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Li H, Long YL, Wang SF, Su LL. Epithelial-myoepithelial carcinoma originating from minor salivary gland in the inferior turbinate: A case report and literature review. EAR, NOSE & THROAT JOURNAL 2024; 103:NP486-NP490. [PMID: 34961360 DOI: 10.1177/01455613211066671] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Epithelial-myoepithelial carcinoma (EMC) is a rare tumor that occurs mainly in the major salivary glands. Cases occurring in the nasal cavity are rarely reported. The patient was a 48-year-old woman with a postoperative pathological diagnosis of EMC. The patient recovered well after surgery. We consulted and summarized all previous cases of nasal EMC. We also discuss the clinical presentation, treatment, and prognosis of EMC of the nasal cavity and paranasal sinuses.
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Affiliation(s)
- Huan Li
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Yi-Lin Long
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shi-Fei Wang
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ling-Lin Su
- Department of Otolaryngology Head and Neck Surgery, the Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Mishra SS, Nanda S, Ahirwar MK, Rath SM, Singh V, Chowhan A. Epithelial-Myoepithelial Carcinoma of Nasal Cavity at an Unusual Age: A Case Report and Review of Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:3305-3311. [PMID: 37974714 PMCID: PMC10645983 DOI: 10.1007/s12070-023-03974-0] [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: 03/09/2023] [Accepted: 06/12/2023] [Indexed: 11/19/2023] Open
Abstract
Introduction Epithelial-myoepithelial carcinoma (EMC) was recognised as a distinct pathologic entity in World Health Organisation classification. It is an extremely rare low grade carcinoma of salivary gland, with characteristic biphasic tubular structures. It predominantly occurs in Parotid gland but can also be seen in nasopharynx, lacrimal gland, paranasal sinuses, larynx, lung. Nasal EMC (excluding the paranasal sinuses as primary tumour site) are very rare with only 13 cases reported till date. In this case report, we described a case of nasal EMC extending into nasopharynx, its clinical features and management. We have also done a literature review of all the relevant cases of nasal EMC. Material and Methods We searched the PubMed database for articles between January 1950 and December 2022 for nasal EMC for this review. Results We found 13 relevant case reports of nasal EMC and median age was 58 years with female preponderance. We found that our patient was the youngest to be reported till date. Two cases, including the current study, showed epicentre of the tumour in posterior nasal cavity, extending to choana and nasopharynx. Most common presentation was epistaxis, followed by nasal obstruction. Only 4 out of 14 cases had information on surgical margin status, out of which only one has positive surgical margin. Five patients (including the patient in the current study) received adjuvant radiotherapy; however 6 patients (42.8%) did not receive any adjuvant radiotherapy.
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Affiliation(s)
- Shiv Shankar Mishra
- Department of Radiotherapy, All India Institute of Medical Sciences, Raipur, Chhattisgarh India
| | - Siddhartha Nanda
- Department of Radiotherapy, All India Institute of Medical Sciences, Raipur, Chhattisgarh India
| | - Manish Kumar Ahirwar
- Department of Radiotherapy, All India Institute of Medical Sciences, Raipur, Chhattisgarh India
| | - Swaroopa Madhuri Rath
- Department of Radiotherapy, All India Institute of Medical Sciences, Raipur, Chhattisgarh India
| | - Vandita Singh
- Department of Pathology, All India Institute of Medical Sciences, Rajkot, Gujarat India
| | - Amit Chowhan
- Department of Pathology, All India Institute of Medical Sciences, Raipur, Chhattisgarh India
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Zhang W, Wang XX, Wang XL, Zhang Y, Li XF, Li Y, Cai YY, Ren HQ, Zhang YX, Hao FR. Epithelial-myoepithelial carcinoma of the nasopharynx: A case report and review of the literature. Front Oncol 2022; 12:923579. [PMID: 35992786 PMCID: PMC9389165 DOI: 10.3389/fonc.2022.923579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/30/2022] [Indexed: 11/13/2022] Open
Abstract
Background Epithelial-myoepithelial carcinoma (EMCa) is a rare low-grade malignant tumor that most commonly occurs in the salivary glands, with approximately 320 cases having been reported worldwide. Here, we report the third case of EMCa occurring in the nasopharynx. Rare cases in the breast, pituitary gland, lacrimal gland, nose, paranasal sinus, nasal cavity, trachea and bronchus, lung, and even the pleura mediastinalis have also been reported. Histopathology and immunohistochemistry are useful for confirming the diagnosis of EMCa, which is characterized by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells and stains for different markers in each layer. However, because of the rarity of EMCa, the clinicopathological characteristics and treatment of these patients remain unclear. Case presentation We report a rare case of EMCa of the nasopharynx. A 51-year-old man presented with a 5-month history of pain while swallowing and aggravation accompanied by right ear tinnitus lasting for 1 month. Nasopharyngoscopy and magnetic resonance imaging (MRI) of the nasopharynx and neck revealed a 5.6 cm × 3.4 cm × 3.1 cm mass in the nasopharyngeal space, invasion of the right cavernous sinus, and lymph node enlargement in the right retropharyngeal space. On 17 April 2019, based on the histopathological and immunohistochemical features, a final diagnosis of EMCa of the right nasopharynx was made. The patient underwent concurrent chemoradiotherapy (CCRT), and his symptoms were relieved after treatment. On 10 January 2022, nasopharynx MRI and biopsy revealed local recurrence, but chest and abdominal computed tomography (CT) showed no obvious signs of metastasis. The local recurrence-free survival (LRFS) period was 33 months. Conclusion To the best of our knowledge, this is the third reported case of EMCa in the nasopharynx and the only case of EMCa in the nasopharynx treated with CCRT, and a partial response was achieved. Therefore, to improve the quality of life and prognosis of patients with unresectable tumors, we believe that CCRT is a suitable option. Further clinical observations are required to elucidate the pathophysiology and prognosis of EMCa.
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Affiliation(s)
- Wei Zhang
- Clinical School, Weifang Medical University, Weifang, China
| | - Xiao-xiao Wang
- Department of Radiation Oncology, Weifang People’s Hospital, Weifang, China
| | - Xiao-li Wang
- Department of Radiation Oncology, Weifang People’s Hospital, Weifang, China
| | - Yan Zhang
- Clinical School, Weifang Medical University, Weifang, China
| | - Xiu-feng Li
- Department of Pathology, Weifang People’s Hospital, Weifang, China
| | - Yang Li
- Department of Radiation Oncology, Weifang People’s Hospital, Weifang, China
| | - Yuan-yuan Cai
- Department of Radiation Oncology, Weifang People’s Hospital, Weifang, China
| | - Hui-qi Ren
- Department of Radiation Oncology, Weifang People’s Hospital, Weifang, China
| | - Yun-xiang Zhang
- Department of Pathology, Weifang People’s Hospital, Weifang, China
| | - Fu-rong Hao
- Department of Radiation Oncology, Weifang People’s Hospital, Weifang, China
- Weifang Key Laboratory of Radiophysics and Oncological Radiobiology, Weifang, China
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Diagnostic Significance of HRAS Mutations in Epithelial-Myoepithelial Carcinomas Exhibiting a Broad Histopathologic Spectrum. Am J Surg Pathol 2020; 43:984-994. [PMID: 30994537 DOI: 10.1097/pas.0000000000001258] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland tumor that is histologically characterized by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells. Because of its histologic variety, it is sometimes challenging to make an accurate diagnosis, and useful ancillary tests are essential for this purpose. We investigated 87 cases of EMC arising in the major and minor salivary glands and seromucinous glands in the nasal cavity or bronchus to describe the histologic features and mutation status of selected key oncogenes. Classic EMC accounted for 40.2% of all cases. Other cases showed various growth patterns and cytologic features in addition to the typical histology; cribriform patterns, a basaloid appearance, and sebaceous differentiation were relatively common (17.2% to 18.4%), whereas oncocytic/apocrine, papillary-cystic, double-clear, squamous, psammomatous, Verocay-like, and high-grade transformation were rare. HRAS mutations were found in 82.7% of EMCs and were concentrated in codon 61. There was no significant correlation between the HRAS mutation status and the histology. No EMC ex pleomorphic adenoma cases had HRAS mutations. PIK3CA and/or AKT1 mutations were the second most frequent mutations (20.7%, 6.5%, respectively) and almost always cooccurred with HRAS mutations. It is noteworthy that the HRAS mutation was not identified in any salivary gland tumor entities manifesting EMC-like features, including adenoid cystic carcinoma, pleomorphic adenoma, basal cell adenoma/adenocarcinoma, and myoepithelial carcinoma. We conclude that HRAS mutations are a frequent tumorigenic gene alteration in EMC, despite its histologic diversity. This study provides further insight into strategies for diagnosing EMC and discriminating it from its mimics.
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Schuman TA, Kimple AJ, Edgerly CH, Ebert CS, Zanation AM, Thorp BD. Sinonasal epithelial-myoepithelial carcinoma: Report of a novel subsite and review of the literature. ALLERGY & RHINOLOGY (PROVIDENCE, R.I.) 2018; 9:2152656718764229. [PMID: 29977654 PMCID: PMC6028158 DOI: 10.1177/2152656718764229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
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.
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Affiliation(s)
- Theodore A. Schuman
- From the Department of Otolaryngology—Head and Neck Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Adam J. Kimple
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Claire H. Edgerly
- Department of Pathology and Laboratory Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Charles S. Ebert
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Adam M. Zanation
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Brian D. Thorp
- Department of Otolaryngology—Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Nguyen S, Perron M, Nadeau S, Odashiro AN, Corriveau MN. Epithelial Myoepithelial Carcinoma of the Nasal Cavity: Clinical, Histopathological, and Immunohistochemical Distinction of a Case Report. Int J Surg Pathol 2017; 26:342-346. [PMID: 29237344 DOI: 10.1177/1066896917747732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Epithelial myoepithelial carcinomas (EMCs) are rare low-grade salivary gland tumors. Here, we report the case of a 75-year-old man presenting with an oncocytic variant of EMC of the nasal cavity, initially diagnosed as an oncocytoma. METHODS Our patient underwent functional sinus surgery in 2012. On pathology, an oncocytic neoplasm was found in the right nasal cavity, characterized by fragments of uniform bland oncocytic cells with bilayered arrangement of nuclei. Immunohistochemical stains demonstrated biphasic cells: luminal epithelial and basal cell-type myoepithelial cells. The tumor was best diagnosed as an oncocytoma. In 2015, the patient presented with a recurrent right inferior turbinate lesion, compatible with oncocytic EMC. RESULTS The patient underwent oncological surgery and received adjuvant radiotherapy. He had no disease recurrence. CONCLUSION Different variants of EMCs exist, such as oncocytic EMC. EMCs should be treated aggressively because they can be locally invasive, recur, and give rise to distant metastases.
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Affiliation(s)
| | | | - Sylvie Nadeau
- 1 Laval University, Quebec City, QC, Canada
- 2 CHU de Québec, Quebec City, QC, Canada
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Panda NK, Patro SK, Verma RK, Wadood A, Chatterjee D. Epithelio- Myoepithelial Carcinoma of Masseteric Space: a Case Report. Indian J Surg Oncol 2017; 8:240-244. [PMID: 28546730 DOI: 10.1007/s13193-016-0537-x] [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: 09/20/2015] [Accepted: 05/31/2016] [Indexed: 11/26/2022] Open
Abstract
Epithelio-myoepithelial carcinoma (EMEC) is a very rare malignancy of the salivary gland which comprises less than 1 % of salivary gland tumors. In the parapharyngeal space they can either arise from the deep lobe of parotid gland or de novo from minor salivary glands. We present a case of epithelio-myoepithelial carcinoma of parapharyngeal and masseteric space. The case is important for its rarity of presentation and we discuss the surgical difficulties and morbidities.
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Affiliation(s)
- Naresh K Panda
- Department of Otolaryngology and Head Neck Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Sourabha K Patro
- Department of Otolaryngology and Head Neck Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Roshan K Verma
- Department of Otolaryngology and Head Neck Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
| | - Abdul Wadood
- Department of Otolaryngology and Head Neck Surgery, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, 160012 India
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Abstract
The nasal cavity and paranasal sinuses occupy the top of the upper respiratory tract and form pneumatic spaces connected with the atmosphere. They are located immediately beneath the base of the cranium, where crucial vital structures are harbored. From this region, very much exposed to airborne agents, arise some of the more complex and rare benign and malignant lesions seen in humans, whose difficulties in interpretation make this remarkable territory one of the most challenging in the practice of surgical pathology. Contents of this chapter cover inflammations and infections, polyps and pseudotumors, fungal and midfacial destructive granulomatous lesions, as well as benign, borderline, and malignant neoplasms. Among the neoplasms, emphasis is made on those entities characteristic or even unique for the sinonasal region, such as Schneiderian papillomas, glomangiopericytoma, intestinal- and non-intestinal-type adenocarcinomas, olfactory neuroblastoma, nasal-type NK-/T-cell lymphoma, and teratocarcinosarcoma. Moreover, recently recognized entities involving this territory, i.e., HPV-related non-keratinizing carcinoma, NUT carcinoma, and SMARCB1-deficient basaloid carcinoma, are also discussed in the light of their specific molecular findings. Furthermore, the text is accompanied by numerous classical and recent references, several tables, and 100 illustrations.
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Affiliation(s)
- Antonio Cardesa
- University of Barcelona, Anatomic Pathology Hospital Clínic University of Barcelona, Barcelona, Spain
| | - Pieter J. Slootweg
- Radboud Univ Nijmegen Medical Center, Pathology Radboud Univ Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Nina Gale
- University of Ljubljana,, Institute of Pathology, Faculty of Medic University of Ljubljana,, Ljublijana, Slovenia
| | - Alessandro Franchi
- University of Florence, Dept of Surg & Translational Medicine University of Florence, Florence, Italy
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9
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Flam JO, Brook CD, Sobel R, Lee JC, Platt MP. Nasal epithelial myoepithelial carcinoma: An unusual cause of epiphora, a case report and review of the literature. ALLERGY & RHINOLOGY 2015; 6:133-7. [PMID: 26302736 PMCID: PMC4541636 DOI: 10.2500/ar.2015.6.0127] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Introduction: Epithelial myoepithelial carcinoma (EMC) of the nasal cavity is a rare tumor, and here we describe the first case of EMC of the nasal cavity presenting with epiphora. A case presentation and review of the literature is provided. Methods: A case report is described of a 63-year-old man who presented with unilateral epiphora and was found via a thorough history and physical examination to have a nasal tumor. The physical examination consisted of an ocular examination, including probing and irrigation, and a detailed nasal examination (anterior rhinoscopy, nasal endoscopy). The nasal examination was prompted by the patient's report of concurrent nasal symptoms during history taking. Immunohistochemistry subsequently identified the nasal tumor as EMC. A literature search was performed to gain insights into similar malignancies of the nasal cavity. Results: Eight cases of EMC of the nasal cavity were identified in the literature, none of the patients presented with epiphora. The case presented here resulted in resolution of the patient's symptoms and no evidence of disease after surgical excision. Conclusion: Epithelial myoepithelial is a rare salivary gland malignancy that can arise in the nasal cavity. Unilateral epiphora with concurrent nasal symptoms should prompt nasal cavity examination for the possibility of an obstructive tumor.
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Affiliation(s)
- Juliette O Flam
- Boston University School of Medicine, Boston, Massachusetts, USA
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10
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Konoglou M, Cheva A, Zarogoulidis P, Porpodis K, Pataka A, Mpaliaka A, Papaiwannou A, Zarogoulidis K, Kontakiotis T, Karaiskos T, Kesisis G, Kolettas A, Giouleka A, Madesis A, Vretzakis G, Sakkas L, Tsakiridis K. Epithelial-myoepithelial carcinoma of the trachea-a rare entity case report. J Thorac Dis 2014; 6 Suppl 1:S194-9. [PMID: 24672694 DOI: 10.3978/j.issn.2072-1439.2013.11.17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Accepted: 11/23/2013] [Indexed: 01/30/2023]
Abstract
Epithelial-myoepithelial tumors of the lung are rare neoplasms whose biological behavior and clinical course still remain to be defined. Epithelial-myoepithelial carcinoma (EMCa) is a low-grade malignant tumour. According to literature, most commonly occurs in salivary glands, particularly in parotic gland, but it can also occur in unusual locations such as breast, lachrymal gland, nose, paranasal sinus, lung, bronchus and, as in our case, trachea. There are no many documented case reports of a primary myoepithelial carcinoma in the trachea. We report a case of a 34-year-old man diagnosed with this unusual location of an epithelial-myoepithelial tumor. The tumour was removed by segmental tracheal resection and end-to-end anastomosis.
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Affiliation(s)
- Maria Konoglou
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Aggeliki Cheva
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Paul Zarogoulidis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Konstantinos Porpodis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Athanasia Pataka
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Aggeliki Mpaliaka
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Antonios Papaiwannou
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Konstantinos Zarogoulidis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Theodoros Kontakiotis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Theodoros Karaiskos
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Georgios Kesisis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Alexander Kolettas
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Alina Giouleka
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Athanasios Madesis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - George Vretzakis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Leonidas Sakkas
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
| | - Kosmas Tsakiridis
- 1 Intesive Care Unit, 2 Pathology Department, "G. Papanikolaou" General Hospital, Thessaloniki, Greece ; 3 Pulmonary Department, 4 Cardiothoracic Surgery Department, "G. Papanikolaou" General Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece ; 5 Oncology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 6 Anesthesiology Department, "Saint" Luke Private Hospital, Thessaloniki, Greece ; 7 Anesthesiology Department, University Hospital of Larisa, Greece
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Epithelial-myoepithelial carcinoma of the maxillary sinus: A rare case. Laryngoscope 2012; 122:1579-81. [DOI: 10.1002/lary.23310] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 02/22/2012] [Indexed: 01/06/2023]
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12
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An unusual presentation of aggressive epithelial-myoepithelial carcinoma of the nasal cavity with high-grade histology. The Journal of Laryngology & Otology 2011; 125:1286-9. [DOI: 10.1017/s0022215111002222] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractBackground:Epithelial-myoepithelial carcinoma is an uncommon, low-grade carcinoma that generally occurs in the salivary glands. A few cases of epithelial-myoepithelial carcinoma arising in the nasal cavity have been reported. We describe a unique case of aggressive epithelial-myoepithelial carcinoma in the nasal cavity.Case report:A 36-year-old woman presented with a mass in her left nasal cavity. Histopathological evaluation revealed it to be an epithelial-myoepithelial carcinoma with overt nuclear atypia, frequent mitoses and necrosis. The tumour recurred in the contralateral nasal cavity 15 months following primary excision. Medial maxillectomy and radiation therapy were performed. Seven-month follow up revealed extensive bone metastases.Conclusion:We report a rare case of aggressive epithelial-myoepithelial carcinoma in the nasal cavity, with high-grade histology.
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Kuran G, Sagıt M, Akın I, Hucumenoglu S, Ocal BG, Celık SY. Bilateral epithelial-myoepithelial carcinoma: an extraordinary tumor of the paranasal sinuses. Skull Base 2011; 18:145-50. [PMID: 18769533 DOI: 10.1055/s-2007-1016955] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A 54-year-old woman presented with a 6-month history of swelling on the right side of her face. On physical examination she was found to have a huge mass in the right nasal cavity. Magnetic resonance images of the paranasal sinuses revealed a soft tissue mass in the right maxillary sinus and a mass was also seen in the left maxillary sinus. On histopathologic examination, the tumor had a lobular structure with infiltrating margins. Two cell types, an outer layer of myoepithelial and an inner layer of duct-like cells, were found. On immunohistochemical examination, myoepithelial cells stained positively for calponin, p63, GFAP, S-100 protein, alpha-smooth muscle actin cytokeratin-14. The tumors were resected completely and no recurrence or metastasis was found 30 months after surgery. We describe here an unusual case of epithelial-myoepithelial carcinoma (EMC) arising from the paranasal sinuses. This is the first case report in the literature describing bilateral EMC in the maxillary sinuses.
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Affiliation(s)
- Gokhan Kuran
- 1st ENT Department, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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14
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Radi M, Makki H, Al Bozom I. Epitheiial-Myoepithelial Carcinoma (EMC): Uncommon tumor with rare presentation, importance of immunohistochemistry for the diagnosis. Qatar Med J 2010. [DOI: 10.5339/qmj.2010.2.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Epithelial myoepithelial carcinomas (EMC) are rare carcinomas of the salivary glands. We report here the 6th case of this tumor which arises at the nasal cavity. In case of any histopathological report shows up a pleomorphic adenoma in an unusual site, we highly recommended the use of immunohistochemistry assay as an important tool for the diagnosis of this tumor.
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Affiliation(s)
- M.M. Radi
- *ORL-HNS (ENT) Section, Surgery Department
| | - H.A. Makki
- *ORL-HNS (ENT) Section, Surgery Department
| | - I. Al Bozom
- **Laboratory Medicine and Pathology Department, Hamad Medical Corporation, Doha, Qatar
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Yamanegi K, Uwa N, Hirokawa M, Ohyama H, Hata M, Yamada N, Ogino K, Toh K, Terada T, Tanaka A, Sakagami M, Terada N, Nakasho K. Epithelial–myoepithelial carcinoma arising in the nasal cavity. Auris Nasus Larynx 2008; 35:408-13. [DOI: 10.1016/j.anl.2007.10.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2007] [Revised: 09/29/2007] [Accepted: 10/02/2007] [Indexed: 11/28/2022]
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Antic T, Venkataraman G, Oshima K. Oncocytic epithelial-myoepithelial carcinoma: an evolving new variant with comparative immunohistochemistry. Pathology 2008; 40:415-8. [PMID: 18446637 DOI: 10.1080/00313020802040667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Zhou SH, Ruan LX, Gong L, Wang SQ. Primary malignant myoepithelioma of the left maxillary sinus: a case report. J Int Med Res 2008; 36:362-5. [PMID: 18380949 DOI: 10.1177/147323000803600221] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
We describe the case of a 41-year-old woman who presented with a malignant myoepithelioma (MME) in her left maxillary sinus. Exploratory biopsy of the left maxillary sinus was performed and pathological examination demonstrated that the tumour was positive for calponin and cytokeratin 14, which are indicative of MME. Lateral rhinotomy and left total maxillectomy were undertaken and the patient received radiotherapy and chemotherapy post-surgery. Primary recurrence and metastasis to the left angle of the mandible occurred 9 months after the surgery. The patient died of cachexia 13 months after the surgery.
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Affiliation(s)
- S H Zhou
- Department of Otolaryngology, The First Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, Zhejiang, The People's Republic of China
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18
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M'sakni I, Laabidi B, Bougrine F, Sabbegh-Znaïdi N, Benzarti S, Chebbi K, Bouziani A. Carcinome épithélial–myoépithélial de la cavité nasale. ACTA ACUST UNITED AC 2007; 124:228-31. [PMID: 17803952 DOI: 10.1016/j.aorl.2007.04.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2007] [Accepted: 04/30/2007] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Epithelial-myoepithelial carcinoma is a rare tumor of the salivary glands with an incidence of less than 1%. Most cases arise in the parotid gland. Extraoral location is exceptional. The purpose of this study was to describe a case with nasal location, which is exceptionally reported in the literature. MATERIALS AND METHODS We report a case of epithelial-myoepithelial carcinoma arising in the nasal cavity of a 54-year-old woman. RESULTS The woman presented with right recurrent epistaxis and on nasal endoscopic examination was found to have a polypoid tumor in the right nasal cavity. The CT-scan demonstrated a soft tissue mass without extension to the rhinopharynx or bony destruction. Histopathologic examination revealed the tumor to consist of a mixture of a solid, tubular, and trabecular structures with a double-layered arrangement of inner eosinophilic cells and outer clear cells. Dual differentiation toward myoepithelial and epithelial cells was confirmed immunohistochemically. CONCLUSION The occurrence of epithelial-myoepithelial carcinoma in the nasal cavity is possible. In published cases, no recurrence or metastasis has been reported in this location.
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Affiliation(s)
- I M'sakni
- Service d'anatomie et de cytologie pathologiques, hôpital militaire de Tunis, Tunisie.
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19
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Pradhan SA, Khannan R, Hazarika B, Desai M. Sinonasal epithelial-Myoepithelial carcinoma-A rare entity. Indian J Otolaryngol Head Neck Surg 2007; 59:168-70. [PMID: 23120422 PMCID: PMC3451784 DOI: 10.1007/s12070-007-0050-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Epithelial-myoepithelial carcinoma is a rare salivary gland tumor. It comprises less than 1% of all salivary gland tumors. It generally arises from the parotid gland. Unusual sites of occurrence include sinonasal tract, lung, trachea, lacrimal gland and breast. Histopathologically epithelial-myoepithelial carcinoma comprises a dual population of ductal and myoepithelial cells. We report an extremely rare case of epithelial-myoepithelial carcinoma occurring in the sinonasal tract of young man.
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Affiliation(s)
- Sultan A. Pradhan
- Dept of Oncology, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai, 400 010 India
- Dept. of Surgical Oncology, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai, 400 010 India
| | - Rajan Khannan
- Dept of Oncology, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai, 400 010 India
- Dept. of Surgical Oncology, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai, 400 010 India
| | - Biswajyoti Hazarika
- Dept of Oncology, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai, 400 010 India
- Dept. of Surgical Oncology, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai, 400 010 India
| | - Meena Desai
- Dept. of Pathology, Prince Aly Khan Hospital, Nesbit Road, Mazagaon, Mumbai, 400 010 India
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Seethala RR, Barnes EL, Hunt JL. Epithelial-myoepithelial carcinoma: a review of the clinicopathologic spectrum and immunophenotypic characteristics in 61 tumors of the salivary glands and upper aerodigestive tract. Am J Surg Pathol 2007; 31:44-57. [PMID: 17197918 DOI: 10.1097/01.pas.0000213314.74423.d8] [Citation(s) in RCA: 231] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
To further define the clinicopathologic spectrum of epithelial-myoepithelial carcinoma (EMCa), we report the gross, histologic, and immunophenotypic characteristics of 61 tumors seen within a 30-year-period. The mean age at presentation was 60.9 years, with a female predominance (1.5:1). The most common sites were parotid (62.1%), sinonasal mucoserous glands (10.3%), palate (8.6%), and submandibular (8.6%). Most EMCas showed a characteristic nodular/multinodular growth pattern and classic biphasic tubular histology. However, new morphologies in EMCa such as ancient change (8.2%), "Verocay"-like change (3.3%), and sebaceous differentiation (13.1%) were noted. Specific histologic variants were dedifferentiated EMCa (3.3%), oncocytic EMCa (8.2%), EMCa ex pleomorphic adenoma (1.6%), double-clear EMCa (3.3%), and EMCa with myoepithelial anaplasia (3.3%). All cytokeratin cocktails selectively highlighted the epithelial component well. Of the myoepithelial markers, p63, smooth muscle actin and vimentin performed best. Bcl-2 and c-kit were frequently positive (66.7% and 69.2%, respectively). p53 was highly expressed only in 1 dedifferentiated EMCa. The recurrence rate was 36.3% (median disease-free survival 11.34 y), but death was rare with 5-year and 10-year disease-specific survivals of 93.5% and 81.8%, respectively. The most important univariate predictors of recurrence were margin status (log rank P=0.006), angiolymphatic invasion (P=0.002), tumor necrosis (P=0.004), and myoepithelial anaplasia (P=0.038). Thus, EMCa is generally a low-grade tumor with a broader morphologic spectrum than previously thought, with several key features predictive of recurrence. Immunohistochemistry can aid diagnosis by highlighting the biphasic nature of the tumor.
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Affiliation(s)
- Raja R Seethala
- Head and Neck/Endocrine Division, Department of Pathology, University of Pittsburgh Medical Center, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
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