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Cureus Mar 2017A 58-year-old female had a mass in the right breast palpable beneath the areola. A mammogram revealed a 1.5-centimeter soft tissue density that was confirmed with a...
A 58-year-old female had a mass in the right breast palpable beneath the areola. A mammogram revealed a 1.5-centimeter soft tissue density that was confirmed with a subsequent ultrasound. The patient underwent a core needle biopsy which was initially reported as a moderately differentiated invasive ductal carcinoma. Immunohistochemical analysis revealed negative staining for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor (HER2), mammaglobin, and gross cystic disease fluid protein 15 (GCDFP-15). A wide local excision of the mass was performed. The pathology report stated the tumor had an infiltrative growth pattern with a desmoplastic stromal response with enhanced epithelial atypia consistent with malignant transformation of a nodular clear cell hidradenoma. Clear cell hidradenoma is a very rare tumor originating from the sweat gland and has a propensity for the face and extremities. The malignant variant of this tumor is extremely rare and has been reported to originate from the breast in few cases. This case represents the difficulty in diagnosing this tumor along with the radiographic and histologic features that can distinguish this malignancy from other entities.
PubMed: 28409065
DOI: 10.7759/cureus.1064 -
The American Journal of Surgical... Jul 2021Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland cancer characterized by biphasic tubular structures composed of inner ductal and outer clear... (Comparative Study)
Comparative Study
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland cancer characterized by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells. Because of its histologic variety and overlap of histologic features with other salivary gland tumors, there are broad differential diagnoses. The HRAS Q61R mutation has been reported to be frequent in and specific to EMC. We evaluated the usefulness of RAS Q61R mutant-specific immunohistochemical (IHC) staining for detecting this genetic alteration in EMC. We investigated 83 EMC cases and 66 cases of salivary gland tumors with an EMC-like component, including pleomorphic adenoma, adenoid cystic carcinoma, basal cell adenoma/adenocarcinoma, and myoepithelial carcinoma. Sanger sequencing was performed for HRAS, KRAS, and NRAS. The diffuse and membranous/cytoplasmic RAS Q61R IHC expression was observed in 65% of EMC cases, in which all cases harbored the HRAS Q61R mutation. IHC-positive cases were present only in de novo EMCs (54/76 cases, 71%) but not in EMCs ex pleomorphic adenoma. The immunoreactivity was almost always restricted to the myoepithelial cells. Conversely, all EMC cases lacking the HRAS Q61R mutation were negative on IHC. In addition, only 3% of EMC-like tumors showed the abovementioned immunopositivity. None of the cases examined carried KRAS or NRAS mutations. IHC for RAS Q61R is highly sensitive and specific for detecting the HRAS Q61R mutation in EMC. Since significant immunopositivity was almost exclusively identified in nearly two thirds of EMCs but seldom in the histologic mimics, the IHC of RAS Q61R is a useful tool for diagnosing EMC in general pathology laboratories.
Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; DNA Mutational Analysis; Diagnosis, Differential; Female; Humans; Immunohistochemistry; Japan; Male; Middle Aged; Mutation; Myoepithelioma; Neoplasms, Glandular and Epithelial; Predictive Value of Tests; Proto-Oncogene Proteins p21(ras); Reproducibility of Results; Retrospective Studies; Salivary Gland Neoplasms
PubMed: 33481388
DOI: 10.1097/PAS.0000000000001673 -
BMC Neurology May 2013Malignant myoepithelioma is a relatively rare malignant tumor occurring most frequently in the salivary glands. A few isolated cases have been described in other...
BACKGROUND
Malignant myoepithelioma is a relatively rare malignant tumor occurring most frequently in the salivary glands. A few isolated cases have been described in other locations, including soft tissue, bone, lung, bronchus, oral cavity, nasopharynx, larynx, and maxillary sinus. Malignant myoepithelioma, however, is uncommonly involved within the cavernous sinus. To the best of our knowledge, this is the first report of malignant myoepithelioma arising from within the cavernous sinus.
CASE PRESENTATION
Herein, we report a case of a 48-year-old woman who presented a 1-month history of diplopia and blepharoptosis as well as radiological evidence of a rapidly developing cavernous sinus tumor. The patient underwent a trans-sphenoidal biopsy and a histological diagnosis indicated a malignant myoepithelioma. After diagnosis, the tumor grew rapidly and her clinical condition deteriorated progressively. Therefore, a pterional craniotomy with partial tumor removal was performed. The patient's clinical state was worsened, and she died two months after the initial operation. Because the malignant myoepithelioma could not be traced to an organ of origin, other than the cavernous sinus, this case was diagnosed as a primary intracranial malignant myoepithelioma.
CONCLUSION
The purpose of presenting this case report is to raise awareness among clinicians to consider malignant myoepithelioma as a differential diagnosis when a cavernous sinus mass is identified. Furthermore, an ideal management strategy for malignant myoepithelioma is not known and the prognosis seems to be unfavorable; therefore, more cases are needed to enhance our knowledge of the diagnosis, treatment, and prognosis of this rare intracranial lesion.
Topics: Actins; Biopsy; Cavernous Sinus; Female; Glial Fibrillary Acidic Protein; Humans; Magnetic Resonance Imaging; Maxillary Sinus Neoplasms; Middle Aged; Myoepithelioma; S100 Proteins; Vimentin
PubMed: 23642050
DOI: 10.1186/1471-2377-13-40 -
Indian Journal of Otolaryngology and... Nov 2019Myoepithelioma is a rare tumour of the salivary glands. Only 3 cases of myoepithelioma in the nasal cavity have been reported. A 29 year old male presented to us with...
Myoepithelioma is a rare tumour of the salivary glands. Only 3 cases of myoepithelioma in the nasal cavity have been reported. A 29 year old male presented to us with epistaxis and nasal obstruction. There was a fleshy mass occupying the right middle meatus. Biopsy showed evidence of myoepithelioma and an endoscopic excision of the tumour was done. Histopathological examination of the resected tumour was consistent with myoepithelioma. Due to its rarity, the nature of the tumour is not known and regular follow-ups are needed for early detection of recurrence and malignancy.
PubMed: 31763237
DOI: 10.1007/s12070-017-1093-6 -
Archives of Pathology & Laboratory... Nov 2001This report describes a benign myoepithelioma of the lung that occurred in a 60-year-old woman. The patient had experienced hoarseness for 6 weeks, and a computed... (Review)
Review
This report describes a benign myoepithelioma of the lung that occurred in a 60-year-old woman. The patient had experienced hoarseness for 6 weeks, and a computed tomographic scan showed a nodule of approximately 2 cm in diameter at the peripheral portion of her right upper lung. Positron emission tomography showed no uptake of F-18 fluorodeoxyglucose in the nodule. Wedge biopsy of the lesion showed benign spindle cells arranged in a whorled pattern. The cells were positive for both cytokeratin and smooth muscle actin, which corresponded to the presence of tonofilaments and myofilaments that were identified ultrastructurally. The features of the present case of benign myoepithelioma that differ from features of previously reported benign and malignant cases of myoepithelioma in the lung are discussed in the report.
Topics: Actin Cytoskeleton; Actins; Biopsy; Cell Nucleus; Cytoplasm; Deoxyglucose; Female; Fluorine Radioisotopes; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Keratins; Lung Neoplasms; Middle Aged; Muscle, Smooth; Myoepithelioma; Tomography, Emission-Computed; Tomography, X-Ray Computed; Vimentin
PubMed: 11698012
DOI: 10.5858/2001-125-1494-BMOTL -
Journal of Clinical Pathology Aug 1997To evaluate whether the immunoexpression of c-erbB-2 and p53 is involved in the pathogenesis and progression of salivary tumours with myoepithelial differentiation.
AIM
To evaluate whether the immunoexpression of c-erbB-2 and p53 is involved in the pathogenesis and progression of salivary tumours with myoepithelial differentiation.
METHODS
233 tumours from 211 patients were studied. These included 76 primary and 24 recurrent adenocarcinomas (polymorphous low grade adenocarcinoma, 13; epithelial-myoepithelial carcinoma, 19; adenoid cystic carcinoma, 56; and basal cell adenocarcinoma, 12) and 133 pleomorphic adenomas and myoepitheliomas, 96 being primary and the remaining recurrent tumours. All cases were formalin fixed and paraffin wax embedded. A StrepABC peroxidase method and polyclonal c-erbB-2 and p53 specific antisera were used.
RESULTS
Cell membrane staining of c-erbB-2 was not found in any benign or malignant tumour. There was p53 protein accumulation in one primary and one recurrent pleomorphic adenoma and in 10 adenocarcinomas (polymorphous low grade adenocarcinoma, one; epithelial-myoepithelial carcinoma, one; adenoid cystic carcinoma, five; and basal cell adenocarcinoma, three), three of them being recurrences.
CONCLUSIONS
The c-erbB-2 and p53 proteins are not involved in the pathogenesis of pleomorphic adenoma and myoepithelioma and do not constitute biomarkers in assessing the risk of recurrence. c-erbB-2 is not involved in the genesis of low grade salivary neoplasia with myoepithelial differentiation. The percentage of this type of neoplasia with p53 accumulation is low (10%) and does not appear to be related to tumour recurrence.
Topics: Adenocarcinoma; Adenoma, Pleomorphic; Adolescent; Adult; Aged; Aged, 80 and over; Child; Disease Progression; Female; Gene Expression Regulation, Neoplastic; Humans; Immunoenzyme Techniques; Male; Middle Aged; Myoepithelioma; Neoplasm Proteins; Neoplasm Recurrence, Local; Receptor, ErbB-2; Salivary Gland Neoplasms; Tumor Suppressor Protein p53
PubMed: 9301549
DOI: 10.1136/jcp.50.8.661 -
Asian Journal of Neurosurgery 2021Myoepithelial tumors are rare neoplasms that develop from myoepithelial cells in glandular structures and soft tissues. Primary intracranial myoepithelial neoplasms are...
Myoepithelial tumors are rare neoplasms that develop from myoepithelial cells in glandular structures and soft tissues. Primary intracranial myoepithelial neoplasms are even rarer with around ten cases reported. On the other hand, adrenocortical carcinoma (ACC) is also uncommon with an annual incidence of 0.7-2 per million and carries a poor prognosis. It is known to have an association with certain familial cancer syndromes. Even in sporadic cases, a significant portion of them had other malignancies before and after diagnosis of ACC. We reported a 34-year-old gentleman who was diagnosed to have ACC without known familial cancer syndrome. After that, he was also found to have right occipital myoepithelioma that was confirmed by excisional biopsy. There was no known association between these two pathologies. This is the first report of coincidence of ACC and intracranial myoepithelioma.
PubMed: 34660377
DOI: 10.4103/ajns.AJNS_502_20 -
International Journal of Clinical and... 2013A 9-year-old girl consulted to our hospital because of lower lip tumor. Excision of the tumor was performed. Histologically, the tumor consisted of cellular spindle and...
A 9-year-old girl consulted to our hospital because of lower lip tumor. Excision of the tumor was performed. Histologically, the tumor consisted of cellular spindle and round cells with hyperchromatic nuclei and nucleoli. Mitotic figure and apoptotic bodies were scattered. Immunohistochemically, the tumor cells were strongly and diffusely positive for CD10 and vimentin. The tumor was focally positive for S100 protein, α-smooth muscle actin, PDGFRA, HER2/neu, p53, and CD68. The Ki-67 labeling was 20%. In contrast, the tumor cells were negative for pancytokeratins (AE1/3, CAM5.2, WSS, KL-1, HNF116), cytokeratin (CK) 5/6, CK34βE12, CK7, CK8, CK14, CK18, CK19, CK20, EMA, desmin, CD34, melanosome, KIT, p63, myoglobin, CD45, CD56, GFAP, D2-40, CEA and synaptophysin. The Histologies, positive p53 protein, and Ki-67 labeling of 20% suggested low grade malignancy. Although histological type was unclear, the author diagnosed this tumor as malignant myoepithelioma arising from the lip minor salivary gland because of positive reaction for S100 protein, α-smooth muscle actin, and CD10. The patient is now free from tumor 8 years after the first presentation.
Topics: Biomarkers, Tumor; Child; Female; Humans; Immunohistochemistry; Lip Neoplasms; Myoepithelioma; Neprilysin
PubMed: 23638234
DOI: No ID Found -
Journal of the American Veterinary... May 2013To describe the clinical characteristics, treatments, outcomes, and factors associated with survival time in a cohort of dogs with lingual neoplasia that underwent...
OBJECTIVE
To describe the clinical characteristics, treatments, outcomes, and factors associated with survival time in a cohort of dogs with lingual neoplasia that underwent surgical excision.
DESIGN
Retrospective case series. Animals-97 client-owned dogs.
PROCEDURES
Medical records of dogs with a lingual tumor examined between 1995 and 2008 were reviewed. Records were included if a lingual tumor was confirmed by histologic examination and surgical excision of the mass was attempted. Data were recorded and analyzed to identify prognostic factors.
RESULTS
Clinical signs were mostly related to the oral cavity. For 93 dogs, marginal excision, subtotal glossectomy, and near-total glossectomy were performed in 35 (38%), 55 (59%), and 3 (3%), respectively. Surgery-related complications were rare, but 27 (28%) dogs had tumor recurrence. The most common histopathologic diagnoses for the 97 dogs were squamous cell carcinoma (31 [32%]) and malignant melanoma (29 [30%]). Eighteen (19%) dogs developed metastatic disease, and the overall median survival time was 483 days. Median survival time was 216 days for dogs with squamous cell carcinoma and 241 days for dogs with malignant melanoma. Dogs with lingual tumors ≥ 2 cm in diameter at diagnosis had a significantly shorter survival time than did dogs with tumors < 2 cm.
CONCLUSIONS AND CLINICAL RELEVANCE
Similar to previous studies, results indicated that lingual tumors are most commonly malignant, and squamous cell carcinoma and malignant melanoma predominate. A thorough physical examination to identify lingual tumors at an early stage and surgical treatment after tumor identification are recommended because tumor size significantly affected survival time.
Topics: Animals; Carcinoma, Squamous Cell; Dog Diseases; Dogs; Female; Hemangioma; Lymphoma; Male; Mastocytoma; Melanoma; Myoepithelioma; Nerve Sheath Neoplasms; Plasmacytoma; Retrospective Studies; Sarcoma; Survival Analysis; Tongue Neoplasms
PubMed: 23634684
DOI: 10.2460/javma.242.10.1392 -
International Journal of Oral Science Feb 2018Prompted by a unique case of an ectomesenchymal chondromyxoid tumor (ECT) of the palate in a 54-year-old female, we reviewed the English and German literature on this... (Review)
Review
Prompted by a unique case of an ectomesenchymal chondromyxoid tumor (ECT) of the palate in a 54-year-old female, we reviewed the English and German literature on this entity until the end of 2016 using PubMed. The search produced 74 lingual cases with a nearly equal sex distribution and a mean age of 39.3 years, and two extra-lingual cases sharing histological and immunohistological features including nodular growth, round, fusiform or spindle-shaped cellular architecture, and chondromyxoid stroma. Immunophenotyping showed the majority of cases to be positive for glial fibrillary acidic protein (GFAP), S-100 protein, glycoprotein CD57, pancytokeratin (AE1/AE3), and smooth muscle actin (SMA); in isolated cases there was molecular-genetic rearrangement or gain of Ewing sarcoma breakpoint region 1 (EWSR1) but no rearrangement of pleomorphic adenoma gene 1 (PLAG1). At present, ectomesenchymal cells that migrate from the neural crest are considered to play a pivotal role in tumor origin. All cases had a benign course, although there were three recurrences. Because of the rarity of this tumor and the need for differential diagnostic differentiation from myoepithelioma and pleomorphic adenoma, both oral surgeons and pathologists should be aware of this entity.
Topics: Biomarkers, Tumor; Chondroma; Diagnosis, Differential; Female; Humans; Immunophenotyping; Mesenchymoma; Middle Aged; Myoepithelioma; Palatal Neoplasms
PubMed: 29491357
DOI: 10.1038/s41368-017-0003-9