Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in Korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectomy was performed under the impression of thyroid carcinoma. The resected thyroid gland showed a poorly circumscribed hard mass. Histologically, the tumor consisted of solid nests of large atypical cells with dense fibrous stroma. The tumor cells showed squamoid appearance with abundant eosinophilic cytoplasm. There were also rare mucin-containing cells within the nests. Within the hyalinized stroma, numerous eosinophils were found. The surrounding thyroid parenchyma displayed Hashimoto's thyroiditis. There was metastasis in a regional lymph node. Two years after initial surgery, she underwent a modified radical neck dissection due to recurrent neck mass. After the radiation therapy for eight weeks, laryngectomy and esophagectomy were performed due to a recurrent carcinoma in the esophageal wall. We report an additional case of SMECE, with metastasis to regional lymph nodes and esophagus. The tumor appears to be more aggressive than previously reported and a correct diagnosis can be rendered by just examining the metastatic lesions.
Carcinoma, Mucoepidermoid/surgery ; Carcinoma, Mucoepidermoid/secondary* ; Carcinoma, Mucoepidermoid/pathology* ; Carcinoma, Mucoepidermoid/complications ; Case Report ; Eosinophilia/pathology ; Eosinophilia/complications* ; Esophageal Neoplasms/surgery ; Esophageal Neoplasms/secondary* ; Female ; Human ; Laryngectomy ; Lymph Nodes ; Middle Age ; Recurrence ; Sclerosis ; Thyroid Gland/pathology* ; Thyroid Neoplasms/surgery ; Thyroid Neoplasms/pathology* ; Thyroid Neoplasms/complications ; Thyroiditis, Autoimmune/complications

Adenocarcinoma, Clear Cell ; metabolism ; pathology ; surgery ; Adult ; Carcinoma ; metabolism ; pathology ; Carcinoma, Mucoepidermoid ; metabolism ; pathology ; Carcinoma, Renal Cell ; metabolism ; pathology ; secondary ; Diagnosis, Differential ; Humans ; Keratins ; metabolism ; Male ; Nasal Cavity ; Nose Neoplasms ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism

Because the tongue is superficially located and the initial manifestation of most diseases occurring there is mucosal change, lingual lesionscan be easily accessed and diagnosed without imaging analysis. Some lingual neoplasms, however, may manifest as a submucosal bulge and be located in a deep portion of the tongue, such as its base; their true characteristics and extent may be rec-ognized only on cross-sectional images such as those obtained by CT or MRI. Some uncommon tongue neoplasms may have characteristic radiologic fea-tures, thus permitting quite specific radiologic diagnosis. Lipomas typically manifest at both CT and MR imaging as homogeneous nonenhancing lesions. Relative to subcutaneous fat they are isoattenuating on CT images, and all MR sequences show them as isointense. Due to the paramagnetic properties of melanin, metastases from melanotic melanoma usually demonstrate high signal intensity on T1-weighted MR images and low signal intensity on T2-weighted images. Although the radiologic findings for other submucosal neoplasms are nonspecific, CT and MR imaging can play an important role in the diagnostic work-up of these unusual tumors. Delineation of the extent of the tumor, and recognition and understanding of the spectrum of imaging and the pathologic features of these lesions, often help narrow the differential diagnosis.
Carcinoma, Adenoid Cystic/diagnosis ; Carcinoma, Mucoepidermoid/diagnosis ; Hemangioma/diagnosis ; Human ; Lipoma/diagnosis ; Lymphoma/diagnosis ; Magnetic Resonance Imaging ; Myoepithelioma/diagnosis ; Neurilemmoma/diagnosis ; Tomography, X-Ray Computed ; Tongue Neoplasms/*diagnosis/secondary