Mucoepidermoid carcinoma of the lung: a case report

Mucoepidermoid carcinoma of the lung (MEC) is a tumor of low malignant potential of bronchial gland origin. MEC and adenoid cystic carcinoma are both considered to be salivary gland-type neoplasms. MECs are comparatively rare with an incidence of all lung cancers. We recently encountered a case of this type of lung cancer. A 60-year-old man was found to have an abnormal shadow in the left lower lung field on a regular check-up for lung cancer at his company. Chest radiography and CT revealed a mass shadow measuring 30 mm in diameter in the left lower lung field. Bronchoscopy revealed a protuberant tumor in the S9 bronchus, leading to a diagnosis of low-grade MEC by transbronchial lung biopsy. He underwent left lower lobe resection and mediastinal lymph node dissection using VATS. Tumor cells had a scattering of mucus-producing epithelial components in papillary growth of stratified squamous epithelia with anisokaryosis and minimal pleomorphism, indicating a diagnosis of MEC. Because the postoperative course was good and the tumor was low-grade, no adjuvant treatment was administered. The patient has had no signs of tumor recurrence for 9 months, to date, since resection of the tumor.

Primary mucinous adenocarcinoma of the larynx in female patient: a rare entity

Laryngeal malignant tumors are mainly composed of squamous cell carcinomas. Glandular carcinomas of the larynx are rare tumors that constitute less than 1% of all laryngeal malignancies where "adenocarcinoma not otherwise specified" is the most common histologic subtype. Here we report a case of a 70-year-old female patient with primary laryngeal mucinous adenocarcinoma. The rarity of the tumor type and the differential diagnosis of this tumor before reporting it as a primary adenocarcinoma of the larynx are discussed here with literature findings.

Mucoepidermoid carcinoma of trachea in a 22 years old woman: a case report

Mucoepidermoid carcinoma is a relatively common salivary glands tumor. This tumor is characterized by mucus secretion, cell type can be intermediate or squamous. Mucoepidermoid carcinoma of the bronchi and especially trachea is very unusual. We are reporting the case of a 22 years old female who presented with main complaint of exertional dyspnea and stridor for about 2 month. Bronchoscopy examination showed a mass with smooth surface in trachea. After surgery a low grade mucoepidermoid carcinoma was confirmed by pathological examination.

Diagnosis and management of mucoepidermoid carcinoma of the lacrimal duct

Primary tumors of the lacrimal sac are rare, and mucoepidermoid carcinomas of the lacrimal sac have only been reported 13 times in the literature. We reported an intermediate-grade mucoepidermoid carcinoma that was managed with wide local excision, medial maxillectomy, and external beam radiotherapy, and the patient has remained disease-free for 7 years. Orbital exenteration had generally been recommended for these tumors, but newer, more conservative resections along with radiation therapy may be equally effective.

Sclerosing mucoepidermoid carcinoma of the salivary gland: Case report and literature review

Sclerosing mucoepidermoid carcinoma (SMEC) is an extremely rare variant of mucoepidermoid carcinoma with unique histologic features. To the best of our knowledge, only 14 cases of salivary gland SMEC have been previously reported in the English-language literature since it was discovered in 1987. We report a new case of salivary gland SMEC, and we review the literature. Because of SMEC's distinctive histologic features and rarity, its diagnosis can be difficult. Moreover, no clear treatment strategy has emerged with regard to adjuvant postoperative radiotherapy. We attempt to elucidate a natural course of this disease, and we propose a conservative approach to postoperative management.

Mucoepidermoid carcinoma misdiagnosed as palatal odontogenic infection: an overview on the differential diagnosis of palatal lesions

Mucoepidermoid carcinoma (MEC) accounts for approximately 30% of malignant salivary gland tumors and approximately 30% occur in minor salivary glands. The palate is the most frequent localization for those arising in minor glands. A 33-year-old male patient with MEC of the hard palate was treated as an acute odontogenic infection, which was not cured after tooth endodontic treatments, repeated incisions and antibiotics. On the hard palate ovoid, a hard painless mass, which had not extended over the middle palatal line, was observed. Partial maxillectomy was performed. A review of the literature was performed in order to provide a coherent overview on the differential diagnosis of palatal lesions. To the best of authors' knowledge, this is the first report in English literature describing palatal MEC misdiagnosed and treated as odontogenic infection. Considering the extensive list of MEC's differential diagnoses on the hard palate, acute odontogenic infection can now be added to that list.

Composite follicular variant of papillary carcinoma and mucoepidermoid carcinoma of thyroid gland: a case report

A 50-yr-old male presented a thyroid mass with dysphasia and hoarseness. He underwent total thyroidectomy and neck node dissection. Pathologically, the tumor had two distinct tumor components with intermingled areas: follicular variant of papillary carcinoma and mucoepidermoid carcinoma. Mucoepidermoid carcinoma composed of columnar cells, mucocytes, and squamoid cells showing solid and cystic lesion. Several small cysts lined by benign ciliated columnar epithelia suggesting that this tumor had originated from solid cell nest were seen around the tumor. By immunohistochemistry, columnar cells and squamoid cells in mucoepidermoid carcinoma were positive for cytokeratin but negative for thyroglobulin, TTF-1 and calcitonin. Positivity of p63 was seen in squamoid cells and basal cells of cysts. Some mucocytes are CEA positive. Tumor cells of papillary carcinoma are positive for TTF-1, thyroglobulin but negative for CEA, calcitonin and p63.

Mucoepidermoid carcinoma: a retrospective study

AIM

The aim of this study was to review the cases of mucoepidermoid carcinoma diagnosed at the Stomatology Service of São Lucas Hospital (PUCRS).

METHODS

Medical charts were reviewed focusing on the sex and age of the patients, clinical aspect, anatomic site, signs and symptoms, size and histological grade of the lesion.

RESULTS AND CONCLUSION

Of the 19383 patients who were seen between 1978 and 2009, 675 (3.48%) had a histopathological diagnosis of malignant neoplasm of the oral maxillofacial region including 12 (1.78%) cases of mucoepidermoid carcinoma. The mean age of patients with mucoepidermoid carcinoma was 43.8 years, and there was a predilection for males (58.7%). All cases occurred in the minor salivary glands, and the palate was the site most frequently affected (41.7%). Pain and local irritation were present in 50% of cases, and the size of lesions ranged from 0.3 cm to 5.0 cm. The histological classification of low- and intermediate-grade occurred at the same frequency (36.4%), and symptoms (pain, local irritation) occurred indiscriminately in different grades of tumor.

Primary salivary gland tumors in eastern Nepal tertiary care hospital

BACKGROUND

The knowledge of the distribution and pattern of salivary gland tumors in the tertiary care center can provide overview of the disease pattern in the region. It also helps in planning the strategies to treat the disease and launch the awareness program in the community to this largely curable disease.

METHODS

A retrospective observational study of all the salivary gland tumors treated in the department of Otolaryngology, B. P. Koirala Institute of Health Sciences during April 2004 to March 2009 was done. Age, sex, presenting features, radiological findings, histopathological type of the tumor and type of surgery were recorded and descriptive analysis was done to calculate frequencies, percentage and their relations.

RESULTS

Out of total 51 cases, 81% (n=41) were benign and 19% (n=10) malignant tumors. Male to female ratio was 1:2.1. Mean age for benign and malignant tumors were 32.3 and 46.5 years respectively. Parotid tumor outnumbered all other sites comprising 69%, followed by submandiibular 18% and minor glands 13%. Pleomorphic adenoma was the commonest tumor (76%) of all primary salivary gland tumors. Benign to malignant tumor ratio of parotid, submandibular and minor glands were 6:1, 3.5:1 and 1.3:1 respectively. Adenoid cystic carcinoma (40%) and mucoepidermoid carcinoma (30%) were commonest malignant tumors.

CONCLUSIONS

The principal site for salivary gland tumors in eastern Nepal population was the parotid and the pleomorphic adenoma outnumbered all other tumors. Most of the cases in both benign and malignant group presented with painless lump often misleading the gravity of disease.

Parotid neoplasms: analysis of 600 patients attended at a single institution

Salivary gland tumors are rare, generally benign and affect mainly the parotid gland.

AIM

The purpose of this study was to retrospectively analyze all cases of parotid tumors treated at our institution from 1953 to 2003.

METHODS

All patients with primary parotid tumors were selected; clinical and histopathological data were analyzed and described.

RESULTS

600 cases of parotid tumors were selected; 369 were benign and 231 were malignant. Pleomorphic adenoma was the most frequent benign tumor. The most common malignant tumor was the mucoepidermoid carcinoma. Therapy in most cases consisted of parotidectomy. Adjuvant therapy -- mainly radiotherapy -- was used in some cases with malignant tumors. The incidences of local, regional and distant recurrences of malignant tumors were 10%, 8% and 9%.

CONCLUSION

Patients with parotid tumors treated at our institution were mainly adults, with marginally more female patients. Benign tumors were mostly the pleomorphic adenoma, which were more frequent than malignancies. Most of the patients were treated by partial or total parotidectomy. Adjuvant therapy, mainly radiotherapy, was used in selected malignant cases.

Is maspin immunolocalization a tool to differentiate central low-grade mucoepidermoid carcinoma from glandular odontogenic cyst?

Mucoepidermoid carcinoma (MEC) of the salivary glands has a low-grade variant (LGMEC), which may be found within the jawbones. LGMEC shares a number of histopathological similarities with glandular odontogenic cysts (GOC) of the jawbones. Maspin has been identified in several benign and malignant salivary gland neoplasms. We investigated the immunolocalization of maspin in LGMEC and GOC and evaluated its potential to distinguish between these two entities. Cases of LGMEC (n=6), GOC (n=8) and various odontogenic cysts with marked mucous metaplasia (OCMM, n=7), which served as controls, were immunohistochemically labeled for the binding of an antibody directed against maspin. Immunomorphometry was performed separately for maspin-immunopositive epithelial cells and epithelial-mucous cells in either their nuclear or cytoplasmic compartments. Results were presented as the volume fraction (Vv) of each element. The Vv of the maspin-immunopositive epithelial-mucous cytoplasm and nuclei was significantly higher in LGMEC than in GOC and OCMM (p<0.001 and p=0.026, respectively). In the epithelial cells, no significant differences were observed among the lesions (p>0.05). It is suggested that the high levels of maspin in the epithelial-mucous cells (in both cytoplasm and nuclei) in LGMEC may serve as a tool to distinguish it from GOC. This may be useful especially in equivocal cases and in small incisional biopsy samples.

[Recurrent pneumonia in a teenage boy]

Pneumonia is a common paediatric and juvenile infection, which upon proper treatment will almost always heal completely. Sometimes pneumonia will become prolonged or recur, causing the need to consider additional investigations. Refractory or recurrent pneumonia in children may be caused by a structural, functional or immunological factor. Diseases of the lung tissue are rare. We describe a teenage boy, whose recurrent pneumonia revealed an underlying malignant disease, mucoepidermioid carcinoma.

Mucoepidermoid carcinoma of a nasal cavity--a rare tumour

BACKGROUNDS

Mucoepidermoid tumours arise from the ductal cells of the salivary glands, most commonly the parotid. The occurrence of these tumours in the mucus glands of the air passages is extremely rare. They are very aggressive tumours with poor prognosis.

CASE

A case of nasal mucoepidermoid carcinoma with probable origin from the middle turbinate is reported.

CONCLUSION

Nasal mucoepidermoid carcinomas are extremely rare. They usually present with symptoms similar to sinusitis. When dealing with a recurrent/aggressive tumour in the ethmoids, the possibility of mucoepidermoid carcinoma can be considered in the differential diagnosis. They are aggressive tumours with a poor prognosis.

Central mucoepidermoid carcinoma of the maxilla: a case report

BACKGROUND AND OBJECTIVE

Primary mucoepidermoid carcinoma of the jaw is a rare lesion, comprising 2-3% of all mucoepidermoid carcinomas reported in literature. Central mucoepidermoid carcinoma of the maxilla is rarer, comprising only 8% of the mucoepidermoid carcinomas found in the jaw.

METHODOLOGY

A 52-year-old man suffered from central mucoepidermoid carcinoma of the right maxilla with cervical metastasis, and underwent partial maxillectomy and neck dissection in our hospital. The diagnosis was confirmed by histopathology, dental orthopantomography, CT, and PET/CT scans.

RESULT

The man was followed-up regularly and was disease free after 21 months.

CONCLUSION

Primary central mucoepidermoid carcinoma of the jaw is a rare lesion and radical surgical resection is the preferred treatment.

Sclerosing mucoepidermoid carcinoma of the parotid gland: case report

Mucoepidermoid carcinoma is the most common malignant salivary gland neoplasm. Its sclerosing morphologic variant, however, is an extremely rare entity. Only 7 cases have been reported in the literature, and only 2 of those reports have discussed this unusual malignancy in detail. This report describes a case involving a 57-year-old woman with an intermediate-grade sclerosing mucoepidermoid carcinoma of the parotid gland. She underwent superficial parotidectomy and radiation therapy with excellent results. Diagnosis and options for treatment are discussed, as well as a review of the literature, which demonstrates that this is an extremely rare malignancy with no strict protocol for treatment.

[Salivary gland mucoepidermoid carcinoma: unusual variants with detection of the t(11,19)(q21;p13) translocation]

Mucoepidermoid carcinoma (MEC) represents the most common malignant salivary gland tumour. Based on the proportion of their constituent cell types, MECs may display a wide morphological spectrum, thereby mimicking diverse types of other primary salivary gland carcinomas. The correct diagnosis relies on demonstration of classical MEC features, assisted by histochemical and immunohistochemical stains in equivocal cases. The current article aims to demonstrate, on the basis of own observations, how the detection of the MEC-typical t(11, 19) translocation may be of great value in difficult-to-classify cases. The differential diagnosis includes squamous cell carcinoma, clear cell carcinoma and oncocytic neoplasms, as well as highly malignant adenocarcinomas which cannot be further classified.

Necrotizing sialometaplasia: a practical approach to the diagnosis

CONTEXT

Necrotizing sialometaplasia is a benign, self-limited lesion of both major and minor salivary glands, although more commonly the latter. It can represent a diagnostic dilemma and may be mistaken for a malignant neoplasm, such as mucoepidermoid carcinoma, as well as invasive squamous cell carcinoma. A major causal relationship has been ascribed to ischemia. Bulimia, an eating disorder with increasing prevalence in our society, may also be an underlying underreported cause.

OBJECTIVE

To discuss the potential pathogenesis, diagnostic pitfalls, and the application of immunohistochemistry as an aid in the diagnosis of necrotizing sialometaplasia.

DATA SOURCES

This report uses a previously published case history for illustrative purposes and a review of the current literature.

CONCLUSIONS

The diagnosis of necrotizing sialometaplasia may be difficult and is reliant upon a well-oriented biopsy section and a complete clinical history. Diagnosis may be further supplemented via immunohistochemistry, demonstrating focal to absent immunoreactivity for p53, low immunoreactivity for MIB1 (Ki-67), and the presence of 4A4/p63- and calponin-positive myoepithelial cells. Interpreted in context collectively, these findings may be helpful adjuncts in the diagnosis of necrotizing sialometaplasia; nonetheless, to date, hematoxylin-eosin staining remains the gold standard.

Mucoepidermoid carcinoma with spindle cell change: a low-grade lesion potentially mistaken for sarcomatoid dedifferentiation

An unusual case of mucoepidermoid carcinoma (MEC) of intraoral minor salivary gland origin with spindled morphology was presented. A fascicular stream of bland spindle cells from typical MEC areas amounted to more than 70% of the tumor. Spindle population had features consistent with immunohistochemical and ultrastructural profiles of intermediate cells and lacked overexpression of p53 and cyclin D1. There was no difference in the Ki-67 index between two distinct components. Awareness of extensive spindle cell change replacing a significant portion of low-grade MEC is crucial to avoid an erroneous interpretation of dedifferentiated sarcomatoid transformation.

Bronchial mucoepidermoid carcinoma with recurrent hemoptysis in a pregnant woman: report of a case

Mucoepidermoid carcinoma of the tracheobronchial tree, which is thought to arise from the minor salivary gland tissue of the proximal airway, is an extremely rare neoplasm. We herein report a case of a 31-year-old pregnant woman in her 36th week, who complained of recurrent hemoptysis from bronchial mucoepidermoid carcinoma. As massive bleeding from the tumor was seen during a caesarean section, it was necessary to add bronchial artery embolization. The tumor was successfully removed by a sleeve resection of the left main bronchus after the embolization. The patient is doing well without any signs of recurrence at 3 years after undergoing the operation.

Adenomyomatous hamartoma of lung mimicking benign mucinous tumor in fine needle aspiration biopsy: a case report

BACKGROUND

Typical cytologic features of pulmonary hamartoma (PH) are usually smears of hyaline cartilage, fibrous tissue, smooth muscle, adipocytic components and respiratory epithelium. Cytologic features of adenomyomatous hamartoma, a special variant of PH, are not documented in the literature and are confused with epithelial neoplasm in the case of sparse stromal cellularity.

CASE

A 59-year-old man presented with a solitary pulmonary nodule by chest radiograph at his routine health examination. Fine needle aspiration biopsy (FNAB) revealed numerous mucinous epithelial cells presenting predominantly in cohesive cellular sheets that suggested benign mucinous epithelial lesion. The patient underwent surgery for the tumor, and it was histologically proven to be an adenomyomatous hamartoma.

CONCLUSION

An unusual type of PH could lead to misdiagnosis by FNAB in the case of few stromal components. This case demonstrates the wide spectrum of PH in FNAB and led us to consider PH as a differential diagnosis despite lack of chondromyxoid stromal components.

Mucoepidermoid carcinoma of parotid presenting as unilocular cyst

An interesting case of a 09 years old girl is reported who presented with a painless, mobile, spherical, fluctuant and brilliantly translucent swelling in front of left ear. The fine needle aspiration revealed turbid dark yellow colour fluid. This cystic swelling was completely excised and the specimen on histopathology was reported as low grade Mucoepidermoid carcinoma. Recovery was uneventful. This unusual presentation of Mucoepidermoid carcinoma as a preauricular cyst is one of the rare unique reported case.