A malignant myoepithelioma is one of the rarest salivary gland neoplasms which may either arise de novo or develop within a preexisting pleomorphic adenoma or benign myoepithelioma. The parotid gland is the most common primary site and the palate the most common intra-oral site of occurrence. Herein is present a case of a malignant myoepithelioma arising in the hard palate of a 79-year-old woman. The lesion had been examined by biopsy at another hospital, and diagnosed as a poorly differentiated squamous cell carcinoma. The patient underwent a wide local tumor resection. Examination of the resection specimen showed the characteristic histopathological and immunohistochemical features of a malignant myoepithelioma. Five months after the operation, the patient was well without evidence of recurrence or metastasis.
Aged ; Female ; Humans ; Immunohistochemistry ; Myoepithelioma/*diagnosis/*pathology/surgery ; Palatal Neoplasms/*diagnosis/*pathology/surgery ; Palate/*pathology/*surgery

Prompted by a unique case of an ectomesenchymal chondromyxoid tumor (ECT) of the palate in a 54-year-old female, we reviewed the English and German literature on this entity until the end of 2016 using PubMed. The search produced 74 lingual cases with a nearly equal sex distribution and a mean age of 39.3 years, and two extra-lingual cases sharing histological and immunohistological features including nodular growth, round, fusiform or spindle-shaped cellular architecture, and chondromyxoid stroma. Immunophenotyping showed the majority of cases to be positive for glial fibrillary acidic protein (GFAP), S-100 protein, glycoprotein CD57, pancytokeratin (AE1/AE3), and smooth muscle actin (SMA); in isolated cases there was molecular-genetic rearrangement or gain of Ewing sarcoma breakpoint region 1 (EWSR1) but no rearrangement of pleomorphic adenoma gene 1 (PLAG1). At present, ectomesenchymal cells that migrate from the neural crest are considered to play a pivotal role in tumor origin. All cases had a benign course, although there were three recurrences. Because of the rarity of this tumor and the need for differential diagnostic differentiation from myoepithelioma and pleomorphic adenoma, both oral surgeons and pathologists should be aware of this entity.
Biomarkers, Tumor ; analysis ; Chondroma ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Immunophenotyping ; Mesenchymoma ; pathology ; surgery ; Middle Aged ; Myoepithelioma ; pathology ; surgery ; Palatal Neoplasms ; pathology ; surgery

A patient diagnosed with myoepithelial carcinoma was recently treated in our department. The neoplasm was huge, located in the left maxillofacial region, blocking both eyes, impeding feeding. About one month before admission, the tumor began to bleed frequently, about 100 ml each time, causing headache, dizziness, fatigue, and cold sweats. CT showed the maximum diameter of the tumor was about 23 cm, with uneven density, and maxillofacial bone destruction. MRI revealed internal bleeding and necrosis inside the tumor. After admission, blood routine test showed erythrocyte count 3.64 x 10(12)/L(↓), hemoglobin 106 g/L(↓), hematocrit 0.320 (↓), serum iron 6.2 μmol/L(↓). After surgery, the patient recovered smoothly.
Carcinoma ; diagnosis ; surgery ; Humans ; Magnetic Resonance Imaging ; Myoepithelioma ; diagnosis ; surgery ; Nasal Cavity ; pathology ; Paranasal Sinus Neoplasms ; diagnosis ; surgery ; Paranasal Sinuses ; pathology

OBJECTIVETo evaluate clinical feature, diagnosis, treatment and prognosis of myoepithelial carcinoma (MC) in the head and neck.

METHODSClinical data of 11 patients which were confirmed by pathology and immunohistochemistry in Cancer Center, Sun Yat-sen University from Jan. 1992 to Dec. 2006, were reviewed. There were 5 cases in parotid gland, 1 in hard palate, 1 in maxillary sinus, 1 in pharyngeal recess, 1 in bucca cavioris, 1 in scalp, and 1 in gingiva. Male female ratio is 4 to 7. The median age at diagnosis was 37 years (range: 14 - 60 years).

RESULTSAll cases were operated, 4 underwent surgery alone, 2 underwent surgery plus adjuvant radiotherapy, 2 received surgery plus adjuvant chemotherapy, 3 underwent surgery plus adjuvant chemoradiation. After operation, 8 cases occurred local recurrence and 4 cases occurred distance and lymph nodes metastasis. There was spindle cell type in 5 cases, clear cell type, plasmacytoid cell type in 2 cases, epithelioid cell type, mixed type in 1 case. The median follow-up time was 40 months. AS to the last follow-up time, 8 patients died.

CONCLUSIONSThe characteristics of the tumor were rapidly enlarging, invading the surrounding regions, high rates of lymph node metastasis, high rates of distance metastasis. It was easily recurrence if the surgical excision was not radically for MC, and the prognosis was poorly. MC was a sort of malignant tumor. Radical operation must be advocated initially. Chemotherapy and radiotherapy may be effective after operation.

Adolescent ; Adult ; Female ; Head and Neck Neoplasms ; diagnosis ; pathology ; surgery ; Humans ; Lymphatic Metastasis ; Male ; Middle Aged ; Myoepithelioma ; diagnosis ; pathology ; surgery ; Neoplasm Metastasis ; Prognosis ; Retrospective Studies ; Young Adult

Chordoma ; metabolism ; pathology ; Diagnosis, Differential ; Elbow ; Humans ; Immunohistochemistry ; Male ; Mucin-1 ; metabolism ; Myoepithelioma ; metabolism ; pathology ; surgery ; Soft Tissue Neoplasms ; metabolism ; pathology ; surgery ; Vimentin ; metabolism ; Young Adult

Adenocarcinoma ; metabolism ; pathology ; Adenocarcinoma, Clear Cell ; metabolism ; pathology ; Biomarkers ; metabolism ; Carcinoma ; metabolism ; pathology ; surgery ; Diagnosis, Differential ; Female ; Humans ; Keratins ; metabolism ; Membrane Proteins ; metabolism ; Middle Aged ; Mucin-1 ; metabolism ; Myoepithelioma ; metabolism ; pathology ; surgery ; Neoplasm Recurrence, Local ; Parotid Gland ; surgery ; Parotid Neoplasms ; metabolism ; pathology ; surgery ; S100 Proteins ; metabolism