MRI findings of epithelial–myoepithelial carcinoma of the parotid gland with radiologic–pathologic correlation

Purpose This study aimed to describe the MRI findings of epithelial-myoepithelial carcinoma (EMC) of the parotid gland. Materials and methods Seven patients (four males and three females) aged 40–86 years (mean age, 64 years) with histologically proven EMC of the parotid gland who underwent surgical resection after preoperative MRI were enrolled. MRI images were retrospectively reviewed and contrasted with pathological findings. Results Five patients (71%) had predominantly solid lesions, and two (29%) had predominantly cystic lesions. All seven lesions had well-demarcated margins and capsules without the invasion of adjacent structures. The capsules were incomplete in five lesions (71%) and complete in two (29%). Four lesions (57%) exhibited a multinodular structure with internal septa. Cystic components were observed in three lesions (43%). On T1-weighted images, the solid components were frequently homogeneous (5/7, 71%), and demonstrated isointensity in five lesions (71%) and hypointensity in two (29%) relative to the spinal cord. On T2-weighted images, the solid components were usually heterogeneous (6/7, 86%), and demonstrated hyperintensity in five lesions (71%) and isointensity in two (29%) relative to the spinal cord. The mean apparent diffusion coefficient value of the solid components was 0.967 × 10−3 mm2/s. Conclusion Parotid gland EMCs usually appeared as predominantly solid lesions with well-demarcated margins and capsules. A multinodular structure with internal septa was characteristics of EMCs.

Epithelial–myoepithelial carcinoma originating from minor salivary gland in the inferior turbinate: A case report and literature review

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.

Case Report: Nasal Cavity Epithelial-Myoepithelial Carcinoma With High Fluoro-D-Glucose Uptake on Positron Emission Tomography/Computed Tomography

Epithelial-myoepithelial carcinoma (EMC) is a rare malignant neoplasm arising most frequently in the salivary glands and exceptionally in the nasal cavity. EMC accounts for ~1–2% of salivary gland tumors. Even if the nodal and distant metastasis rates are low, tumor staging remains indicated. Here, the authors present the 2-deoxy-2-[18F]fluoro-D-glucose PET-CT (18F-FDG-PET/CT) study of a very rare case of biopsy-proven EMC of the left nasal cavity. This 18F-FDG-PET/CT was performed to stage this tumor and guide the therapeutic strategy due to an atypical high-grade presentation in immunohistochemistry. To our knowledge, this is the first case reporting such high 18F-FDG avidity of EMC of the nasal cavity in PET/CT.

A Case of Epithelial-Myoepithelial Carcinoma of Parotid Gland and Analysis of 33 Cases Reported in Korea

Epithelial-myoepithelial carcinoma is rare, low-grade malignant neoplasm that compromises approximately 1% of all salivary gland neoplasms. We reported a 68-year-old woman with epithelial-myoepithelial carcinoma in the parotid gland. We analyzed demographic and clinicopathological characteristics of salivary gland epithelial-myoepithelial carcinoma which has been reported in 33 cases in Korea from 1992 to 2017, and compared this result to overseas retrospective cohort studies. There was no significance in terms of mean age at diagnosis, the predominance of females, low frequency in regional lymph nodes, and distant metastasis between the two groups. However, T classification and AJCC stage at diagnosis in domestic cases are more advanced than those of overseas cases. Although the recurrence rate in domestic cases has been reported lower than that of overseas, further study may be needed considering that the follow-up period after treatment is short in domestic cases.

Epithelial-Myoepithelial Carcinoma of the Minor Salivary Glands: Case Series with Comprehensive Review

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, which is especially uncommon in the minor salivary glands (MSG). Because of its histologic variety, complexity, and heterogeneity, it is sometimes challenging to make the accurate diagnosis. Here, we report a literature review of EMC of the MSGs with our experience of two cases. Incisional biopsy was suggestive of pleomorphic adenoma in Case 1 and pleomorphic adenoma or a low-grade salivary gland carcinoma in Case 2. Both cases were performed intraoral tumor resection, and they have good postoperative courses and are alive with no evidence of local recurrence or metastasis at 31 and 16 months, respectively. Considering that the anatomy, structure, and size of salivary glands are quite different from MSGs, it might be difficult to predict EMCs of the MSG similarly to EMCs of the major salivary glands. This comprehensive review also reports the features of EMC of the MSG cases and the trends of diagnosis and discusses treatment strategy.

Hybrid Carcinoma of the Parotid Gland: An Extremely Rare Three Cases with an Immunohistochemical Analysis and a Review of the Literature

Salivary hybrid carcinoma (HC) is defined as when two or more kinds of carcinoma exist at the same location in a single mass. We reestimated and examined three cases of salivary gland HC. Case 1 involved a 76-year-old male. Case 2 involved a 74-year-old female. Case 3 involved a 66-year-old male. Histologically, case 1 involved a combination of salivary duct carcinoma (SDC) and squamous cell carcinoma (SqCC). Immunohistochemically, the former was positive for gross cystic disease fluid protein (GCDFP)-15 and androgen receptor (AR). Case 2 involved a combination of SqCC and neuroendocrine carcinoma. Immunohistochemically the latter was positive for synaptophysin and neural cell adhesion molecule (NCAM). Case 3 involved a combination of SDC and epithelial–myoepithelial carcinoma (EMC). Immunohistochemically, the former was positive for GCDFP-15 and AR, whereas the inner cells of the latter were positive for cytokeratin 7, and the outer cells of the latter were positive for actin. Because of the transitional zone between SDC and EMC, it was speculated that high-grade SDC arose from low-grade EMC.

Multiple Warthin Tumors With Epithelial–Myoepithelial Carcinoma of the Ipsilateral Parotid Gland: A Case Report

Multiple primary tumors of the parotid gland refer to the occurrence of 2 or more primary tumors in the ipsilateral or bilateral parotid gland metachronously or synchronously, which do not originate from postoperative recurrence or metastasis. Multiple primary tumors of the parotid gland, especially synchronous benign and malignant tumors, are extremely uncommon. A rare case of multiple Warthin tumors with epithelial–myoepithelial carcinoma of the ipsilateral parotid gland is reported as follows.

Epithelial lacrimal gland tumors in dogs and cats: Is the human WHO classification appropriate for animals?

Lacrimal gland tumors (LGTs) in dogs and cats are rare neoplasms that can affect either the nictitans (NLG) or the main lacrimal gland (MLG). A consistent classification scheme for canine and feline LGTs is lacking; however, the importance of a classification scheme for LGTs has been emphasized in the human literature, and an update to the World Health Organization (WHO) classification has recently been published. The aim of this study was to investigate the occurrence of different subtypes of canine and feline LGTs in accordance with the human WHO classification system. Epithelial LGTs ( n = 46 tumors; 38 dogs, 8 cats) were reviewed and immunophenotyping for p63, CK14, SMA, calponin, CKAE1/AE3, and CK19 was performed. Consistent with previous literature reports, lacrimal carcinomas outnumbered adenomas in dogs and cats. Based on the WHO classification of human LGTs, the most common subtypes identified in dogs were pleomorphic, ductal, adenoid cystic, and epithelial-myoepithelial carcinoma. In cats, a lower number of subtypes was observed, and adenocarcinoma “not otherwise specified” (NOS) was the most frequent diagnosis. An uncommon case of feline epithelial-myoepithelial carcinoma was also observed. The application of the human WHO-LGT classification scheme to canine and feline tumors increased the diversity of diagnoses and allowed for the identification of numerous subtypes. Further studies to identify possible correlations between pathological subtypes and prognosis are warranted.

Breast Epithelial-myoepithelial Carcinoma With HER2 Gene Amplification: a Rare Case and Review of Literature

Background: Epithelial-myoepithelial carcinoma is a very rare carcinoma that both luminal and myoepithelial components are malignant. What’s more, HER2 gene amplification has not been detected in the literature up to now. Herein, we report a rare case of breast epithelial-myoepithelial carcinoma with HER2 gene amplification.Case presentation: An 80-year-old woman presented with a mass in the upper outside region of her left breast. The core needle biopsy of the left breast mass revealed invasive breast carcinoma, and then modified radical mastectomy of left breast was performed. Macroscopically, the tumor was measured 6cm in diameter, and it was a solid and lobulated mass with areas of cystic and hemorrhagic lesions. Microscopically, the histological findings of tumor were consisted of 3 components. One component showed biphasic proliferation of both eosinophilic luminal epithelial and pale abluminal myoepithelial cells, arranging predominantly in dilated tubular architecture, which accounted for most of the lesion. Papillary architecture and eosinophilic secretions could be seen in some dilated ducts. The second component was proliferation of myoepithelial cells with pale cytoplasm around the glandular epithelium forming casing-like structures. The third component was few solid-appearing areas which was displayed a predominance of monophasic proliferation of myoepithelial cells. Both cell types exhibited enlarged and markedly atypical nuclei, with obvious nucleoli and prominent mitoses (up to 10-15/10 high power fields). Foci of infiltration were identified at the periphery of the lobules and the surrounding adipose tissue. Areas of central necrosis and stromal hyalinization could be seen. A diagnosis of EMC was made by morphology and immunohistochemistry. It's worth noting that HER2 gene amplification has not been detected in malignant adenomyoepitheIioma in the literature up to now; While in our present report, HER2 was 2+ membranous immunoreactivity, and then HER2 gene amplification was detected by fluorescence in situ hybridization. Conclusion: Accurate diagnosis of malignant adenomyoepitheIioma is challenging but of great importance, and the management of malignant adenomyoepitheIioma would be made according to histologic features.