Sinonasal epithelial-Myoepithelial carcinoma-A rare entity

A first case report of primary epithelial myoepithelial carcinoma-like renal tumor showing a perivascular pseudorosette-like pattern: Description of morphologic, immunohistochemical, and genetic features

RATIONALE

Over the past decade, although several new entities of renal tumors have emerged, a form of renal cell carcinoma (RCC) that morphologically resembles epithelial-myoepithelial carcinoma has not been reported thus far. Herein, we describe a case of an unusual renal tumor that remained unclassified under a current RCC subtype, and briefly present its morphologic, immunophenotypic, and genetic features.

PATIENT CONCERNS

The patient was an 85-year-old man who presented with hematuria and flank pain. Imaging studies revealed a left renal mass without enlarged lymph nodes. There were no abnormal masses or nodules in other organs.

DIAGNOSES

The patient underwent no other treatment except the left radical nephrectomy under a clinical diagnosis of invasive urothelial carcinoma and was discharged on the thirteenth day. Histologically, the renal tumor showed biphasic proliferation of epithelial (strongly cytokeratin-positive; P63, P40, and vimentin-negative) and myoepithelial (strongly vimentin-positive; focal P63 and P40-positive; and weakly cytokeratin-positive) cells arranged in a perivascular pseudorosette-like pattern. No mutations were detected in multiple gene tests. According to the pathological structure, the patient was diagnosed as primary epithelial myoepithelial carcinoma-like renal tumor.

INTERVENTIONS

To the best of our knowledge, the present tumor has not been previously described, and thus, this variant has not been integrated into a known form of PCC. Therefore, we cannot diagnose this type of tumor with other types of kidney tumors.

OUTCOMES

Three years after primary diagnosis, the patient died of multiple organ failure result from multiple distant metastases.

LESSONS

We present the first case of carcinoma of the kidney with EMC-like features and a perivascular pseudorosette-like growth pattern. Clinicians should be aware of the features of this uncommon variant of RCC to avoid diagnostic delays or misdiagnosis and prevent unnecessary or inappropriate treatment.

Sinonasal epithelial-myoepithelial carcinoma: Report of a novel subsite and review of the literature

BACKGROUND

Epithelial-myoepithelial carcinoma (EMC) is a rare tumor of the major and minor salivary glands. Sinonasal EMC is extremely uncommon and hitherto not described within the frontal or ethmoid sinuses.

OBJECTIVE

To present a novel sinonasal subsite and review the literature regarding sinonasal EMC.

METHODS

A case of frontoethmoidal EMC was presented. A medical literature data base was queried from January 1, 1950, to August 8, 2017, for all reports of sinonasal EMC.

RESULTS

A 69-year-old man underwent combined open and endoscopic craniofacial resection of a right frontoethmoidal EMC, a previously undescribed primary location for this tumor. A comprehensive review of the literature revealed 13 additional cases of sinonasal EMC.

CONCLUSION

EMC is an uncommon neoplasm typically found in the major salivary glands; occurrence in the nose or paranasal sinuses is extremely rare. EMC often follows an indolent clinical course, although, in a minority of cases, particularly in large tumors with nuclear atypia, more aggressive behavior may be observed.

Epithelial-myoepithelial carcinoma of the nasopharynx: A case report and review of the literature

An 80-year-old female with complaints of right-sided nose blockage and occasional epistaxis for several months was referred to Sanggye Paik Hospital (Seoul, Korea). Nasal examination revealed a hemorrhagic mass protruding towards the right posterior nasal cavity, for which the patient was subjected to excisional biopsy. The pathological diagnosis was epithelial-myoepithelial carcinoma, as immunohistochemical analysis revealed that the inner cells stained positive for cytokeratin 7, an epithelial cell marker, whereas the outer cells stained positive for smooth muscle actin and P63, consistent with a myoepithelial phenotype. The patient received concurrent chemoradiation therapy followed by systemic chemotherapy. Following the achievement of a partial response, the patient's treatment course was uneventful. Follow-up at 24 months revealed a stable status at partial response, with no subsequent progression.