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Arora V, Chakraborty A, Lahiri A, Aggarwal M, Yadav V, Dewan AK. A Case of Myoepithelioma of Nasal Cavity and Short Review of Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:2890-2894. [PMID: 37974825 PMCID: PMC10645747 DOI: 10.1007/s12070-023-03852-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 05/03/2023] [Indexed: 11/19/2023] Open
Abstract
Introduction: Myoepithelioma is a rare neoplasm of the salivary glands and accounts for less than 1% of salivary gland neoplasms. Only 7 cases of myoepithelioma in the nasal cavity have been reported till date in literature. Case Report: A 61 year old male presented to us with epistaxis. There was a pinkish fleshy mass occupying the right nasal cavity. Biopsy showed evidence of an epithelial tumor of intermediate aggressiveness. We did an endoscopic complete excision of nasal cavity mass. Histopathological examination of the resected tumor was consistent with myoepithelioma. Due to its rarity, the nature of the tumor is not known and regular follow-ups are needed for early detection of recurrence and malignancy. There has been no evidence of tumor recurrence in the 18 months following surgery.
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Affiliation(s)
- Vikas Arora
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Arnab Chakraborty
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Anupam Lahiri
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Manisha Aggarwal
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Vishal Yadav
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
| | - Ajay kumar Dewan
- Department of Head and Neck Oncology, Rajiv Gandhi Cancer Institute & Research Centre, New Delhi, 110085 India
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Abstract
This article provides an overview of rare orbital diseases. Congenital
malformations, inflammatory diseases, benign and malignant neoplasias are
described. Although it represents a relatively small area of the body the
orbit contains multiple different tissues. Therefore, a great variety of
diseases can be found within the orbital space. That is the reason, why both
the completeness and the level of detail in the description of particular
diseases must be somewhat limited. Nevertheless, clinical manifestations,
important aspects of diagnosis, treatment strategies, and, when specific
data are available, the prognosis are described. The authors tried to
highlight the most characteristic aspects of the different diseases to
describe their relevant aspects in spite of the brevity of the
subsections.
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Affiliation(s)
- Ulrich Kisser
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Halle/S. (Klinikdirektor: Prof. Dr. med. S. Plontke)
| | - Jens Heichel
- Universitätsklinik und Poliklinik für Augenheilkunde, Halle/S. (Klinikdirektor: Prof. Dr. med. A. Viestenz)
| | - Alexander Glien
- Universitätsklinik und Poliklinik für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie, Halle/S. (Klinikdirektor: Prof. Dr. med. S. Plontke)
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Chang AY, Tran AQ, Plum W, Tooley AA, Purushothaman S, Kazim M. Atypical presentation of invasive myoepithelioma in a pediatric patient. Orbit 2021; 41:657-660. [PMID: 33906572 DOI: 10.1080/01676830.2021.1918724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A 15-year-old girl presented with a mobile lesion with yellowish hue on the posterior lamella of the right lower eyelid adjacent to the punctum. Four years prior, a lesion thought to be a chalazion was excised from the same location. There was subsequent progressive painless enlargement. The patient ultimately underwent an internal excision of the mass. Histopathology demonstrated infiltrative nests and cords of epithelioid and plasmacytoid cells with abundant eosinophilic myxoid-collagenous stroma along with focal infiltration of skeletal muscle with immunohistochemical staining consistent with an invasive myoepithelioma of mixed-cell type. Given concern for invasive disease, the patient underwent subsequent Mohs resection resulting in a 25% full thickness eyelid defect, which was repaired with direct closure of the wedge defect. There has been no recurrence of the disease for 7 months since the Mohs resection. This case illustrates the atypical presentation of an invasive myoepithelioma of the eyelid in a pediatric patient.
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Affiliation(s)
- Angela Y Chang
- Columbia University Irving Medical Center - NewYork-Presbyterian Hospital, New York, New York, USA
| | - Ann Q Tran
- Columbia University Irving Medical Center - NewYork-Presbyterian Hospital, New York, New York, USA
| | - William Plum
- Columbia University Irving Medical Center - NewYork-Presbyterian Hospital, New York, New York, USA
| | - Andrea A Tooley
- Columbia University Irving Medical Center - NewYork-Presbyterian Hospital, New York, New York, USA
| | - Sonya Purushothaman
- Department of Pathology, Columbia University Irving Medical Center - NewYork-Presbyterian Hospital, New York, New York, USA
| | - Michael Kazim
- Columbia University Irving Medical Center - NewYork-Presbyterian Hospital, New York, New York, USA
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Abstract
A 59-year-old woman presented with a 4-year history of a progressively growing, subcutaneous, painless, left lower eyelid mass with associated swelling and discomfort. Excisional biopsy established the diagnosis of a myoepithelioma, a tumor which, to the authors' knowledge, has not been previously reported in the lower eyelid.
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Larbcharoensub N, Pangpunyakulchai D, Aroonroch R, Tuntiyatorn L, Mahaisavariya P. Lacrimal myoepithelial carcinoma ex recurrent pleomorphic adenoma: A clinicopathological report and review of the literature. Mol Clin Oncol 2017; 8:209-213. [PMID: 29387416 DOI: 10.3892/mco.2017.1488] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 10/31/2017] [Indexed: 11/05/2022] Open
Abstract
Myoepithelial carcinoma is an uncommon malignant tumor of the lacrimal gland, composed of neoplastic myoepithelial cells with an infiltrative growth. The present study describes a unique case of progressive proptosis and blindness of the right eye in a 68-year-old woman following total tumor removal for lacrimal pleomorphic adenoma. Clinical study, surgical exploration, and pathology revealed lacrimal myoepithelial carcinoma ex recurrent pleomorphic adenoma, T2N0M0. In addition, 18 cases of lacrimal myoepithelial tumor that have been previously described in the literature are reviewed. The application of clinical, radiological, histopathologic, and immunohistochemical investigations may help to reach the definite diagnosis. Criteria for malignancy of lacrimal myoepithelial tumor should be the same as salivary myoepithelial tumor diagnosis, until long-term outcome data for a larger number of patients with lacrimal myoepithelial carcinoma become available.
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Affiliation(s)
- Noppadol Larbcharoensub
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Duangjai Pangpunyakulchai
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Rangsima Aroonroch
- Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Lojana Tuntiyatorn
- Department of Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
| | - Pornchai Mahaisavariya
- Department of Ophthalmology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Ratchathewi, Bangkok 10400, Thailand
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Karthik RS, Sivakumar JS, Cholan R, Shanmugapriya, Rajan VS, Moorthy MS, Yamunadevi A, Karthik BV. Myoepithelioma. J Pharm Bioallied Sci 2015; 7:S779-81. [PMID: 26538968 PMCID: PMC4606710 DOI: 10.4103/0975-7406.163560] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Myoepithelioma is a benign salivary gland tumor in the head and neck region, accounting for 1–1.5% of all glandular tumors. The diagnosis is rendered histopathologically, and it includes the proliferation of myoepithelial cells, without chondroid or myxochondroid stroma and ductal components (up to 5% of ductal component is acceptable). In our case report, this lesion has occurred in a 46-year-old female patient, and presented as well defined, nodular growth on the right posterior palatal region. Bony erosion and invasion were observed radiographically, and the lesion was excised surgically, with 1–2 cm of clear margin. The microscopic features included proliferating tumor sheets, composed of bland looking spindle and plasmacytoid shaped myoepithelial cells, and few cells showed clear cytoplasm, which were confirmed immunohistochemically as myoepithelial cells. Thus, the final diagnosis of benign myoepithelioma was rendered and no recurrence had been reported so far in the regular follow-up.
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Affiliation(s)
- Ramasamy Sundararajan Karthik
- Department of Oral and Maxillofacial Surgery, Sri Ramakrishna Dental College and Hospital, SNR College Road, Nava India, Coimbatore, India
| | - Jambai Sampathkumar Sivakumar
- Department of Conservative Dentistry and Endodontics, Vivekananda Dental College and Hospital, Thiruchengode, Namakkal, India
| | - Ramanujam Cholan
- Department of Prosthodontics, SRM Dental College and Hospital, Katankulathur, Chennai, India
| | - Shanmugapriya
- Department of Oral and Maxillofacial Surgery, SRM Dental College and Hospital, Katankulathur, Chennai, India
| | - Veerakesari Sundara Rajan
- Department of Oral and Maxillofacial Surgery, Sri Ramakrishna Dental College and Hospital, Coimbatore, India
| | | | - A Yamunadevi
- Department of Oral Pathology, Vivekananda Dental College and Hospital, Thiruchengode, Namakkal, India
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Jakobiec FA, Callahan AB, Stagner AM, Lee NG, Rashid A, Mendoza P, Grove A, Freitag SK. Malignant rhabdoid transformation of a longstanding, aggressive, and recurrent orbital angiomyxoma. Surv Ophthalmol 2015; 60:166-76. [DOI: 10.1016/j.survophthal.2014.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 12/04/2014] [Accepted: 12/09/2014] [Indexed: 10/24/2022]
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Pleomorphic Adenoma With Prominent Clear Cell Myoepithelioma Component of the Lacrimal Gland. Ophthalmic Plast Reconstr Surg 2015; 32:e18-21. [PMID: 25603534 DOI: 10.1097/iop.0000000000000374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
A case of a pleomorphic adenoma of the lacrimal gland with a prominent clear cell myoepitheliomatous component was reported. An 81-year-old Caucasian woman experienced a 2-month history of right supraorbital swelling and proptosis. Excisional biopsy revealed a multicomponent lesion including a stromal component featuring glandular structures made of small epithelioid and spindle cells and a trabecular component with small islands of vacuolated cells, displaced nuclei, and clear cytoplasm. Immunohistochemical analysis revealed strong cytokeratin AE1/3 reactivity and focal smooth muscle actin positivity. The pathologic findings including immunohistochemistry results were consistent with a pleomorphic adenoma with prominent clear cell myoepithelioma component.
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Hayward DM, Yoo D, Lee JM, Wild E, Prabhu VC. Myoepithelioma of the Orbital Apex and Middle Cranial Fossa: Case Report and Review of the Literature. Neuroophthalmology 2014; 38:14-20. [PMID: 27928268 PMCID: PMC5122934 DOI: 10.3109/01658107.2013.856030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2013] [Revised: 08/24/2013] [Accepted: 08/25/2013] [Indexed: 11/13/2022] Open
Abstract
Myoepitheliomas are rare tumours that originate from glandular tissues such as the parotid or salivary glands, and less commonly from soft tissues of the head, neck, and other parts of the body. Intraorbital myoepitheliomas generally arise from the lacrimal gland. Intracranial myoepitheliomas are rare. We report a myoepithelioma of the orbital apex that did not originate from the lacrimal gland. It extended to the middle cranial fossa from the orbital apex and involved the dura and adjacent bone. A diagnostic biopsy via a lateral orbitotomy preceded resection. We review the natural course and histopathology of myoepithelial neoplasms, the surgical nuances of approaching an orbital apex tumour with maximal functional preservation, and the optimal management practices of these rare lesions.
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Affiliation(s)
- Dustin M. Hayward
- Department of Neurological Surgery, Loyola University Medical CenterMaywood, IllinoisUSA
| | - David Yoo
- Department of Ophthalmology, Loyola University Medical CenterMaywood, IllinoisUSA
| | - John M. Lee
- Department of Pathology (Neuropathology section), Northshore University Medical CenterChicago, IllinoisUSA
| | - Elizabeth Wild
- Department of Neurological Surgery, Louisiana State University Health Sciences CenterShreveport, LouisianaUSA
| | - Vikram C. Prabhu
- Department of Neurological Surgery, Loyola University Medical CenterMaywood, IllinoisUSA
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Diagnostic Challenges of Myoepithelioma Arising From a Minor Salivary Gland. J Oral Maxillofac Surg 2011; 69:2830-2. [DOI: 10.1016/j.joms.2011.03.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Revised: 03/09/2011] [Accepted: 03/09/2011] [Indexed: 11/22/2022]
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Nakaya K, Oshima T, Watanabe M, Hidaka H, Kikuchi T, Higashi K, Honkura Y, Hara Y, Kobayashi T. A case of myoepithelioma of the nasal cavity. Auris Nasus Larynx 2010; 37:640-3. [PMID: 20392578 DOI: 10.1016/j.anl.2010.03.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2009] [Revised: 02/17/2010] [Accepted: 03/10/2010] [Indexed: 11/29/2022]
Abstract
Myoepithelioma is a rare tumor, most frequently located in the salivary gland. Case reports of extra-salivary myoepithelioma are sporadic, with only one case in the nasal cavity. A 68-year-old male patient presented with a myoepithelioma of the nasal cavity manifesting as nasal obstruction and epistaxis, which was treated successfully with endoscopic excision. Histological examination revealed myoepithelial cells and myxoid stroma, which confirmed the diagnosis of myoepithelioma. The behavioral pattern is similar to if not identical with that of the mixed tumor, pleomorphic adenoma, which is benign, but the potential for recurrence is always present, especially if complete resection is not achieved.
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Affiliation(s)
- Kazuhiro Nakaya
- Department of Otolaryngology-Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-cho, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
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12
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Primary myoepithelioma of the orbit in an infant. J AAPOS 2009; 13:303-5. [PMID: 19541273 DOI: 10.1016/j.jaapos.2009.02.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2008] [Revised: 02/21/2009] [Accepted: 02/23/2009] [Indexed: 11/23/2022]
Abstract
Myoepitheliomas are rare tumors with various growth patterns and cellular variants. Primary myoepithelioma is rare in the orbit, with most previously reported cases involving the lacrimal gland region of adult patients. The authors report the case of a primary orbital soft tissue myoepithelioma in a 3-month-old boy. Diagnostic criteria and management considerations of this unusual tumor presenting in a young child are discussed.
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