Diagnostic Challenges of Myoepithelioma Arising From a Minor Salivary Gland

Intraoral exophytic lesion in an adolescent: A case report of myoepithelioma with unique clinical presentation

Myoepithelioma is an infrequent benign tumor of the salivary glands, characterized by its composition of myoepithelial cells which can show different shapes and be arranged in various patterns with a well-circumscribed or encapsulated growth. This tumor commonly presents in adults as an asymptomatic swelling of the parotid gland, very rarely in minor salivary glands of children or adolescents, and even rarer in the buccal mucosa, with only six cases reported to date and only one of them presented in an adolescent. We present an additional case of myoepithelioma in the buccal mucosa of a 16-year-old male, with a novel clinical presentation as a non-submucosal exophytic mass. Immunohistochemically, neoplastic cells were positive for CK, S100, p63, and GFAP. The tumour was treated surgically, and the patient showed satisfactory evolution at 1 year of follow-up. The clinical and histopathological characteristics of the reported cases are discussed.

Psammoma Bodies in a Large Myoepithelioma

Myoepithelioma is a rare benign tumor of the salivary glands, in which the vast majority of neoplastic cells are myoepithelial. A rare microscopic finding in salivary gland tumors, including myoepitheliomas, is the presence of psammoma bodies (PBs), whose etiology and role in the tumors are uncertain. The objective of this study is to describe the unusual histopathologic findings, such as psammomas, of a large myopephelioma on the palate and the prosthetic restorative treatment performed after resection of the tumor. A 52-year-old woman was referred for evaluation of a tumor-like lesion, of smooth surface and normal mucosal color, measuring approximately 5 cm, on the left side hard palate, which had been identified 4 years earlier. The diagnostic hypothesis was a pleomorphic adenoma (PA), and an incisional biopsy was performed. After histopathologic analysis, a PA was suggested, and surgical resection of the tumor was performed. The histopathologic findings were compatible with myoepithelioma showing numerous calcified basophilic structures compatible with PB. Sixteen months after resection of the tumor, a removable maxillary obturator prosthesis was made because of the communication into oral and nasal cavity due from the surgical procedure. The treatment of choice for myoepithelioma is surgical excision with a nonlesional area margin. In the present report, the authors achieve good postoperative results without recurrences. After installation of the prosthesis, the patient had an excellent adaptation and acceptance, thus restoring her function and psychologic condition.