Oncocytic variant of central mucoepidermoid carcinoma
a rare case report
DOI:
https://doi.org/10.5935/2525-5711.20210007Keywords:
Carcinoma, Mucoepidermoid Mandibular Neoplasms, Pathology, OralAbstract
Mucoepidermoid carcinoma constitutes a heterogeneous lesion and may present histological variations that make the diagnosis challenging. This study aims to report a rare diagnosis of central oncocytic mucoepidermoid carcinoma (OMEC). A 45-year-old female patient, presenting a 10-year-old history of increase of volume in the left posterior mandible, with dental displacement and no clinical sign of mucosal involvement. A well- limited hypodense area was observed radiographically, with cortical bone thinning and a discrete area of solution of continuity. Histopathological analysis of incisional biopsy revealed a malignant neoplasia with glandular differentiation, presenting multiple cystic and ductiform spaces and a prominent component of large oncocytic cells, such as cells with squamous, basaloid, and mucous aspects. Histochemical and Immunohistochemical findings contributed to the diagnosis of OMEC. Tumor resection and mandibular reconstruction with microsurgical fibular graft were considered. However, the patient refused the treatment. This is the first report of OMEC with intraosseous occurrence.
References
Masson P, Berger L. Epithéliomas à double métaplasie de la parotide. Bull Ass Fr Étud Cancer. 1924;13:366-73.
Stewart FW, Foote FW, Becker WF. Mucoepidermoid tumors of salivary glands. Ann Surg. 1945 Nov;122(5):820-44. DOI: https://doi.org/10.1097/00000658-194511000-00005.
Eversole LR. Mucoepidermoid carcinoma: review of 815 reported cases. J Oral Surg. 1970 Jul;28(7):490-4.
Barnes L, Eveson JW, Reichart P, Sidransky D. WHO classification of tumour: pathology and genetics of head and neck tumours. IARC. 2005 Jan;65(1):214-5. DOI: https://doi.org/10.1016/j.urology.2004.09.048
Simon D, Somanathan T, Ramdas K, Pandey M. Central mucoepidermoid carcinoma of mandible - a case report and review of the literature. World J Surg Oncol. 2003 Feb;1:1. DOI: https://doi.org/10.1186/1477-7819-1-1
Goode R, Auclair P, Ellis G. Mucoepidermoid carcinoma of the major salivary glands: clinical and histopathologic analysis of 234 cases with evaluation of grading criteria. Cancer. 1998 Apr;82(7):1217-24.
Batsakis JG, Luna MA. Histopathologic grading of salivary gland neoplasms: I mucoepidermoid carcinomas. Ann Otol Rhinol Laryngol. 1990 Oct;99(10 Pt 1):835-8.
Brandwein M, Ferlito A, Bradley P, Hille J, Rinaldo A. Diagnosis and classification of salivary neoplasms: pathologic challenges and relevance to clinical outcomes. Acta Otolaryngol. 2002;122(7):758-64.
Ellis GL. What's new in the AFIP fascicle on salivary gland tumors: a few highlights from the 4th series atlas. Head Neck Pathol. 2009 Jul;3(3):225-30. DOI: https://doi.org/10.1007/s12105-009-0128-z
Seethala RR. An update on grading of salivary gland carcinomas. Head Neck Pathol. 2009 Feb;3(1):69-77. DOI: https://doi.org/10.1007/s12105-009-0102-9
Seethala RR, Stenman G. Update from the 4th Edition of the World Health Organization classification of head and neck tumours: tumors of the salivary gland. Head Neck Pathol. 2017 Feb;11(1):55-67. DOI: https://doi.org/10.1007/s12105-017-0795-0
Coca-Pelaz A, Rodrigo JP, Triantafyllou A, Hunt JL, Rinaldo A, Strojan P, et al. Salivary mucoepidermoid carcinoma revisited. Eur Arch Otorhinolaryngol. 2015;272(4):799-819. DOI: https://doi.org/10.1007/s00405-014-3053-z
Silva LP, Serpa MS, Silva LAB, Sobral APV. Central mucoepidermoid carcinoma radiographically mimicking an odontogenic tumor: A case report and literature review. J Oral Maxillofac Pathol. 2016 Apr;20(3):518-22. DOI: https://doi.org/10.4103/0973-029X.190957
Von Fallen A. Em beitrag zur histologie des mukoepidermoidkarzinoms*. Laryngo-Rhino-Otol. 1994;73:482-7.
Khan HA, Loya A, Azhar R, Din NU, Bell D. Central mucoepidermoid carcinoma, a case report with molecular analysis of the TORC1/MAML2 gene fusion. Head Neck Pathol. 2010 Jul;4(3):261-4. DOI: https://doi.org/10.1007/s12105-010-0191-5
Moghadam SA, Moghadam FA. Intraosseous mucoepidermoid carcinoma: report of two cases. J Dent (Shiraz). 2014 Jun;15(2):86-90.
Sepúlveda I, Frelinghuysen M, Platin E, Spencer ML, Compan A, Munzenmayer J, et al. Mandibular central mucoepidermoid carcinoma: a case report and review of the literature. Case Rep Oncol. 2014 Oct;7(3):732-8. DOI: https://doi.org/10.1159/000368825
Spoorthi BR, Rao RS, Rajashekaraiah PB, Patil S, Venktesaiah SS, Purushothama P. Predominantly cystic central mucoepidermoid carcinoma developing from a previously diagnosed dentigerous cyst: case report and review of the literature. Clin Pract. 2013;3(2):48-50. DOI: https://doi.org/10.4081/cp.2013.e19
Skálová A, Stenman G, Simpson RHW, Hellquist H, Slouka D, Svodoba T, et al. The role of molecular testing in the differential diagnosis of salivary gland carcinomas. Am J Surg Pathol. 2017 Feb;42(2):11-7. DOI: https://doi.org/10.1097/PAS.0000000000000980
Souza LL, Pontes FSC, Pontes HAR, Conte Neto N, Carvalho WRS, Guimarães DM. Central mucoepidermoid carcinoma: an up-to-date analysis of 147 cases and review of prognostic factors. J Cranio-Maxillofacial Surg. 2018 Jan;46(1):162-7. DOI: https://doi.org/10.1016/j.jcms.2017.10.020
Nagasaki A, Ogawa I, Sato Y, Takeuchi K, Kitagawa M, Ando T, et al. Central mucoepidermoid carcinoma arising from glandular odontogenic cyst confirmed by analysis of MAML2 rearrangement: a case report. Pathol Int. 2018;68(1):31-5. DOI: https://doi.org/10.1111/pin.12609
Pires FR, Chen SY, Cruz Perez DE, Almeida OP, Kowalski LP. Cytokeratin expression in central mucoepidermoid carcinoma and glandular odontogenic cyst. Oral Oncol. 2004 May;40(5):545-51. DOI: https://doi.org/10.1016/j.oraloncology.2003.11.007
Meer S, Altini M. CK7+/CK20- immunoexpression profile is typical of salivary gland neoplasia. Histopathology. 2007 Jun;51(1):26-32. DOI: https://doi.org/10.1111/j.1365-2559.2007.02728.x
Luo XL, Sun MY, Lu CT, Zhou ZH. The role of Schwann cell differentiation in perineural invasion of adenoid cystic and mucoepidermoid carcinoma of the salivary glands. Int J Oral Maxillofac Surg. 2006 Aug;35(8):733-9. DOI: https://doi.org/10.1016/j.ijom.2006.01.012
Xu XY, Yang GY, Yang JH, Li J. Analysis of clinical characteristics and differential diagnosis of the lung biopsy specimens in 99 adenocarcinoma cases and 111 squamous cell carcinoma cases: UTILITY of an immunohistochemical panel containing CK5/6, CK34βE12, p63, CK7 and TTF-1. Pathol Res Pract. 2014 Oct;210(10):680-5. DOI: https://doi.org/10.1016/j.prp.2014.06.021
Yu C, Song Z, Xiao Z, Lin Q, Dong X. Mucoepidermoid carcinoma arising in Warthin's tumor of the parotid gland: Clinicopathological characteristics and immunophenotypes. Sci Rep. 2016 Jul;6:30149. DOI: https://doi.org/10.1038/srep30149
Hirokawa M, Takada N, Abe H, Suzuki A, Higuchi M, Miya A, et al. Thyroid sclerosing mucoepidermoid carcinoma with eosinophilia distinct from the salivary type. Endocr J. 2018;65(4):427-36. DOI: https://doi.org/10.1507/endocrj.EJ17-0462
Chundru NSV, Prasanth T, Nandan SRK, Rajesh A. Central mucoepidermoid carcinoma. J Cancer Res Ther. 2015 Oct;11(3):657. DOI: https://doi.org/10.4103/0973-1482.138038
Kumar R, Natarajan S, Sneha KS, Chitra NS, Boaz K, Manaktala N. Case report oncocytes in mucoepidermoid carcinoma of the palate: diagnostic challenges. Case Rep Dent. 2017;2017:1-4.
Sonika ASKJ, Arul ASSJ, Chitra S. Infiltrative oncocytoma arising from minor salivary glands of palate: a case report. Tanza Dent J. 2014;18(2):476-81.
Kwon H, Lim W, Choi Y, Nam JH, Han CW, Kim JS, et al. High-grade oncocytic mucoepidermoid carcinoma of the minor salivary gland origin: a case report with immunohistochemical study. Oral Surg Oral Med Oral Pathol. 2010;109(6):e72-e7. DOI: https://doi.org/10.1016/j.tripleo.2010.01.026
Fujimaki M, Fukumura Y, Saito T, Mitani K, Uchida S, Yokoyama J, et al. Oncocytic mucoepidermoid carcinoma of the parotid gland with CRTC1-MAML2 fusion transcript: report of a case with review of literature. Hum Pathol. 2011 Dec;42(12):2052-5. DOI: https://doi.org/10.1016/j.humpath.2011.02.021
Jing H, Meng Q, Tai Y. Oncocytic mucoepidermoid carcinoma with prominent tumour-associated lymphoid proliferation of the submandibular gland. Oral Oncol. 2012 Feb;48(2):e7-8. DOI: https://doi.org/10.1016/j.oraloncology.2011.09.009
Jain D, Nayak NC. Oncocytic mucoepidermoid carcinoma of the parotid gland: a case report and review of the literature. Ear Nose Throat J. 2015 Jul;94(7):E11-8.
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Copyright (c) 1969 Maria Elisa Quezado Lima-Verde, Fabrício de Lamare Ramos, Cleto Dantas Nogueira, Fábio Rocha Fernandes Távora, Eduardo Costa Studart Soares, Fabrício Bitu Sousa, Mário Rogério Lima Mota, Ana Paula Negreiros Nunes Alves
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