J Korean Assoc Oral Maxillofac Surg.  2011 Dec;37(6):505-509. 10.5125/jkaoms.2011.37.6.505.

Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report

• Jin SM
• Ryu HH
• Ryu SH
• Shin DY
• Hwang HS
• Kim CH
• Kim BJ

• KMID: 2136988
• DOI: http://doi.org/10.5125/jkaoms.2011.37.6.505

Abstract

Epithelial-myoepithelial carcinoma (EMC) is a low-grade malignant salivary gland neoplasm that was first described in 1972. EMC occurs in the older age group, there is a female predilection and mainly involves the parotid gland. Most authors recommend superficial parotidectomy as a treatment for low-grade malignant tumor in the superficial lobe of parotid gland. The treatment of epithelial-myoepithelial tumors typically includes surgical excision aimed at achieving a R0 resection. This paper reports a case of EMC of the parotid gland treated only by a conservational surgical excision. The lesion was exposed by the retromandibular approach and detached. After the parotid gland envelop was exposed, the mass was observed and was easy to remove due to capsulation. The preoperative diagnosis was a pleomorphic adenoma on the left parotid gland. The tumor was removed surgically with a conservative extracapsular dissection. The postoperative diagnosis was EMC, so superficial parotidectomy or radiation therapy was considered. Nevertheless, the patient was observed and no additional treatment was attempted because the patient was old and a successfully excision of the tumor had been achieved.

Keyword

Epithelial-myoepithelial carcinoma; Parotid gland

MeSH Terms

Adenoma, Pleomorphic
Female
Humans
Parotid Gland
Salivary Gland Neoplasms

Figure

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  Fig. 1. Facial view illustrating the 3–4 cm swelling on patient's left cheek. Sun-Mi Jin et al: Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 2. Computed tomography (CT) scan. A. Transverse view of CT scan. B. Coronal view of CT scan. Sun-Mi Jin et al: Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 3. Macroscopic view (external) shows well-circumscribed, thinly encapsulated mass with soft consistency. Sun-Mi Jin et al: Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 4. Macroscopic view (cross section) shows a relatively well defined grayish white soft tissue mass with focal cystic change on sectioning. The tumor is confined to the gland. Sun-Mi Jin et al: Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 5. Microscopic view (H&E staining, ×100). The parotid gland mass is composed of double layered tubules and solid area of clear cells (short arrows). The tubules are lined by inner cuboidal cells with eosinophilic cytoplasm and outer layer of clear, myoepithelial type cells (long arrow). Sun-Mi Jin et al: Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 6. Microscopic view (H&E staining, ×40). The tumor also shows cystic area with papillary fronds (arrows). Sun-Mi Jin et al: Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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  Fig. 7. The immunohistochemical stain confirms the outer layer of tubules are lined by p63 positive myoepithelial cells (arrows) (anti-p63 immunohistochemistry, ×100). Sun-Mi Jin et al: Epithelial-myoepithelial carcinoma on the superficial lobe of the parotid gland: a case report. J Korean Assoc Oral Maxillofac Surg 2011

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