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Heliyon Jan 2024Warthin-like Mucoepidermoid carcinoma (MEC) is a new and rare morphological variant of MEC, with only a few case reports in the literature. The clinicopathological,...
BACKGROUND
Warthin-like Mucoepidermoid carcinoma (MEC) is a new and rare morphological variant of MEC, with only a few case reports in the literature. The clinicopathological, molecular features and bio-behaviors of Warthin-like MEC has not been studied extensively. We reappraisal all Warthin-like MEC patients diagnosed and treated at our hospital.
METHODS
Patient characteristics including clinicopathological features, genetic aberrations, treatment, and prognostic information were assessed and evaluated.
RESULTS
Twenty-nine Warthin-like MEC patients were identified, 19 patients were female (65.5 %), and 10 were male (34.5 %). The patients' age varied widely from 8 to 68 years (mean 42.3 years). Genetic aberrations of rearrangement were detected in all Warthin-like MEC patients, which suggesting this genetic event is the unique feature of Warthin-like MEC. Twenty-five patients (86.2 %) were assessed as having a low-stage disease (I/II), and four (13.8 %) as having high-clinical stage disease (III/IV). More than half of the patients (16/29) underwent only partial sialoadenectomy; 2 patients underwent extended sialoadenectomy, and 11 patients underwent extended sialoadenectomy with cervical lymph node dissection. After a median follow-up time of 73 months (5-128 months), Twenty-eight patients were alive without recurrence at the end of the follow-up period, one patient died 1 year after surgery due to lung metastasis.
CONCLUSION
Our data suggested that most Warthin-like MEC exhibited mild clinicopathological course and less aggressive bio-behavior, and an aggressive bio-behavior seemed to be very rare. In addition, in the salivary gland, MAML2 rearrangement seems to be a unique molecular feature of salivary Warthin-like MEC.
PubMed: 38304779
DOI: 10.1016/j.heliyon.2024.e24873 -
Journal of Oral and Maxillofacial... 2023Salivary gland tumours are relatively uncommon, and there exists a considerable diagnostic difficulty owing to their diverse histological features in individual lesions...
Salivary gland tumours are relatively uncommon, and there exists a considerable diagnostic difficulty owing to their diverse histological features in individual lesions and the presence of a number of types and variants, in addition to overlapping histological patterns similar to those observed in different tumour entities. One such group of variations is clear cell tumours of oral cavity which constitute an assorted group of lesions that may be odontogenic or metastatic or of salivary gland origin. The clear cell variant of mucoepidermoid carcinoma is at times misleading to the clinician because of its atypical location and innocent appearance. The pathologist needs to be familiar with the molecular alterations so that there may be a strong potential to implement good treatment. Hereby, we report a rare case of intraosseous clear cell variant of mucoepidermoid carcinoma which histopathologically posed challenges due to its variable presentation, suggesting the need for histochemical stains and molecular work-up for a definitive diagnosis and a better therapeutic and prognostic insight.
PubMed: 38304498
DOI: 10.4103/jomfp.jomfp_133_23 -
Journal of Oral and Maxillofacial... 2023Mucoepidermoid carcinoma (MEC) is a rare salivary gland malignancy characterized by diverse cellular components. This case report presents a unique instance of low-grade...
Mucoepidermoid carcinoma (MEC) is a rare salivary gland malignancy characterized by diverse cellular components. This case report presents a unique instance of low-grade MEC in a 28-year-old female, emphasizing the importance of accurate diagnosis and tailored management. The patient exhibited a painless, enlarging lower lip swelling over a year, with imaging suggestive of a fibrolipomatous lesion. Surgical excision was successfully performed, with subsequent histopathological analysis displaying mucinous cystic spaces, varied epithelial cell types and other characteristic features consistent with MEC. The case findings aligned with hallmark MEC features are seen in established literature, highlighting the significance of precise diagnosis and grading for appropriate management. This report contributes to the understanding of MEC's varied presentations and underscores the importance of thorough: histopathological examination, lower lip, mucoepidermoid carcinoma clinical evaluation, accurate histopathological analysis and interdisciplinary collaboration. The case highlights the value of considering MEC in younger patients, even with atypical presentations, and encourages ongoing exploration of diagnostic and therapeutic strategies to improve patient outcomes.
PubMed: 38304491
DOI: 10.4103/jomfp.jomfp_379_23 -
Journal of Dental Sciences Jan 2024
Mucoepidermoid carcinoma arising from a glandular odontogenic cyst of posterior maxilla and further development into a radiation-induced second primary squamous cell carcinoma.
PubMed: 38303810
DOI: 10.1016/j.jds.2023.10.002 -
JCEM Case Reports Feb 2024Neuroendocrine tumors (NETs) may mimic many endocrine syndromes, including Cushing syndrome (CS) secondary to ectopic ACTH secretion. Radiotherapy (RT) is often used as...
Neuroendocrine tumors (NETs) may mimic many endocrine syndromes, including Cushing syndrome (CS) secondary to ectopic ACTH secretion. Radiotherapy (RT) is often used as adjuvant therapy for such persistent or recurrent NETs. However, RT may predispose a susceptible person to a second malignancy. Here, we reported the story of a 37-year-old male, who presented with progressive weight loss, bone pain, and shortness of breath in the emergency department. He was diagnosed with CS secondary to a carcinoid tumor in the bronchopulmonary tree a decade previous and underwent total bilateral adrenalectomy. He also underwent lobectomy, and subsequent RT for a primary NET and was in clinical remission. His presenting symptoms were considered a recurrence of pulmonary NETs. However, the biopsy suggested high-grade mucoepidermoid carcinoma (MEC). MEC of the lung is a rare tumor with a prevalence of <1% of all lung malignancies. MEC of the lung after RT for bronchial NET-causing ectopic CS has not yet been reported in the literature. The present patient did not survive despite achieving remission of CS and primary tumor because of the aggressive second malignancy attributed to RT, which was given for the primary tumor.
PubMed: 38283728
DOI: 10.1210/jcemcr/luad127 -
Medicine Jan 2024Primary mucoepidermoid carcinoma (MEC) is a common malignant neoplasm of the salivary glands, but is very rare in the pancreas. To date, only 10 cases have been reported... (Review)
Review
INTRODUCTION
Primary mucoepidermoid carcinoma (MEC) is a common malignant neoplasm of the salivary glands, but is very rare in the pancreas. To date, only 10 cases have been reported in the literature. Because MEC of the pancreas is very rare, there is little information about its diagnosis, treatment, and metastasis. Herein, we present the eleventh case and review the relevant literature.
PATIENT CONCERNS
A 65-year-old woman presented with a mass in the body of the pancreas and multiple masses in the liver on abdominal magnetic resonance imaging. The patient initially underwent EUS-guided fine-needle aspiration and was diagnosed with adenocarcinoma. After adjuvant chemotherapy, resection of the pancreatic body and tail was performed, and the tissues were pathologically, histologically, and immunochemically examined. Specific strains and gene rearrangements were analyzed.
DIAGNOSIS
Mucoepidermoid pancreatic cancer.
INTERVENTION
After a 4-month course of adjuvant chemotherapy, laparoscopic surgery was performed.
OUTCOMES
The patient is alive until the submission of this paper.
CONCLUSION
We presented a case of mucoepidermoid pancreatic cancer in a 65-year-old woman. Pathological examination revealed that the tumor parenchyma consisted of 3 cell types. There are mainly epidermoid cells, intermediate cells between the basal and epidermoid cells, and mucus-producing cells in varying proportions. Immunohistochemical staining showed that there were different types of cells with unique morphological characteristics. In summary, primary MECs of the pancreas are rare and have poor prognosis. Few studies have been conducted on the diagnosis, treatment, and metastasis of MECs; therefore, further studies are needed to detect them.
Topics: Female; Humans; Aged; Carcinoma, Mucoepidermoid; Pancreas; Pancreatic Neoplasms; Abdomen; Biopsy, Fine-Needle
PubMed: 38277552
DOI: 10.1097/MD.0000000000036993 -
National Journal of Maxillofacial... 2023The objective of this study was to know the various types of parotid tumors and their clinical presentations, surgical management, and post-operative outcome.
AIM OF THE STUDY
The objective of this study was to know the various types of parotid tumors and their clinical presentations, surgical management, and post-operative outcome.
MATERIAL AND METHODS
Data of 102 patients assessed from hospital records who underwent parotid surgery between the years 2013 and 2018 were obtained. Parameters included age, sex, socio-demographic profile, presenting complaints, examination findings, and cytopathology. Surgical techniques, post-operative complications such as a facial scar, retro-mandibular and pre-auricular depression, facial palsy, Frey's syndrome, and numbness over the ear lobule were analyzed.
RESULT
Out of a total of 102 patients, 54.0% of patients were male, and 45.1% were female. The mean age of patients was 33.30 ± 13.87 years ranging from 7 to 65 years. The most common clinical presentation was swelling in the parotid region (95.1%), and associated symptoms with swelling were pain (17.5%), facial palsy (4.9%), discharging sinus (4.9%), and ulcerative lesions (1%) at the time of presentation. Pleomorphic adenoma was the most common benign neoplasm (76.5%), followed by Warthin's tumors (2.9%). Mucoepidermoid carcinoma was the most common malignant neoplasm (3.9%). After parotid surgery, 35% of patients had a sensory impairment or hypoesthesia of the ear lobule, and 23.28% had temporary facial nerve weakness. 5.0% of patients had permanent facial weakness, and 2.06% of patients had weakness of the marginal mandibular nerve.
CONCLUSION
Pleomorphic adenoma and mucoepidermoid carcinoma are the most common benign and malignant tumors, respectively, and parotidectomy is the treatment of choice, depending on the tumor location. Successful treatment depends on early diagnosis and histopathological and radiological investigations. Sensory impairment and temporary facial nerve paralysis are the most common post-operative complications, which are minimized by proper knowledge of anatomy and meticulous dissection of the facial nerve during parotid surgery.
PubMed: 38273931
DOI: 10.4103/njms.njms_111_22 -
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 -
BMC Oral Health Jan 2024This study aims to discuss the characteristics and treatment methods of malignant tumors in the parotid region, as well as the therapeutic effects of immediate free flap...
OBJECTIVE
This study aims to discuss the characteristics and treatment methods of malignant tumors in the parotid region, as well as the therapeutic effects of immediate free flap reconstruction of soft tissue for postoperative defects.
MATERIALS AND METHODS
A retrospective review was conducted on 11 cases of soft tissue flap reconstruction for postoperative defects following the resection of malignant tumors in the parotid region. Statistical analysis was performed based on clinical data.
RESULTS
Among the 11 cases of malignant tumors in the parotid region, there were 2 cases of secretory carcinoma (SC) of the salivary gland, 2 cases of squamous cell carcinoma (SCC), 2 cases of carcinosarcoma, 1 case of mucoepidermoid carcinoma (MEC), 1 case of epithelial-myoepithelial carcinoma (EMC), 1 case of salivary duct carcinoma (SDC), 1 case of basal cell carcinoma (BCC), and 1 case of osteosarcoma. Among these cases, 4 were initial diagnoses and 7 were recurrent tumors. The defect repairs involved: 8 cases with anterolateral thigh free flap (ALTF), 2 cases with pectoralis major muscle flaps, and 1 case with forearm flap. The size of the flaps ranged from approximately 1 cm × 3 cm to 7 cm × 15 cm. The recipient vessels included: 4 cases with the facial artery, 4 cases with the superior thyroid artery, and 1 case with the external carotid artery. The ratio of recipient vein anastomosis was: 57% for branches of the internal jugular vein, 29% for the facial vein, and 14% for the external jugular vein. Among the 8 cases that underwent neck lymph node dissection, one case showed lymph node metastasis on pathological examination. In the initial diagnosis cases, 2 cases received postoperative radiotherapy, and 1 case received I seed implantation therapeutic treatment after experiencing two recurrences. Postoperative follow-up revealed that 2 cases underwent reoperation due to local tumor recurrence, and there were 2 cases lost to follow-up. The survival outcomes after treatment included: one case of distant metastasis and one case of death from non-cancerous diseases.
CONCLUSION
Immediate soft tissue flap reconstruction is an important and valuable option to address postoperative defects in patients afflicted with malignant tumors in the parotid region.
Topics: Humans; Skin Transplantation; Parotid Region; Neoplasm Recurrence, Local; Carcinoma, Squamous Cell; Algorithms
PubMed: 38238723
DOI: 10.1186/s12903-024-03872-z -
Annals of Medicine and Surgery (2012) Jan 2024Mucoepidermoid carcinoma (MEC) ex pleomorphic adenoma is a rare type of salivary gland cancer. Surgical resection remains the standard therapy for this malignancy. After...
INTRODUCTION AND IMPORTANCE
Mucoepidermoid carcinoma (MEC) ex pleomorphic adenoma is a rare type of salivary gland cancer. Surgical resection remains the standard therapy for this malignancy. After tumor removal, larger defects may require a local, regional, or free flap, while smaller ones can be closed primarily. Managing medium-sized defects can be challenging, especially on the buccal mucosa.
PRESENTATION OF CASE
A 47-year-old man had a buccal mucosa mass for 10 years, which gradually grew over a year and irritated his chewing. A 2.2×2 cm buccal mass was observed with telangiectatic and erythematous alterations in the surrounding mucosa. The preoperative tissue biopsy suggested salivary gland malignancy. The patient underwent surgical excision and a single-stage buccal advancement flap reconstruction, successfully closing the 4 cm defect. The final diagnosis was MEC ex pleomorphic adenoma. He reported mild discomfort during the first few months while opening his mouth. The patient had fully recovered after 6 months.
CLINICAL DISCUSSION
This is the first case of MEC arising in a pleomorphic adenoma of the buccal mucosa. For low-grade and small-sized tumors, a single modality is appropriate for treatment. Local flaps such as buccal fat pad or musculomucosal flap can repair medium-sized defects. However, the buccal advancement flap provides effective functional and esthetic benefits, optimal healing conditions, and reduces complications risk.
CONCLUSION
The buccal advancement flap is a valuable option for reconstructing medium-sized buccal defects up to 4 cm. The single-stage surgical procedure has been proven to yield minimal complications and provide a favorable outcome.
PubMed: 38222703
DOI: 10.1097/MS9.0000000000001514