Mucoepidermoid Carcinoma of the Major Salivary Glands Clinical and Histopathologic Analysis of 234 Cases with Evaluation of Grading Criteria BACKGROUND. The authors had previously conducted an investigation of minor (original) (raw)
Related papers
Salivary mucoepidermoid carcinoma revisited
European Archives of Oto-rhino-laryngology, 2014
Mucoepidermoid carcinoma (MEC) is a malignant epithelial neoplasm composed of varying proportions of mucous, epidermoid, intermediate, columnar, and clear cells and often demonstrates prominent cystic growth. MEC is usually subclassified as low, intermediate, or high grade on the basis of its histologic features, including the presence of cystic spaces, cellular differentiation, proportion of mucous cells, growth pattern, type of invasion, and cytologic atypia. Because even low-grade neoplasms may metastasize, the term mucoepidermoid tumor is inappropriate. The 3-level grading approach to tumor classification has found general acceptance among pathologists; differences in biologic behavior can be demonstrated even though clinical stage has become a better prognosticator. However, in the case of MEC, no universal agreement exists regarding which histologic grading criteria are most the useful, and grading has varied. These issues have led to the investigation of more subjective systems. We describe these new schemes, the histologic variants of MEC, and the ancillary methods that allow for further stratification of patients with MEC, especially for patients with grade 2 tumors, which have a variable and unpredictable clinical course.
Fine needle aspiration biopsy (FNAB) is considered as one of the most useful diagnostic procedure on palpable and nonpalpable lesions guided with radiologic methods. Mucoepidermoid carcinoma (MEC), a rare but the most common primary malignant tumor of salivary glands. Low grade MEC needs to be distinguished from benign lesions of the salivary gland and may cause false negative results. High grade MEC may resemble squamaous cell carcinoma especially in cases with dense cystic component. Herein, we report a case of cytologically diagnosed and histologically confirmed MEC; in order to impress the importance and the effect of FNAB in the differential diagnosis of salivary gland lesions.
A cytohistologic correlation of mucoepidermoid carcinoma: emphasizing the rare oncocytic variant
Pathology research international, 2011
It is well-known that the morphological variability of mucoepidermoid carcinoma (MEC) of the salivary glands may lead to interpretative difficulties on fine-needle aspiration (FNA) diagnosis. In this study we identify morphologic features that may be useful in the FNA diagnosis of MEC. The cohort included 23 cases of MEC; cytology and histology slides were reviewed and assessed for % cystic component, extracellular mucin, mucous and intermediate cells, oncocytes, cells with foamy/clear cytoplasm, keratinized cells and lymphocytes. On FNA 12/23 (52%) cases were diagnosed as consistent with or suggestive of MEC; 6/23 (26%) as salivary gland neoplasm and 5/23 (22%) as no tumor seen. The cystic component was ≥50% in 18/23 (78%) and <50% in 5 cases. The features prevalent in FNA and histology were: mucous cells (96% and 91%), extracellular mucin (91% both), intermediate cells (100 and 83%), lymphocytes (96 and 78%) and cells with foamy/clear cytoplasm (74% both). Oncocytes were seen i...
A study on the morphological spectrum of salivary gland tumors
IP innovative publication pvt ltd, 2020
Introduction: Salivary gland neoplasm are relatively uncommon and are constitute about 3% of all head and neck neoplasm. Atleast 80% of tumors are located in the parotid gland and the remaining tumors are located in submandibular, sublingual and in minor salivary glands. Objective: The aim is to identify the occurrence of various salivary gland tumors and to categorize them as per WHO classification. Further to identify the histomorphological patterns of salivary gland tumors. Materials and Methods: The biopsy and excised specimens of salivary gland tumors were received in the department of pathology. A gross examination of biopsy and excised specimen was carried out. All the biopsy specimens were well fixed in 10% buffered formalin, processed, embedded with paraffin. After the paraffin blocks were sectioned and stained with Haematoxylin-Eosin, special stains like PAS, Mucicarmin were applied to the sections where ever indicated. The stained slides were examined for histomorphological patterns of salivary gland neoplasms and categorized as per WHO classification. Result and Conclusion: A total of 57 salivary gland tumors specimens were included in the present study. The study report revealed that 40 cases were belong to benign making it 70.2% and the remaining 17 were malignant making it to 29.8% of the total Salivary gland tumors. Pleomorphic Adenoma was the most commonly observed benign tumor. Out of 40 benign tumors 33 were Pleomorphic adenoma (82.5%). Mucoepidermoid carcinoma was the most commonly observed malignant tumor. Out of 17 malignant tumors 6 were Mucoepidermoid carcinomas (35.2%) of all the malignant tumors.
Mucoepidermoid Carcinoma of Salivary Gland: Limitations and Pitfalls on FNA
Journal of clinical and diagnostic research : JCDR, 2017
Mucoepidermoid Carcinoma (MEC) is the most common malignant neoplasm of salivary gland origin. However, its morphologic heterogeneity poses difficulty in interpretation. In the present series we discuss the morphologic features of MEC, limitations and pitfalls in its diagnosis on Fine Needle Aspiration Cytology (FNAC). Fourteen cases of suspected MEC were evaluated cytologically followed by histopathological examination for confirmation. A definite cytological diagnosis was rendered in nine cases; three of the remaining five were underdiagnosed as abscess, pleomorphic adenoma and mucus cyst. Of the remaining two cases, one case each of sebaceous carcinoma and sialadenitis was mislabeled as MEC on cytology. A satisfactory aspirate composed of intermediate cells, mucin secreting cells and squamous cells in a mucinous background may not be obtained in all cases of low grade MEC. High grade MEC can be classified as squamous cell carcinoma. Hence, awareness of confounding factors with cl...
International Journal of Morphology
The biological features and clinical behavior of mucoepidermoid carcinomas are widely variable and poorly understood. This study aimed to investigate prognostic factors that may affect survival in patients with a primary diagnosis of head and neck mucoepidermoid carcinomas. The effects of age, gender, anatomic localization, tumor size, clinical stage, histological grade, recurrence, metastasis, compromised surgical margins and treatment on clinicopathological outcomes were investigated. Survival curves were generated using the Kaplan-Meier method and analyses were performed using the log rank test. A total of 16 cases were analyzed over a period of 18 years; males were 68.7 %, with ages ranging from 13 to 83 years. The 75 % of the tumors developed in the major salivary glands, 56.3 % in the parotid gland and they were predominantly classified as stage II 37.5 % and lowgrade lesions 37.5 % at diagnosis. Surgical resection was performed in all patients. The follow-up period in this study ranged from 6 to 217 months. The 5 and 10-year overall survival rates were both 85.6 %. Disease-free survival rates were 81.8 % (5 years) and 68.2 % (10 years). There were statistically significant effects of tumor size (p= 0.05), metastasis (p= 0.04) and primary anatomic localization (p= 0.04) on disease-free survival rates. Through a long follow-up period in present study we could highlight the relevance of primary anatomical site, tumor size and metastasis as useful prognostic factors that may affect survival in patients with a primary diagnosis of head and neck mucoepidermoid carcinomas.
Journal of Surgical Oncology, 1991
Thirty-nine cases of mucoepidermoid carcinoma of the salivary glands were reviewed for a reappraisal of the influence of the grade of differentiation on the outcome of the disease. The age of the patients ranged between 7 and 84 years. Fifteen patients were females and 24 males. The tumors were located at the parotid gland (n=30), the submaxillary gland (n=1), the soft palate (n=5) and the oral mucosa NOS (n=3). At presentation 4 tumors were intraglandular and 35 extraglandular; three patients had lymph node metastases and one patient lung metastases. The grade of differentiation was assessed using the criteria of Healey et al. Twelve tumors were classified as grade I, 17 as grade II, and 10 as grade III. Follow-up information was obtained with a duration of 5-144 months (mean 44.7 months). Six cases recurred locally and 5 developed metastases. Five years cumulative survival was 100% for grade I, 70.1% for grade II, and 47.2% for grade III. The results point to the usefulness of the assessment of the grade of differentiation as a guide to anticipate the outcome of the disease.