Epithelial-myoepithelial carcinoma

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Epithelial-myoepithelial carcinoma
Epithelial-myoepithelial carcinoma - very high mag.jpg
Micrograph of an epithelial-myoepithelial carcinoma (right of image). The epithelial component has a tubular morphology and is evident only focally (upper left of image). Benign serous glands (parotid salivary gland) are also seen (left of image). H&E stain.
Specialty ENT surgery

Epithelial-myoepithelial carcinoma (EMCa) is a rare malignant tumour that typically arises in a salivary gland and consists of both an epithelial and myoepithelial component. They are predominantly found in the parotid gland [1] and represent approximately 1% of salivary gland tumours. [2]

Salivary gland exocrine gland that produces saliva

The salivary glands in mammals are exocrine glands that produce saliva through a system of ducts. Humans have three paired major salivary glands as well as hundreds of minor salivary glands. Salivary glands can be classified as serous, mucous or seromucous (mixed).

Epithelium Type of animal tissue and human

Epithelium is one of the four basic types of animal tissue, along with connective tissue, muscle tissue and nervous tissue. Epithelial tissues line the outer surfaces of organs and blood vessels throughout the body, as well as the inner surfaces of cavities in many internal organs. An example is the epidermis, the outermost layer of the skin.

Parotid gland

The parotid gland is a major salivary gland in many animals. In humans, the two parotid glands are present on either side of the mouth and in front of both ears. They are the largest of the salivary glands. Each parotid is wrapped around the mandibular ramus, and secretes serous saliva through the parotid duct into the mouth, to facilitate mastication and swallowing and to begin the digestion of starches. There are also two other types of salivary glands; they are submandibular and sublingual glands. Sometimes accessory parotid glands are found close to the main parotid glands.

Contents

Cause

Diagnosis

EMCas are diagnosed by examination of tissue, e.g. a biopsy.

Biopsy medical test involving sampling of cells or tissues for examination

A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist involving extraction of sample cells or tissues for examination to determine the presence or extent of a disease. The tissue is generally examined under a microscope by a pathologist, and can also be analyzed chemically. When an entire lump or suspicious area is removed, the procedure is called an excisional biopsy. An incisional biopsy or core biopsy samples a portion of the abnormal tissue without attempting to remove the entire lesion or tumor. When a sample of tissue or fluid is removed with a needle in such a way that cells are removed without preserving the histological architecture of the tissue cells, the procedure is called a needle aspiration biopsy. Biopsies are most commonly performed for insight into possible cancerous and inflammatory conditions.

This tumour is characterised by biphasic tubular structures composed of inner ductal and outer clear myoepithelial cells.

Its appearance is very similar to adenomyoepithelioma of the breast, which may be the same tumour at a different anatomical site. [3]

Adenomyoepithelioma of the breast

An adenomyoepithelioma of the breast is a rare tumour in the breast composed of glandular elements (adeno-) and myoepithelial cells. It is usually benign; however, there are reports of malignant behaviour.

The histologic differential diagnosis includes adenoid cystic carcinoma and pleomorphic adenoma.

In medicine, a differential diagnosis is the distinguishing of a particular disease or condition from others that present similar clinical features. Differential diagnostic procedures are used by physicians to diagnose the specific disease in a patient, or, at least, to eliminate any imminently life-threatening conditions. Often, each individual option of a possible disease is called a differential diagnosis.

Adenoid cystic carcinoma type of cancer

Adenoid cystic carcinoma is a rare type of cancer that can exist in many different body sites. This tumor most often occurs in the salivary glands, but it can also be found in many anatomic sites, including the breast, lacrimal gland, lung, brain, bartholin gland, trachea, and the paranasal sinuses.

Pleomorphic adenoma gastrointestinal benign neoplasm that is a located in the salivary glands

Pleomorphic adenoma is a common benign salivary gland neoplasm characterised by neoplastic proliferation of parenchymatous glandular cells along with myoepithelial components, having a malignant potentiality. It is the most common type of salivary gland tumor and the most common tumor of the parotid gland. It derives its name from the architectural Pleomorphism seen by light microscopy. It is also known as "Mixed tumor, salivary gland type", which refers to its dual origin from epithelial and myoepithelial elements as opposed to its pleomorphic appearance.

Prognosis

They generally have a good prognosis. [1] In one larger study, the 5-year and 10-year survival were over 90% and 80% respectively. [4]

See also

Epithelial-myoepithelial carcinoma of the lung is a very rare histologic form of malignant epithelial neoplasm ("carcinoma") arising from lung tissue.

Related Research Articles

Adenocarcinoma carcinoma that has material basis in abnormally proliferating cells, derives from epithelial cells, which originate in glandular tissue

Adenocarcinoma is a type of cancerous tumor that can occur in several parts of the body. It is defined as neoplasia of epithelial tissue that has glandular origin, glandular characteristics, or both. Adenocarcinomas are part of the larger grouping of carcinomas, but are also sometimes called by more precise terms omitting the word, where these exist. Thus invasive ductal carcinoma, the most common form of breast cancer, is adenocarcinoma but does not use the term in its name—however, esophageal adenocarcinoma does to distinguish it from the other common type of esophageal cancer, esophageal squamous cell carcinoma. Several of the most common forms of cancer are adenocarcinomas, and the various sorts of adenocarcinoma vary greatly in all their aspects, so that few useful generalizations can be made about them.

Brenner tumour usually benign tumor composed of solid and cystic nests of epithelial cells resembling transitional epithelium; it is surrounded by an abundant stromal component that is dense and fibroblastic in nature

Brenner tumors are an uncommon subtype of the surface epithelial-stromal tumor group of ovarian neoplasms. The majority are benign, but some can be malignant.

Oncocytoma Human disease

An oncocytoma is a tumor made up of oncocytes, epithelial cells characterized by an excessive amount of mitochondria, resulting in an abundant acidophilic, granular cytoplasm. The cells and the tumor that they compose are often benign but sometimes may be premalignant or malignant.

Canalicular adenoma Benign salivary gland tumor

Canalicular adenoma is a benign, epithelial salivary gland neoplasm arranged in interconnecting cords of columnar cells. This is a very rare benign neoplasm, that makes up about 1% of all salivary gland tumors, or about 4% of all benign salivary gland tumors.

Myoepithelial cells are cells usually found in glandular epithelium as a thin layer above the basement membrane but generally beneath the luminal cells. These may be positive for alpha smooth muscle actin and can contract and expel the secretions of exocrine glands. They are found in the sweat glands, mammary glands, lacrimal glands, and salivary glands. Myoepithelial cells in these cases constitute the basal cell layer of an epithelium that harbors the epithelial progenitor. In the case of wound healing, myoepithelial cells reactively proliferate. Presence of myoepithelial cells in a hyperplastic tissue proves the benignity of the gland and, when absent, indicates cancer. Only rare cancers like adenoid cystic carcinomas contains myoepithelial cells as one of the malignant component.

Acinic cell carcinoma carcinoma that has material basis in abnormally proliferating cells, derives from spindle cells and/or derives from giant cells

Acinic cell carcinoma is a malignant tumor representing 2% of all salivary tumors. 90% of the time found in the parotid gland, 10% intraorally on buccal mucosa or palate. The disease presents as a slow growing mass, associated with pain or tenderness in 50% of the cases. Often appears pseudoencapsulated.

Salivary gland tumour human disease

Salivary gland tumours or neoplasms are tumours that form in the tissues of salivary glands. The salivary glands are classified as major or minor. The major salivary glands consist of the parotid, submandibular, and sublingual glands. The minor salivary glands consist of 800-1000 small mucus-secreting glands located throughout the lining of the oral cavity.

Salivary gland–like carcinomas of the lung generally refers a class of rare cancers that arise from the uncontrolled cell division (mitosis) of mutated cancer stem cells in lung tissue. They take their name partly from the appearance of their abnormal cells, whose structure and features closely resemble those of cancers that form in the major salivary glands of the head and neck. Carcinoma is a term for malignant neoplasms derived from cells of epithelial lineage, and/or that exhibit cytological or tissue architectural features characteristically found in epithelial cells.

Sebaceous lymphadenoma

Sebaceous lymphadenoma is a benign tumour of the salivary gland.

Collagenous spherulosis

Collagenous spherulosis, or simple spherulosis, is a benign finding in breast pathology. It is almost always an incidental finding, though it is occasionally associated with calcifications, which may lead to a biopsy.

Myoepithelioma of the head and neck neoplasm composed of outgrowths of myoepithelial cells from a sweat gland

Myoepithelioma of the head and neck, also myoepithelioma, is a salivary gland tumour of the head and neck that is usually benign.

Hyalinizing clear cell carcinoma

Hyalinizing clear cell carcinoma (HCCC) is a rare malignant salivary gland tumour, with a good prognosis, that is usually found on the tongue or palate.

A sialoblastoma is a low-grade salivary gland neoplasm that recapitulates primitive salivary gland anlage. It has previously been referred to as congenital basal cell adenoma, embryoma, or basaloid adenocarcinoma. It is an extremely rare tumor, with less than 100 cases reported worldwide.

Carcinoma ex pleomorphic adenoma

Carcinoma ex pleomorphic adenoma is a type of cancer typically found in the parotid gland. It arises from the benign tumour pleomorphic adenoma.

Transitional cell carcinoma of the ovary

Transitional cell carcinoma of the ovary is a rare type of ovarian cancer that has an appearance similar to urothelial carcinoma.

Sclerosing polycystic adenosis

Sclerosing polycystic adenosis is a rare salivary gland tumor first described in 1996 by Dr. Brion Smith. The major salivary glands, specifically the parotid gland and the submandibular gland, are affected most commonly. Patients usually come to clinical attention with a mass or swelling in their salivary glands in the 5th decade of life, with females affected much more commonly than males. Nearly all of the cases reported so far have a benign behavior, although there is a single case that has had an associated malignant transformation.

References

  1. 1 2 Kasper, HU.; Mellin, W.; Kriegsmann, J.; Cheremet, E.; Lippert, H.; Roessner, A. (1999). "Epithelial-myoepithelial carcinoma of the salivary gland--a low grade malignant neoplasm? Report of two cases and review of the literature". Pathol Res Pract. 195 (3): 189–92. doi:10.1016/S0344-0338(99)80033-8. PMID   10220800.
  2. Tralongo, V.; Daniele, E. (1998). "Epithelial-myoepithelial carcinoma of the salivary glands: a review of literature". Anticancer Res. 18 (1B): 603–8. PMID   9568184.
  3. Seifert, G. (Sep 1998). "Are adenomyoepithelioma of the breast and epithelial-myoepithelial carcinoma of the salivary glands identical tumours?". Virchows Arch. 433 (3): 285–8. doi:10.1007/s004280050249. PMID   9769134.
  4. Seethala, RR.; Barnes, EL.; Hunt, JL. (Jan 2007). "Epithelial-myoepithelial carcinoma: a review of the clinicopathologic spectrum and immunophenotypic characteristics in 61 tumors of the salivary glands and upper aerodigestive tract". Am J Surg Pathol. 31 (1): 44–57. doi:10.1097/01.pas.0000213314.74423.d8. PMID   17197918.