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Kerkar A, Savlania A, Kundu R, Mitra S, Rohilla M, Singh H, Bhujade H. Fine-needle aspiration cytology of retroperitoneal myoepithelial carcinoma: A rare encounter with diagnostic dilemmas. Diagn Cytopathol 2024. [PMID: 38923864 DOI: 10.1002/dc.25375] [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: 04/21/2024] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
Myoepithelial carcinoma (MC) arises from the myoepithelial cells. It is a rare tumor with a predilection for salivary glands. MC in soft tissue is uncommon. Soft tissue MC exhibits dual epithelial and smooth muscle phenotype. The extremities and limb girdles are commonly affected. We present cytological findings of retroperitoneal MC with an accurate diagnosis being rendered with the aid of immunocytochemistry on the cell block and demonstration of EWSR1 rearrangements by fluorescence in situ hybridization on cytology smear. The smears were cellular, showing loose clusters and sheets of tumor cells embedded in dense eosinophilic to myxoid matrix material. The cells were oval to polygonal, with focal areas showing moderate nuclear pleomorphism, vesicular to coarse chromatin, and vacuolated cytoplasm with clearing. On immunocytochemistry, tumor cells were positive for epithelial membrane antigen, pan-cytokeratin, calponin, smooth muscle actin, and S-100. A literature review shows only a handful of cases of soft tissue MC. The current report emphasizes the need for cytomorphological awareness with the employment of ancillary testing for accurately diagnosing this rare tumor at an uncommon location. We also discuss the diagnostic challenges and troubleshooting.
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Affiliation(s)
- Aadya Kerkar
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Savlania
- Department of General Surgery, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Reetu Kundu
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Suvradeep Mitra
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Manish Rohilla
- Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harmandeep Singh
- Department of Nuclear Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Harish Bhujade
- Department of Radiodiagnosis and Imaging, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Lu H, Zhao HP, Liu YY, Yu J, Wang R, Gao JB. Esophageal myoepithelial carcinoma: Four case reports. World J Clin Cases 2022; 10:2938-2947. [PMID: 35434113 PMCID: PMC8968825 DOI: 10.12998/wjcc.v10.i9.2938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/18/2021] [Accepted: 02/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Myoepithelial carcinoma (MC) is a rare malignant neoplasm that mainly occurs in the salivary gland. MC can be confused with many other tumors when arising outside the salivary glands because it presents with a wide spectrum of cytomorphological and immunohistochemical features. To the best of our knowledge, esophageal MC has not been previously reported. The purpose of this study was to describe the imaging and clinicopathological features of esophageal MC to improve the understanding of the disease.
CASE SUMMARY Three men and one woman diagnosed with esophageal MC were enrolled in this study. The primary clinical symptom was dysphagia. The mass was mainly located in the middle esophagus. Laboratory tests revealed that two patients who underwent tumor abnormal protein were positive. Radical resection was performed for all patients with no adjuvant therapy. Hematoxylin-eosin staining showed infiltrative growth of epithelial cells with hyperchromatic and pleomorphic nuclei toward the periphery. Immunohistochemistry showed that all patients were positive for P63, and most patients were positive for SOX-10, AE1/AE3, P40, and calponin. The Ki-67 values were all higher than 60%. Patient one died one month after discharge from an unknown cause. Patient two lost to follow-up. At patient three’s four-month review, enhanced computed tomography (CT) showed anastomosis recurrence and bilateral lung metastases. He abandoned treatment and lost to follow-up. Patient four attended review appointments regularly and remained in a good general condition.
CONCLUSION Here, we present the first report of esophageal MC and review the relevant literature. Esophageal MC is more likely to occur in the middle esophagus in older patients with male dominance. A fungating type observed on CT scanning may help narrow down the differential diagnosis. Cystic change or necrosis may occur in larger lesions. The final diagnosis should be made according to the pathological examination. The treatment for MC is surgical resection, and the efficacy of chemotherapy needs to be determined with future studies.
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Affiliation(s)
- Hao Lu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Hui-Ping Zhao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Yi-Yang Liu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Juan Yu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Jian-Bo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
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3
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Lu H, Zhao HP, Liu YY, Yu J, Wang R, Gao JB. Esophageal myoepithelial carcinoma: Four case reports. World J Clin Cases 2022; 10:2936-2945. [DOI: 10.12998/wjcc.v10.i9.2936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Myoepithelial carcinoma (MC) is a rare malignant neoplasm that mainly occurs in the salivary gland. MC can be confused with many other tumors when arising outside the salivary glands because it presents with a wide spectrum of cytomorphological and immunohistochemical features. To the best of our knowledge, esophageal MC has not been previously reported. The purpose of this study was to describe the imaging and clinicopathological features of esophageal MC to improve the understanding of the disease.
CASE SUMMARY Three men and one woman diagnosed with esophageal MC were enrolled in this study. The primary clinical symptom was dysphagia. The mass was mainly located in the middle esophagus. Laboratory tests revealed that two patients who underwent tumor abnormal protein were positive. Radical resection was performed for all patients with no adjuvant therapy. Hematoxylin-eosin staining showed infiltrative growth of epithelial cells with hyperchromatic and pleomorphic nuclei toward the periphery. Immunohistochemistry showed that all patients were positive for P63, and most patients were positive for SOX-10, AE1/AE3, P40, and calponin. The Ki-67 values were all higher than 60%. Patient one died one month after discharge from an unknown cause. Patient two lost to follow-up. At patient three’s four-month review, enhanced computed tomography (CT) showed anastomosis recurrence and bilateral lung metastases. He abandoned treatment and lost to follow-up. Patient four attended review appointments regularly and remained in a good general condition.
CONCLUSION Here, we present the first report of esophageal MC and review the relevant literature. Esophageal MC is more likely to occur in the middle esophagus in older patients with male dominance. A fungating type observed on CT scanning may help narrow down the differential diagnosis. Cystic change or necrosis may occur in larger lesions. The final diagnosis should be made according to the pathological examination. The treatment for MC is surgical resection, and the efficacy of chemotherapy needs to be determined with future studies.
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Affiliation(s)
- Hao Lu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Hui-Ping Zhao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Yi-Yang Liu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Juan Yu
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Rui Wang
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
| | - Jian-Bo Gao
- Department of Radiology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
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Dsouza SP, Kulkarni A, Sharma N, Banavali SD. Myoepithelial carcinoma of the breast: Case report of a rare entity and its response to chemotherapy. South Asian J Cancer 2020; 6:185. [PMID: 29404303 PMCID: PMC5763635 DOI: 10.4103/sajc.sajc_75_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- Sanyo P Dsouza
- Department of Medical Oncology, TMH, Mumbai, Maharashtra, India
| | - Ajit Kulkarni
- Department of Radiation Oncology, B K L Walawalkar Hospital, Ratnagiri, Maharashtra, India
| | - Nandini Sharma
- Department of Radiation Oncology, B K L Walawalkar Hospital, Ratnagiri, Maharashtra, India
| | - S D Banavali
- Department of Medical Oncology, TMH, Mumbai, Maharashtra, India
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Bhambra AC, Zhang Y, Huang EC, Bishop J, Matin M, Afify A. Pleural fluid metastases of myoepithelial carcinoma: A case report and review of the literature. Cytojournal 2016; 13:13. [PMID: 27382407 PMCID: PMC4916740 DOI: 10.4103/1742-6413.183829] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2015] [Accepted: 01/31/2016] [Indexed: 11/19/2022] Open
Abstract
Myoepithelial carcinoma (MECA) is one of the rarest salivary gland neoplasms, which may either arise de novo or develop within a preexisting pleomorphic adenoma or benign myoepithelioma. The tumor occurs mainly in the parotid gland followed by minor salivary glands and other body sites. As a result of their morphologic heterogeneity, they can be confused easily with many tumors. Awareness of their unique cytoarchitectural patterns and immunohistochemical profile is crucial for accurate identification. Herein, we report a rare case of a 51-year-old female patient with MECA of the maxillary sinus that metastasized to the pleural fluid. To the best of our knowledge, this is the first case of pleural fluid involvement by MECA reported in the literature.
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Affiliation(s)
- Alicia Calderon Bhambra
- Address: Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
| | - Yanhong Zhang
- Address: Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
| | - Eric C Huang
- Address: Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
| | - John Bishop
- Address: Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
| | - Mahan Matin
- Address: Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
| | - Alaa Afify
- Address: Department of Pathology and Laboratory Medicine, UC Davis Medical Center, Sacramento, CA, USA
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