tumour, and other oncocyte tumours. Although the presence of oncocytes is a pathognomonic feature, the role of immunohistochemistry and genetic analysis in diagnosis is discussed in the present paper. Moreover, considering its behaviour as a low-grade MEC, it is prudent to avoid an aggressive treatment strategy and prevent unwarranted morbidity. We recommend prospective studies to better understand the factors that influence the prognosis of OMEC.
PubMed: 38800424
DOI: 10.4103/jomfp.jomfp_332_23 -
Prague Medical Report 2024An 82-year-old woman with COPD presented to the emergency department with cough, increasing sputum production, wheezing, and worsening shortness of breath for two weeks....
An 82-year-old woman with COPD presented to the emergency department with cough, increasing sputum production, wheezing, and worsening shortness of breath for two weeks. On imaging studies, the patient was found to have a right upper lobe spiculated nodule and an endobronchial lesion with near total occlusion of the right lower lobe bronchus with sub-segmental atelectasis. Bronchoscopy with EBUS-TBNA of subcarinal and right hilar lymph nodes revealed lung cancer with clear cell phenotype. Given the predominance of clear cell morphology, the diagnosis of metastatic renal or ovarian cancer was entertained. However, there was no evidence of renal or ovarian lesions on the PET-CT scan, ruling out the possibility. Salivary gland type lung cancer (STLC), which is responsible for less than 1% of all lung cancer cases in adults, was also considered. The two distinct STLCs that may have similar morphologic appearances are hyalinizing clear cell carcinoma (HCCC) and mucoepidermoid carcinoma (MEC). The other type of tumour in the lung that demonstrates a clear cell phenotype is perivascular epithelioid cell neoplasms or PEComa, which are mesenchymal in origin. Immunohistochemical staining was strongly positive for p63, CK5/6, CK7, CK-LMW, and negative for TTF-1, Napsin A, p16, and CK20. Additional staining, including HMB-45, S-100, and mucicarmine, were also negative. Next-generation sequencing for the salivary gland fusion panel, including EWSR1-ATF1 fusion and EWSR1 gene rearrangement for HCCC and MAML2 gene rearrangements for MEC, was negative. She was diagnosed with non-small cell lung cancer favouring squamous cell carcinoma with clear cell phenotype, a rare entity.
Topics: Humans; Female; Lung Neoplasms; Aged, 80 and over; Diagnosis, Differential; Adenocarcinoma, Clear Cell; Bronchoscopy
PubMed: 38761046
DOI: 10.14712/23362936.2024.12 -
Radiology Case Reports Aug 2024Salivary duct carcinoma (SDC) is a major malignant salivary gland tumor that usually forms a solid tumor. Non-necrotic macrocystic SDCs have rarely been reported among...
Salivary duct carcinoma (SDC) is a major malignant salivary gland tumor that usually forms a solid tumor. Non-necrotic macrocystic SDCs have rarely been reported among salivary gland tumors. A 78-year-old Japanese man with a submandibular gland tumor was evaluated radiologically, pathologically, and immunohistochemically. A multilocular lesion with a maximum size of 6 cm was radiologically observed in the left submandibular region. It had been noticed 20 years earlier. Malignant cytological result was obtained, and surgical resection was performed. Pathological examination revealed a non-necrotic, macrocystic submandibular gland tumor lined with glandular, cribriform, or papillary forms of atypical cuboidal cells. Frankly invasive components were observed in intercystic areas. Intraductal, mucoepidermoid, and secretory carcinomas were identified as pathological differential diagnoses because of their macrocystic morphology. We diagnosed SDC because there was no intraductal growth based on the lack of myoepithelial markers, diffuse immunoreactivity to gross cystic disease fluid protein15, androgen receptor, and mammaglobin and immunonegativity to S100 and p63. Postoperative positron emission tomography revealed the absence of lymph node and distant metastases. The patient was disease-free 9 months after surgery. Salivary duct carcinoma can be included in the differential diagnoses of cystic salivary gland tumors.
PubMed: 38756951
DOI: 10.1016/j.radcr.2024.04.014 -
Seminars in Diagnostic Pathology Jul 2024The differential diagnosis of salivary gland lesions with epithelial components and lymphoid stroma is often challenging. Salivary gland carcinoma with tumor-associated... (Review)
Review
The differential diagnosis of salivary gland lesions with epithelial components and lymphoid stroma is often challenging. Salivary gland carcinoma with tumor-associated lymphoid proliferation, tumors composed of both epithelial and lymphoid components, lymphoid neoplasms in the salivary gland, and inflammatory lesions are all included in this category. It encompasses inflammatory lesions and neoplastic lesions. With the exception of Warthin tumors, these lesions are rare, making them more difficult to diagnose. Carcinoma showing thymus-like elements has recently been reported in the salivary gland. Similar to thymic carcinoma, tumor cells are positive for CD5 and are accompanied by T lymphocytes.
Topics: Humans; Salivary Gland Neoplasms; Diagnosis, Differential; Salivary Glands; Adenolymphoma
PubMed: 38734484
DOI: 10.1053/j.semdp.2024.04.004 -
BMC Gastroenterology May 2024Mucoepidermoid Carcinoma of the Esophagus (MECE) is a relatively rare tumor type, with most of the current data derived from case reports or small sample studies. This...
BACKGROUND
Mucoepidermoid Carcinoma of the Esophagus (MECE) is a relatively rare tumor type, with most of the current data derived from case reports or small sample studies. This retrospective study reports on the 10-year survival data and detailed clinicopathological characteristics of 48 patients with esophageal MEC.
METHODS
Data were collected from 48 patients who underwent curative surgery for esophageal MEC at the Fourth Hospital of Hebei Medical University between January 1, 2004, and December 31, 2020. These were compared with contemporaneous cases of Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC). Using the Kaplan-Meier method and multivariate Cox regression analysis, we investigated the clinicopathological factors affecting the survival of patients with MEC.
RESULTS
The incidence of MECE was predominantly higher in males, with a male-to-female ratio of approximately 7:1. The mid-thoracic segment emerged as the most common site of occurrence. A mere 6.3% of cases were correctly diagnosed preoperatively. The lymph node metastasis rate stood at 35.4%. The overall 1-year, 3-year, 5-year, and 10-year survival rates for all patients were 85.4%, 52.1%, 37.0%, and 31.0%, respectively. Post 1:1 propensity score matching, no significant statistical difference was observed in the Overall Survival (OS) between MEC patients and those with Esophageal Squamous Cell Carcinoma (ESCC) and Esophageal Adenocarcinoma (EAC) (P = 0.119, P = 0.669). Univariate analysis indicated that T staging and N staging were the primary factors influencing the prognosis of esophageal MEC.
CONCLUSIONS
MECE occurs more frequently in males than females, with the mid-thoracic segment being the most common site of occurrence. The rate of accurate preoperative endoscopic diagnosis is low. The characteristic of having a short lesion length yet exhibiting significant extramural invasion may be a crucial clinicopathological feature of MECE. The OS of patients with MEC does not appear to significantly differ from those with esophageal squamous carcinoma and adenocarcinoma.
Topics: Humans; Male; Esophageal Neoplasms; Carcinoma, Mucoepidermoid; Female; Middle Aged; Retrospective Studies; Aged; Adenocarcinoma; Adult; Esophageal Squamous Cell Carcinoma; Survival Rate; Lymphatic Metastasis; Kaplan-Meier Estimate; Prognosis; Sex Factors; Neoplasm Staging
PubMed: 38720257
DOI: 10.1186/s12876-024-03215-w -
The Journal of Craniofacial Surgery May 2024Mucoepidermoid carcinoma is one of the most prevalent malignant tumors of the salivary glands. Resection of this tumor can result in postsurgical morbidity, affecting...
Mucoepidermoid carcinoma is one of the most prevalent malignant tumors of the salivary glands. Resection of this tumor can result in postsurgical morbidity, affecting the patient's quality of life and normal oral functioning. This study aimed to present a successful case of postsurgical rehabilitation following mucoepidermoid carcinoma resection in the palate. Following tumor ablative surgery, the 32-year-old patient experienced impairments in both speech and feeding due to the surgical wound. A protective stent that covered the entire extent of the palate and teeth was made. This esthetic device was fabricated in a single session and provided sealing and protection of the surgical site, ensuring comfort, functionality, and, consequently, a higher quality of life during the postoperative period. The simplicity and low cost of the custom palatal stent make it applicable for use in a diverse range of postsurgical oncology patients, providing protection for surgical wounds and reducing postoperative morbidity.
PubMed: 38709032
DOI: 10.1097/SCS.0000000000010211 -
Cancer Diagnosis & Prognosis 2024The parotid is the largest salivary gland and is located anteriorly to the sternocleidomastoid muscle and laterally to the ramus of the mandible. Neoplasms in this gland...
BACKGROUND/AIM
The parotid is the largest salivary gland and is located anteriorly to the sternocleidomastoid muscle and laterally to the ramus of the mandible. Neoplasms in this gland are relatively rare, with 80% being benign and 20% malignant, primarily represented by mucoepidermoid carcinoma. In the head and neck region, lymphoepithelial carcinoma (LEC) accounts for 0.4% of malignant salivary gland tumors.
CASE REPORT
A 35-year-old man with no previous comorbidities was admitted to a Head and Neck Surgery Specialty Service for a painless right cervical mass of uncertain growth. Extensive diagnostic investigation revealed involvement of the contralateral parotid, associated with systemic lymph node enlargement. Thus, adjuvant radiotherapy was decided by the treating team.
CONCLUSION
This case confirms the heterogeneous features and distinctive behavior that the disease can present, as seen with bilateral parotid LEC.
PubMed: 38707721
DOI: 10.21873/cdp.10336 -
Ceskoslovenska Patologie 2024The WHO classification of thyroid tumours enters its second half-century of development with the 5th edition. Compared to the previous 4th edition of the clas-... (Review)
Review
The WHO classification of thyroid tumours enters its second half-century of development with the 5th edition. Compared to the previous 4th edition of the clas- sification, the permanent increase in information is mainly at the molecular biological level. This has changed the view of very traditional entities - the preferred name for polynodous goiter is (given the monoclonal nature of some nodules) follicular nodular thyroid disease. Some terminological relics have also been re- moved - Hürthle cells are definitively referred to as oncocytes. Follicular adenoma has a new subtype with papillary arrangement (and missing nuclear features of papillary carcinoma). In the already used NIFTP unit, subtypes smaller than 10 mm and oncocytic are newly defined. All oncocytic tumours have an arbitrarily set minimum proportion of oncocytes at 75 %. A multidisciplinary approach to the treatment of thyropathies and the stratification of therapeutic procedures according to risk brought about the introduction of grading into several nosological units of papillary, follicular, and medullary carcinomas. Grading using the number of mitoses determines their quantification at 2 mm² instead of the previously used non-uniform HPFs (high power fields of view). Clarification was made on the basis of genetic findings in a number of other, less frequent diagnoses (e.g. classification of squamous cell carcinoma among anaplastic). Among rare tumors a new category of salivary gland - type carcinomas is formulated with two representatives: mucoepidermoid and secretory carcinoma. Cribriform morular carcinoma previously classified as a variant of papillary carcinoma is newly separated on the basis of the immunological and genetic profile into the newly created category of tumors of uncertain histogenesis. This category also includes sclerosing mucoepidermoid carcinoma with eosinophilia. Microcarcino- ma as a separate entity is not included in the 5th edition. A tumor smaller than 10 mm must be characterized by the appropriate features of the corresponding category. Thyroblastoma replaces terminologically malignant teratoma from the previous classification. Part of the newly established diagnostic criteria is also applicable in FNAB diagnosis. The newly introduced grading in some nosological units can exceptionally change the diagnosis (NIFTP/EFVPTC/non-invasive HG FVPTC), but above all it will affect the choice of therapeutic procedures.
Topics: Humans; World Health Organization; Thyroid Neoplasms
PubMed: 38697828
DOI: No ID Found -
The Saudi Dental Journal Apr 2024Malignant salivary gland tumors are rare. However, their morphological overlap and difficulty to differentiate benign from malignant makes diagnosing such diseases a...
BACKGROUND
Malignant salivary gland tumors are rare. However, their morphological overlap and difficulty to differentiate benign from malignant makes diagnosing such diseases a challenging task. Geographical variation in distribution of these diseases is well documented in the literature. This study aims to review the histological and epidemiological variations of malignant salivary gland tumors in Sudanese patients considering the new WHO 2022 classification.
METHODOLOGY
This retrospective study included malignant salivary gland tumours in our lab spanning from the period of 2014 to 2022. Information about clinical data, habits, geographical distribution, pathological diagnosis, duration and sites of tumors were retrieved from our archives. Equivocal cases were checked by a salivary gland expert. Data analysis was performed using IBM SPSS 29.
RESULTS
This study included 107 cases of malignant salivary gland tumours, representing 54 % of the total number of salivary gland tumours in the lab during that period. 47.7 % of the patients in this study were females and 52.3 % were males, the mean age of patients was 50 ± 15.7 years. (30 %) of the patients were from the central region of the country. The most common malignant salivary gland tumor was the Mucoepidermoid carcinoma accounting for 17 %. The palate was found to be the most common site as 38 % of malignant salivary gland tumors occurred in this site.
CONCLUSION
The study found a high percentage of salivary gland tumours in the Sudan suggesting geographical differentiation.
PubMed: 38690377
DOI: 10.1016/j.sdentj.2024.02.001 -
Head and Neck Pathology Apr 2024Salivary gland tumors (SGTs) are rare and highly heterogeneous lesions, making diagnosis a challenging activity. In addition, the small number of studies and samples... (Review)
Review
BACKGROUND
Salivary gland tumors (SGTs) are rare and highly heterogeneous lesions, making diagnosis a challenging activity. In addition, the small number of studies and samples evaluated difficults the determination of prognosis and diagnosis. Despite the solid advances achieved by research, there is still an intense need to investigate biomarkers for diagnosis, prognosis and that explain the evolution and progression of SGTs.
METHODS
We performed a comprehensive literature review of the molecular alterations focusing on the most frequent malignant SGTs: mucoepidermoid carcinoma and adenoid cystic carcinoma.
RESULTS
Due to the importance of biomarkers in the tumorigenenic process, this review aimed to address the mechanisms involved and to describe molecular and biomarker pathways to better understand some aspects of the pathophysiology of salivary gland tumorigenesis.
CONCLUSIONS
Molecular analysis is essential not only to improve the diagnosis and prognosis of the tumors but also to identify novel driver pathways in the precision medicine scenario.
Topics: Carcinoma, Mucoepidermoid; Humans; Carcinoma, Adenoid Cystic; Salivary Gland Neoplasms; Biomarkers, Tumor
PubMed: 38658430
DOI: 10.1007/s12105-024-01629-2