J Rhinol.  2019 Nov;26(2):113-116. 10.18787/jr.2019.26.2.113.

Epithelial-Myoepithelial Carcinoma of the Inferior Turbinate: A Case Report

• Lee E
• Lee S
• Jung MJ
• Choi JH

• KMID: 2465543
• DOI: http://doi.org/10.18787/jr.2019.26.2.113

Abstract

Epithelial-myoepithelial carcinoma (EMC) is a rare and low-grade malignant salivary gland tumor including epithelial and myoepithelial components. EMC frequently arises in the parotid gland but infrequently originates from the salivary glands of the nasal cavity. Here, we report the case of an EMC arising from the inferior turbinate, one of the most uncommon sites. A 60-year-old female patient presented with left nasal obstruction for several months, and PNS CT showed an about 4×1.4-cm-sized heterogeneously enhancing polypoid mass originating from the inferior turbinate of the left nasal cavity. After surgical treatment, the patient was diagnosed with EMC based on pathologic examinations including histopathological and immunohistochemical tests. We report a case of a patient with EMC in the inferior turbinate who was observed over 18 months without radiation therapy after successful wide excision.

Keyword

Epithelial-myoepithelial carcinoma; Inferior turbinate; Pathology

MeSH Terms

Female
Humans
Middle Aged
Nasal Cavity
Nasal Obstruction
Parotid Gland
Pathology
Salivary Glands
Turbinates*

Figure

• 

  Fig. 1. Preoperative endoscopic and CT findings. (A) Preoperative endoscopic finding presents bloody red-colored, necrotic mass originating from inferior turbinate of left nasal cavity. (B) Axial and (C) coronal paranasal sinus CT images present about 4×1.4 cm sized heterogeneously enhancing polypoid mass originated from left inferior turbinate.

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  Fig. 2. Microscopic findings. (A) The polypoid tumor shows predominantly biphasic tubular histology, which are characteristic features of epithelial-myoepithelial carcinoma (H&E, ×40). (B) The inner luminal layer is formed by more hyperchromatic ductal cells and the outer layer is formed by myoepithelial cells with indistinct borders. Mitotic features are frequently identified (B, H&E, ×100). (C, D) Cyto-keratin and p63 immunostains highlight luminal-ductal cells and myoepithelial cells, respectively. This biphasic appearance of immu-nohistochemical stain supports the diagnosis of epithelial-myoepithelial carcinoma ([ C], Cytokeratin immunostain, ×40; [ D], p63 im-munostain, ×40).

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  Fig. 3. Postoperative PET-CT and endoscopic findings. (A) Focal hypermetabolism of the left nasal cavity in PET-CT findings after 1st op-eration. (B) 2nd operation was performed due to the possibility of residual tumor. (C) There was no any local recurrence in the follow-up for 18 months.

Reference

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