In contrast to sdc, mec is observed over a wider age range, has a female or less striking male predominance, and occurs in major and minor salivary glands with approximately equal frequency 34. Pdf role of radiotherapy for mucoepidermoid carcinoma of. The diagnosis of mec can be quite challenging due to the degree of histologic overlap with other glandular, clear cell, or oncocytic salivary gland tumors. Mucoepidermoid carcinoma in a minor salivary gland in. The rest of the studies relied on the clinical followup along with the physical examination and other imaging modalities. Mucoepidermoid carcinoma is the most common type of minor salivary gland malignancy in adults. We utilized tissue microarrays with 78 examples of mucoepidermoid carcinoma and 47 salivary duct carcinomas to evaluate the utility of an immunohistochemical panel consisting of androgen receptor, her2neu, p63, and cytokeratin 56 in distinguishing these. Histologic grade is a significant predictor of outcome in salivary gland carcinomas.
Histopathological grading and clinical features of. Mucoepidermoid carcinoma mec is the most common malignancy of the major salivary glands. Mucoepidermoid carcinoma mec is the most common malignant primary salivary gland tumor and is composed of a mixture of mucous, intermediate, and epidermoid squamoid cells. Intermediatedor highgrade mucoepidermoid carcinoma should be considered when tumors predominantly consist of squamous cells, especially in major salivary glands, except with evident preexisting pleomorphic adenoma. However it can present in the minor salivary glands, especially in the soft palate. Carcinoma expleomorphic adenoma cxpa is an uncommon malignancy, accounting for roughly 11% of primary tumors of the salivary gland.
Histological and inmunohistochemical prognostic factors. Spiro rh, huvos ag, berk r, strong ew 1978 mucoepidermoid carcinoma of salivary gland origin. Nov 29, 2018 how is mucoepidermoid carcinoma of salivary gland treated. They removed around 12 the tounge and replaced with tounge flap from thigh muscle. The purpose of this study was to evaluate the clinical outcomes of mec of minor salivary glands in a group of 16 patients, who were treated in our clinic, and to discuss the management of this carcinoma. Mucoepidermoid carcinoma of the salivary gland sciencedirect.
Maml2 rearrangements are detectable in 80% to 85% of mec, but not in morphologic. Complementary studies to compare carbohydrates of the normal salivary glands must be carried out because subtle alterations in tumor cells glycosylation can influence. Mucoepidermoid carcinoma of the major salivary glands. Mec mainly occurs in the parotid gland, along with minor glands being the second common site, particularly in palate. Outcomes of postoperative concurrent chemoradiotherapy for. They are unencapsulated or poorly encapsulated and infiltrate surrounding tissue freely. Mar 27, 2020 based on this report and others crean et al. Tumors of the salivary glands represent % of head and neck neoplasms. Mucoepidermoid carcinoma mec is the most common salivary gland malignancy and its grading is greatly consequential in the management and prognosis of patients with the disease. Prior reports noted histological grade and tumor stage as consistently important prognostic factors. Note the predominance of malignantappearing squamous cells. Proliferating cell nuclear antigen expression in mucoepidermoid carcinoma of salivary glands.
Upper lip salivary carcinoma salivary gland pathology. They develop less often in the submandibular glands or in. Lowgrade mec tends to have an excellent prognosis, although recurrence of the disease is possible. Mucoepidermoid carcinomas are seen throughout all adult age groups, but are most common in middle age 3565 years of age 5. The parotid glands, the largest salivary glands, are just in front of the ears. Classic features of squamous cell carcinoma may have perineural invasion, clear cell change often component or coexisting with other tumors. There are 3 sets of major salivary glands on each side of the face. These tumors can however be found anywhere there are salivary glands. Cancer in the salivary gland is called salivary gland cancer. In the 22 years between march 1979 and february 2001, we treated 16 patients 10 men and 6 women aged 1080 years mean.
Major salivary glands were involved in 46 cases 44 parotid, two submandibular, and intraoral minor glands in 23. Here, we report 3 cases of primary lec arising in the major salivary glands, which showed unusual imaging features unlike other malignant tumors. Normal salivary glands are made up of many different kinds of cells, and tumors can start in any of these cell types. Diagnostic pitfalls of aspiration cytology of salivary. Mucoepidermoid carcinoma high grade salivary glands. Its peak incidence is between ages 40 and 60, and symptoms include severe pain and, often, facial nerve paralysis. Recently, important genetic advances, including chromosomal translocations t. In such an instance, in2 type cells described by kawahara et al. Mucoepidermoid carcinoma an overview sciencedirect topics. Since then, they have become well recognized as a common salivary gland neoplasm, accounting for approximately 35% of all.
Patients with locally advanced or highgrade carcinomas of the major salivary glands have a poor prognosis. Mucoepidermoid carcinoma mec is the most common malignant tumor of salivary glands with a widely diverse biologic behavior that is correlated with the histological grade of the tumor. Mucoepidermoid carcinoma of the soft palate salivary gland. The treatment may also depend upon the stage, overall health, age, and grade of the tumor. Mucoepidermoid carcinoma mec is one of the most common malignant neoplasms of the salivary glands in both pediatric and adult populations. Due to the rarity of these malignancies, various histologies, and wide ranging clinical behavior it has been difficult to standardize systemic therapy. Mucoepidermoid carcinoma of palatal minor salivary glands. Our first case is a 44yearold man with lec in the right parotid gland, the second case is a 71yearold woman with lec in the right submandibular gland, and the third case is a 35yearold woman. These tumors grow slowly and present as painless masses in most cases. Mucoepidermoid carcinoma the oral cancer foundation. Role in disease edit see mumps parotiditis epidemica, sjogren syndrome and mucocele.
Siegmar reinert, in maxillofacial surgery third edition, 2017. Role of radiotherapy for mucoepidermoid carcinoma of salivary gland. It has been estimated that approximately 80% of patients survive their disease without evidence of tumor at periods from between several months to 25 years after removal wenig and gnepp 1991. Neville, 2002 mucoepidermoid carcinoma appears as asymptomatic swellings in minor salivary glands, being the second most common site of occurrence after the parotid gland, most commonly located on palate, followed by retromolar area, floor of mouth, buccal mucosa, lips, and tongue. It is one of the most aggressive types of salivary gland carcinoma, with a marked tendency towards distant metastasis and. How is mucoepidermoid carcinoma of salivary gland treated. They contain three cellular elements in varying proportions. A combination of surgery, chemotherapy, and radiation therapy are used to treat mucoepidermoid carcinoma of salivary gland. It is a slowly growing malignant transformation of a much more common benign cylindroma. Mucoepidermoid carcinoma genetic and rare diseases.
Sixtynine cases of mucoepidermoid carcinoma with a minimum of five years followup are presented. I have had surgery and will be starting radiation therapy in february after i heal from the surgery. Mc is defined as a malignant epithelial neoplasm of the salivary glands 3 that represents 3040 % of all malignant neoplasms of the salivary glands 4. Salivary gland cancers malignant salivary gland tumors there are many types of salivary gland cancers. We report the case of a 72yearold malay female after presentation with sore throat, fever and odynophagia, was diagnosed with mucoepidermoid. Mucoepidermoid carcinoma mec is the most common epithelial. Highgrade mucoepidermoid carcinoma expleomorphic adenoma of. Sep 28, 2017 the 2 main types of salivary glands are the major salivary glands and minor salivary glands. Salivary duct carcinoma is a highly aggressive salivary gland malignancy that may be misdiagnosed as highgrade mucoepidermoid carcinoma. Despite of its relatively low incidence, the clinical behavior of mec differs tremendously, from slow growing indolent tumor with a generally good prognosis to aggressive tumor accompanied with distant metastasis and causing high mortality. To compare histologic grading systems in mec of minor salivary glands.
However, the sheer variety of tumor type and the rarity of these tumors pose challenges to devising highly predictive grading schemes. Mucoepidermoid carcinoma the salivary glands are those glands whose primary function is to produce saliva. The original report of mucoepidermoid tumors in 1945. Mucoepidermoid carcinoma mec, one of the most common salivary gland malignancies, is rare in children. Prognostic nomograms for predicting overall survival and.
Occasional focal sebaceous cells, goblet type cells, oncocytic change, inflammatory reaction to extravasated mucin or keratin. Clinical, histological, and radiological findings of palatal mec in a 12yearold girl are presented with threeyear followup. June 2017 includes ptnm requirements from the 8th edition, ajcc staging manual. The pathologic diagnoses consisted of 5 salivary duct carcinomas, 6 highgrade mucoepidermoid carcinomas, 10 solidtype adenoid cystic carcinomas, 3 squamous cell carcinomas, 3 ade. Mucoepidermoid carcinoma mucoepidermoid carcinomas are the most common type of salivary gland cancer. However, mucoepidermoid carcinoma is not inherited from a parent or passed down through a family. Histology is similar to invasive ductal carcinoma of the breast specifically luminal androgen receptor ar positive subtype in situ areas frequently have comedo necrosis. Overall distribution across various glands is as follows 5.
Mucoepidermoid carcinoma of intraoral salivary glands evaluation and application of grading criteria in 143 cases paul l. A study of mect1maml2 in mucoepidermoid carcinoma and warthins tumor of salivary glands. About 7 out of 10 salivary gland tumors start here. Mucoepidermoid carcinoma, or cancer of the salivary gland, is a genetic disease in the sense that it occurs due to changes mutations in genes that regulate how cells in the body divide. Although most salivary gland carcinomas, which comprise less than 5% of all head and neck cancers, have a favorable prognosis, there is a sharp increase in the risk of recurrence and metastasis for patients with high t stage and lymph node involvement. Jul 15, 2015 lowgrade mec tends to have an excellent prognosis, although recurrence of the disease is possible. An immunohistochemical panel for reliable differentiation. I was just diagnosed with mucoepidermoid of the minor salivary glands earlier this month.
Intraoral mucoepidermoid carcinoma of salivary glands. Primary pulmonary mucoepidermoid carcinoma pmec is a rare neoplasm that accounts for of all lung carcinomas. Mucoepidermoid carcinoma maml2 mucoepidermoid carcinoma mec is the mostcommon malignant salivary gland tumor and is associated with one of the more clinically useful translocations, involving the maml2 gene. Salivary duct carcinoma is an uncommon but distinctive type of salivary gland tumor that mimics the histologic patterns of intraductal and infiltrating ductal carcinoma of the breast. The differential diagnosis includes metastatic squamous cell carcinoma. As our knowledge base has evolved, it is clear that carcinoma ex pleomorphic adenoma is not automatically a high grade tumor as is traditionally suggested. Approximately 80% of metastases to the major salivary glands may be from primary tumors elsewhere in the head and neck. Mucoepidermoid carcinoma mec of the salivary gland is believed to arise from pluripotent reserve cells of the excretory ducts that are capable of differentiating into squamous, columnar, and mucous cells. The presence of benign cystic lesions in the salivary glands is rare. Several other types of cancer can develop in the salivary glands. It is presumed to originate from the minor salivary glands lining the tracheobronchial tree and is the main salivary glandtype carcinoma of the lung. It is also the most common central salivary gland tumor of the jaws. Had me swollowing and eating soft foods as she hooked me up to electrobs along the neck to help with any swelling and break. Salivary gland malignancies account for of all head and neck cancers, of which 70% are parotid gland malignancies.
Role of ffdg petct in management of highgrade salivary. Two qualitative modified healy and memorial sloankettering cancer center mskcc methods and two. Mucoepidermoid carcinoma is the most common malig nant lesion of the major and minor salivary glands. Systemic therapy for recurrent or metastatic salivary. Salivary gland tumors tehran university of medical sciences. Minor salivary gland mucoepidermoid carcinoma in children and adolescents.
Mucoepidermoid carcinoma mec is the most common histologic subtype, comprising 50% of all parotid malignancies 2. Mucoepidermoid carcinoma in a minor salivary gland in a child. The sympathetic nervous system affects salivary gland secretions indirectly by innervating the blood vessels that supply the glands. For accreditation purposes, this protocol should be used for the following procedures and tumor types.
Mucoepidermoid carcinoma mec is the most common histologic subtype, comprising 50% of all parotid malignancies. Mucoepidermoid carcinoma is the most common malignant salivary gland neoplasm in both adults and children. Mucoepidermoid carcinoma of the salivary glands i write from. Adenoid cystic carcinoma is the most common malignant tumor of minor salivary glands and of the trachea.
It can mimic most other tumors of the glands, and therefore is often considered in the differential. Most primary malignant salivary gland carcinomas have been reported as the malignant component in cxpa. Mucoepidermoid carcinoma is a rare primary thyroid tumor with indolent biologic potential. Mucoepidermoid carcinoma of salivary glands radiology. Mucoepidermoid carcinoma mec is the most common malignant salivary gland neoplasm, representing over 30% of all malignant salivary gland tumors. Mucoepidermoid carcinoma mec of the salivary gland is a rare entity. Mucoepidermoid of the salivary gland cancer survivors. My doctors have told me that mine is stage 1, but it was in there a long time, which makes me worry. The human salivary glands are a group of compound exocrine glands that produce saliva, an important uid required for lubrication, immunity, mastication, deglutition, taste, speech, etc.
Most common salivary gland tumor in infants and children. Salivary duct calculus may cause blockage of the ducts, causing pain and swelling of the gland. In the salivary glands, the most frequently occurring benign tumor is pleomorphic adenoma, and the most frequent malignant tumor is mucoepidermoid carcinoma mc. Mucoepidermoid carcinoma is the most common type of malignancies originating from major salivary gland. It affects chiefly the parotid, but also other major and minor salivary glands. Presents as painless, slowgrowing mass that is firm or hard.
I did go to a speachswallowing specialist and really help. Pdf a study of mect1maml2 in mucoepidermoid carcinoma. We are presenting a rare case of a 55yearold male who presented with a soft swelling on the left side of the face. Mucoepidermoid carcinoma of the salivary glands springerlink. Prognostic factors in mucoepidermoid carcinoma of the. Ellis, dds,t the histopathologic criteria most useful for grading of mucoepidermoid carcinomas are. Two types of tumors have been described under this category. Salivary gland tumors msd manual professional edition. Salivary gland carcinomas are notoriously resistant to therapy and no standard of care exists. Mucoepidermoid carcinoma of minor salivary gland in buccal. Mucoepidermoid carcinoma is a malignant epithelial tumour of glandular tissue, usually of the major salivary glands. Mucoepidermoid carcinomas represent a distinct type of tumor. Salivary gland cancers are named according to which of these cell types they most look like when seen under a microscope. Side effects of radiation mucoepidermoid carinoma of.
Mucoepidermoid carcinoma in a minor salivary gland in childhood volume 101 issue 12 hans gustafsson, ake dahlqvist, matti anniko, bengt carlsoo skip to main content we use cookies to distinguish you from other users and to provide you with a better experience on our websites. Salivary gland malignancies account for neck cancers, of which 70% are parotid gland malignancies 1. Mucoepidermoid tumors of major and minor salivary glands. Mucoepidermoid carcinoma of intraoral salivary glands. Mucoepidermoid carcinomas most frequently arise in the parotid gland, and presents as a painless swelling, with or without facial nerve involvement. Protocol for the examination of specimens from patients with carcinomas of the major salivary glands. Prognostic factors in mucoepidermoid carcinoma of the salivary glands.
The clinicopathologic features and results of log rank tests for clinical variables are shown in tables 1 and 2respectively. Mucicarmine staining is one stain used by pathologist for detection. Pdf mucoepidermoid carcinoma of minor salivary glands. Mucoepidermoid carcinoma is a tumor that usually occurs in the salivary glands. Mucoepidermoid carcinoma can also be found in other organs, such as bronchi, lacrimal sac, and thyroid gland. The majority of mec in minor salivary glands are histologically classified as low grade of malignancy and an association with the cerbb2 immunopositivity could be not demonstrated. As far as radiation thought i got though it pretty good. Learn vocabulary, terms, and more with flashcards, games, and other study tools.
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