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Hu C, Lin L, Ye M, Liu Y, Huang Q, Yuan C, Sun J, Sun H. Re-evaluating a historic cohort of sinonasal and skull base mucoepidermoid carcinoma: an institutional experience. Diagn Pathol 2024; 19:46. [PMID: 38429827 PMCID: PMC10905897 DOI: 10.1186/s13000-024-01466-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 02/10/2024] [Indexed: 03/03/2024] Open
Abstract
AIMS Primary mucoepidermoid carcinomas (MECs) of the sinonasal tract and nasopharynx are rare entities that represent a diagnostic challenge, especially in biopsy samples. Herein, we present a case series of MECs of the sinonasal and skull base and its mimics to evaluate the clinicopathological and molecular characteristics in order to avoid misdiagnosis. METHODS We reviewed the pathology records of patients diagnosed from 2014 to 2022. Thirty MECs were consecutively diagnosed during that period. RESULTS Based on morphological and fluorescence in situ hybridization (FISH) analyses, 30 tumors originally diagnosed as MECs were separated into MAML2 fusion-positive (7 cases) and MAML2 fusion-negative groups (23 cases), in which 14 tumors were positive for the EWSR1::ATF1 fusion; these tumors were reclassified to have hyalinizing clear cell carcinoma (HCCC). The remaining nine MAML2 FISH negative cases were reconfirmed as squamous cell carcinoma (SCC, 3 cases) which showed keratinization and high Ki-67 expression; DEK::AFF2 carcinomas (2 cases), in which DEK gene rearrangement was detected by FISH; and MECs as previously described (4 cases) with typical morphological features. Including 7 MAML2 rearrangements tumors, 11 MEC cases had a male-to-female ratio of 4.5:1, and 6 tumors arose from the nasopharyngeal region, while 5 tumors arose from the sinonasal region. The prognosis of this series of salivary gland-type MECs was favorable. CONCLUSIONS Our study confirmed that HCCC runs the risk of being misdiagnosed as MEC in the sinonasal tract and nasopharynx, particularly with biopsy specimens. Careful histological evaluation with supporting molecular testing can facilitate pathological diagnoses.
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Affiliation(s)
- Chunyan Hu
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
- Department of Radiotherapy, Fudan University Shanghai Cancer Center, 270 Dongan Road, Shanghai, 200032, China
| | - Lan Lin
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Ming Ye
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Yifeng Liu
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Qiang Huang
- Department of Otorhinolaryngology, Eye & ENT Hospital, Fudan University, Shanghai, 200031, China
| | - Cuncun Yuan
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China
| | - Ji Sun
- Department of Pathology, Eye & ENT Hospital, Fudan University, 2600 Jiangyue Road, Shanghai, 201112, China.
| | - Hui Sun
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, 200032, China.
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