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The Malaysian Journal of Pathology Dec 2011Myoepithelial lesions of the breast are extremely rare and can present with a diverse morphology. We report a case of malignant myoepithelioma characterized by... (Review)
Review
Myoepithelial lesions of the breast are extremely rare and can present with a diverse morphology. We report a case of malignant myoepithelioma characterized by proliferation of atypical oval to polygonal cells expressing typical myoepithelial markers. A 45-year-old lady presented with a mass in the left breast. Fine needle aspiration yielded a cellular smear with large papillae-like clusters of monomorphic cells with naked nuclei in the background. A diagnosis of sub-areolar sclerosing duct hyperplasia was made on cytology and the patient underwent excision. The surgical specimen showed a grey-white 5x3 cm mass on cut surface. Histopathology revealed mitotically active (5-6 per 10hpf) oval to polygonal cells tumor cells with clear to eosinophilic cytoplasm arranged in the form of nodules separated by dense sclerotic stroma mimicking clear cell or adenoid-cystic carcinoma. A diagnosis of malignant myoepithelioma was made as the cells were CK14 and SMA positive, and negative for ER and PR on immunohistochemistry. We discuss the unusual morphological features of malignant myoepithelioma, cytological findings and the important differential diagnoses of malignant myoepthelial lesions. A high degree of suspicion with a keen eye for morphological details coupled with relevant immunohistochemistry will aid in arriving at the diagnosis.
Topics: Biomarkers, Tumor; Breast Neoplasms; Carcinoma; Female; Humans; Immunohistochemistry; Middle Aged; Myoepithelioma
PubMed: 22299214
DOI: No ID Found -
Neurology India 2019Intracranial myoepithelial tumors are extremely rare with <10 cases reported outside the sellar region. The authors describe a case of a 43-year-old male patient who... (Review)
Review
Intracranial myoepithelial tumors are extremely rare with <10 cases reported outside the sellar region. The authors describe a case of a 43-year-old male patient who presented with headache, numbness in the face, and a dumbbell-shaped lesion in the Meckel's cave clinically and radiologically suggestive of a Schwannoma. The histopathological and immunohistochemical evaluation led to a diagnosis of myoepithelioma. A review of literature reveals that this is only the ninth case of intracranial myoepithelial tumor reported, fifth benign case, and the first to be reported in the Meckel's cave region.
Topics: Adult; Brain Neoplasms; Humans; Male; Myoepithelioma
PubMed: 31744974
DOI: 10.4103/0028-3886.271273 -
Cold Spring Harbor Molecular Case... Dec 2022Myoepithelial carcinomas (MECs) of soft tissue are rare and aggressive tumors affecting young adults and children, but their molecular landscape has not been...
Myoepithelial carcinomas (MECs) of soft tissue are rare and aggressive tumors affecting young adults and children, but their molecular landscape has not been comprehensively explored through genome sequencing. Here, we present the whole-exome sequencing (WES), whole-genome sequencing (WGS), and RNA sequencing findings of two MECs. Patients 1 and 2 (P1, P2), both male, were diagnosed at 27 and 37 yr of age, respectively, with shoulder (P1) and inguinal (P2) soft tissue tumors. Both patients developed metastatic disease, and P2 died of disease. P1 tumor showed a rhabdoid cytomorphology and a complete loss of INI1 (SMARCB1) expression, associated with a homozygous deletion. The tumor from P2 showed a clear cell/small cell morphology, retained INI1 expression and strong S100 positivity. By WES and WGS, tumors from both patients displayed low tumor mutation burdens, and no targetable alterations in cancer genes were detected. P2's tumor harbored an rearrangement, whereas the tumor from P1 showed a novel fusion. WGS evidenced a complex genomic event involving mainly Chromosomes 17 and 22 in the tumor from P1, which was consistent with chromoplexy. These findings are consistent with previous reports of rearrangements (50% of cases) in MECs and provide a genetic basis for the loss of SMARCB1 protein expression observed through immunohistochemistry in 10% of 40% of MEC cases. The lack of additional driver mutations in these tumors supports the hypothesis that these alterations are the key molecular events in MEC evolution. Furthermore, the presence of complex structural variant patterns, invisible to WES, highlights the novel biological insights that can be gained through the application of WGS to rare cancers.
Topics: Child; Young Adult; Humans; Male; Myoepithelioma; Soft Tissue Neoplasms; Carcinoma; Biomarkers, Tumor
PubMed: 36577525
DOI: 10.1101/mcs.a006227 -
Anticancer Research Feb 2009Malignant myoepithelioma of the head and neck usually arises in the salivary glands. We experienced a rare case with malignant myoepithelioma in the maxillary sinus. A...
Malignant myoepithelioma of the head and neck usually arises in the salivary glands. We experienced a rare case with malignant myoepithelioma in the maxillary sinus. A 47-year-old woman with malignant myoepithelioma in the maxillary sinus underwent partial maxillectomy. However, local recurrence occurred 28 months after surgery and she was subsequently treated with radiation therapy with proton beams. The recurrent tumor showed complete response and the patient was alive with no evidence of disease 30 months after irradiation. No therapy-related severe toxicities were observed. A rare case with malignant myoepithelioma in the maxillary sinus was successfully treated with radiation therapy.
Topics: Female; Humans; Maxillary Sinus Neoplasms; Middle Aged; Myoepithelioma; Neoplasm Recurrence, Local
PubMed: 19331194
DOI: No ID Found -
Journal of Medicine and Life May 2022This study is a systematic review and meta-analysis to assess the overexpression rate of HER2 in patients with salivary gland tumors. We included peer-reviewed... (Meta-Analysis)
Meta-Analysis Review
This study is a systematic review and meta-analysis to assess the overexpression rate of HER2 in patients with salivary gland tumors. We included peer-reviewed publications from 1995 to 2020, indexed in medical databases, using search terms such as "human epidermal growth factor receptor 2 (HER2)" and "salivary gland tumors", and extracted relevant data. The extracted data were analyzed with RevMan 5.3 software. Intra-and intergroup post hoc analyses of outcome variables were performed using t-tests, and the rates of HER2 positivity among studies were evaluated. 80 studies were included in the analysis. The positive rates of HER2 ranged from 3.3% to 84.0% and 1% to 9% in malignant and benign subtypes, respectively. The highest HER2 overexpression rate among malignant tumors was in salivary ductal carcinomas (SDC), with a 45% positive rate (CI 95%: 21.9-70.3%). Mucoepidermoid carcinoma (MEC) had the highest positive rate of 84% (CI 95%: 74.1-90.0%). Among benign salivary gland tumors, the highest rate was found in myoepithelioma, with a positive rate of 9% (CI 95%: 1.7-33.6%). The highest rate of HER2 overexpression is present in malignant subtypes of salivary gland tumors, more specifically in salivary ductal carcinoma, mucoepidermoid carcinomas, salivary duct carcinoma in situ, and carcinoma ex pleomorphic adenoma.
Topics: Biomarkers, Tumor; Carcinoma, Mucoepidermoid; Humans; Receptor, ErbB-2; Salivary Gland Neoplasms; Salivary Glands
PubMed: 35815077
DOI: 10.25122/jml-2021-0394 -
Gland Surgery Jan 2021We report 2 cases of rare thyroid malignancy: angiosarcoma and myoepithelial carcinoma (MC). Thyroid angiosarcomas (TAS) is extremely rare and comprises less than 1% of...
We report 2 cases of rare thyroid malignancy: angiosarcoma and myoepithelial carcinoma (MC). Thyroid angiosarcomas (TAS) is extremely rare and comprises less than 1% of primary thyroid cancer worldwide. MC usually presents as a slow-growing painless mass arising in the salivary glands. It has not been reported in the thyroid gland. The first case describes a 59-year-old patient who was admitted to hospital with the discovery of thyroid nodule for 1 month. The tumor thrombus was found in the left internal jugular vein and superior thyroid artery during the operation. Diagnosis of angiosarcoma of the thyroid was based on positive endothelial markers such as thrombomodulin and CD31 after total thyroidectomy. The left internal jugular vein, left recurrent laryngeal nerve and anterior cervical banding muscle were invaded by thyroid tumor. No lymph node metastasis was observed. The patient died after 4 years. The second case describes a 55-year-old woman who presented with the discovery of thyroid nodule for 1 month. Right thyroid lobectomy and right neck lymph node functional dissection were carried out. The results from postoperative pathology revealed that papillary carcinoma in right lobe of thyroid and MC next to thyroid were found. Besides, the metastasis of MC was observed at right II-IV level and right VI level. Five years later, the patient was re-admitted to hospital, primarily due to the discovery of anterior cervical tumor for one year. Then, she underwent left thyroid lobectomy and right tumor resection. Postoperative routine pathology showed recurrent MC in the right thyroid. After surgery and radiotherapy, the patient was followed up for 2 years. Angiosarcoma and myoepithelioma should be kept in mind in diagnosis of thyroid malignant tumor.
PubMed: 33633996
DOI: 10.21037/gs-20-601 -
Clinical and pathological analysis of 10 cases of salivary gland epithelial-myoepithelial carcinoma.Medicine Oct 2020Epithelial-myoepithelial carcinoma (EMC) is a rare neoplasm of the salivary glands. The aim of this study is to review and evaluate clinicopathological features and...
Epithelial-myoepithelial carcinoma (EMC) is a rare neoplasm of the salivary glands. The aim of this study is to review and evaluate clinicopathological features and treatment of EMC of salivary gland for better sensitivity and specificity of the diagnosis.The clinical and pathological data of the 10 salivary gland EMC cases from 2008 to 2017 were analyzed.Six cases of EMC were diagnosed to be originated from parotid gland and 4 cases were from the minor salivary gland including palate, tongue, and oropharynx. Seven cases were performed radical surgery and 3 cases had radiotherapy postoperation, 2 cases had a local recurrence. The follow-up period was 4 to 104 months and the survival rate was 100%. Histopathology showed the tumors had a dominant prototypical biphasic tubular structure consisting of inner, cuboidal ductal cells and an outer layer of clear, myoepithelial cells, which grew infiltratively. The immunohistochemistry (IHC) showed the marker proteins CK, S-100, CD117, and Calponin were strongly positive in most EMC.EMC is a rare and low-grade malignant tumor with good overall survival but relatively high tendency for local recurrence. Surgery is the priority choice for EMC therapy. Complete surgical excision and negative margins are necessary for good prognosis. Imaging techniques should be used to assess the neck dissection and it is unclear whether adjuvant radiotherapy is beneficial. To ensure the sensitivity and specificity of the EMC diagnosis, we should perform both pathological and IHC analysis.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma; Female; Humans; Male; Middle Aged; Myoepithelioma; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands
PubMed: 33031333
DOI: 10.1097/MD.0000000000022671 -
World Journal of Surgical Oncology Sep 2011The aim of this study was to present a rare neoplasm, Primary myoepithelial carcinoma arising from the palate, and to review its diagnostic criteria, pathologic and...
OBJECTIVES
The aim of this study was to present a rare neoplasm, Primary myoepithelial carcinoma arising from the palate, and to review its diagnostic criteria, pathologic and clinical characteristics, treatment options and prognosis.
CLINICAL PRESENTATION AND INTERVENTION
Myoepitheliomas are tumors arising from myoepithelial cells mainly or exclusively. Myoepitheliomas mostly occur in salivary glands, as well as in breast, skin, and lung. Case of myoepitheliomas in palate has rarely been reported. Myoepithelial carcinoma is malignant counterpart of myoepitheliomas. Adenomyoepithelioma is also a different disease from myoepitheliaomas. Immunohistochemically, tumor cells of myoepithelial carcinoma express not only epithelial markers such as cytokeratin, epithelial membrane antigen (EMA), but also markers of smooth muscle origin such as calponin. The immunohistochemical criteria of myoepithelial differentiation are double positive for both cytokeratins and one or more myoepithelial immunomarkers (i.e., S-100 protein, calponin, p63, GFAP, maspin, and actins). Myoepithelial carcinomas of salivary and breast demonstrate copy number gains and gene deletion. The overall prognosis of myoepithelial carcinoma is poor. There is rarely recurrence or metastasis in benign myoepithelial tumors. Complete excision with tumor-free margin is always the preferred treatment, while local radiation therapy and chemotherapy are suggestive treatment options. Here, a rare case of myoepithelial carcinoma arising from the palate has been described and discussed for the treatment and outcome. Pathological and clinical characters of myoepitheliomas are also compared and discussed.
CONCLUSION
The case report serves to increase awareness and improve the index of diagnosis and treatment of myoepitheliomas.
Topics: Aged; Biomarkers, Tumor; Biopsy; Calcium-Binding Proteins; Combined Modality Therapy; Diagnosis, Differential; Follow-Up Studies; Humans; Immunohistochemistry; Keratins; Male; Microfilament Proteins; Muscle Proteins; Myoepithelioma; Palatal Neoplasms; S100 Proteins; Calponins
PubMed: 21917131
DOI: 10.1186/1477-7819-9-104 -
Medicina Oral, Patologia Oral Y Cirugia... Sep 2008Minor salivary gland tumors (MSGTs) are infrequent, representing 10-15% of all salivary neoplasms. Despite this low frequency, MSGTs conform a heterogeneous group of... (Review)
Review
INTRODUCTION
Minor salivary gland tumors (MSGTs) are infrequent, representing 10-15% of all salivary neoplasms. Despite this low frequency, MSGTs conform a heterogeneous group of neoplasms characterized by a broad range of histological types.
PATIENTS AND METHOD
We identified cases of MSGT in a retrospective study of the biopsies made in the period 1997-2007 in the Service of Oral Surgery (Dental Clinic of the University of Barcelona, Spain). The data collected comprised patient age and sex, the clinical characteristics and location of the tumor, the duration of the lesion, its size, the treatment provided, and the histopathological findings.
RESULTS
Of the 18 cases of MSGT studied, 12 corresponded to women (66.7%) and 6 to men (33.3%). The great majority (94.4%) were benign tumors. The preferential location was the posterior third of the hard palate (33.2%), followed by the soft palate (16.7%) and the mucosa of the upper lip (16.7%). The histopathological diagnoses of our MSGTs comprised 10 pleomorphic adenomas (55.3%), 2 cystadenomas (11.1%), 1 myoepithelioma (5.6%), 1 sialadenoma papilliferum (5.6%), 1 basal cell adenoma (5.6%), 1 Warthin's tumor (5.6%), 1 canalicular adenoma (5.6%), and 1 low-grade polymorphic adenocarcinoma (5.6%).
DISCUSSION AND CONCLUSIONS
Coinciding with our own results, the literature describes a high recurrence rate for MSGTs (5-30%) when surgical removal is incomplete. Six percent of all benign minor salivary gland tumors are considered to relapse, versus 65% of all malignant lesions. Periodic clinical controls are required, since the possibility of malignant transformation must be taken into account.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Retrospective Studies; Salivary Gland Neoplasms; Salivary Glands, Minor; Young Adult
PubMed: 18758404
DOI: No ID Found -
Journal of Oral and Maxillofacial... 2019The aim of this study is to analyze the utility of immunohistochemical markers such as CD117 and smooth muscle actin (SMA) in the diagnosis of various benign and...
OBJECTIVE
The aim of this study is to analyze the utility of immunohistochemical markers such as CD117 and smooth muscle actin (SMA) in the diagnosis of various benign and malignant salivary gland neoplasms.
MATERIALS AND METHODS
The study comprises 17 samples categorized into three groups: Group I consisted of 5 histopathologically normal salivary gland tissue; Group II comprised 7 cases, of which 3 cases were pleomorphic adenoma, 3 cases were myoepithelioma and 1 case was Warthin's tumor; and Group III consisted of 5 cases, of which 1 was mucoepidermoid carcinoma and 4 cases were adenoid cystic carcinoma. The selected cases were subjected to immunohistochemistry (IHC) procedure to assess the expression pattern of CD117 and SMA.
RESULTS
In SMA, 85.8% showed severe-to-moderate intense expression among the tumor cells in benign salivary gland tumor. All the 5 malignant tumors showed the expression of SMA and 3 cases demonstrated severe expression among the tumor cells. An intense expression pattern of SMA was observed in both benign and malignant neoplasms in the periphery and stromal components of the tumor. Only two cases were positive for CD117, and connective tissue components were completely negative in both malignant and benign salivary gland neoplasms.
CONCLUSION
Alpha-SMA can be utilized as reliable IHC markers for salivary gland neoplasms due to its diagnostic importance in tumors with myoepithelial origin indicative of the histogenesis of salivary gland tumors.
PubMed: 31516227
DOI: 10.4103/jomfp.JOMFP_225_18