An unusual case of intraosseous mucoepidermoid carcinoma of the mandible

Abstract

Rationale:Mucoepidermoid carcinoma (MEC) is the most common primary salivary gland malignancy. Ectopic MEC can occur in any part of the body, however, only 2% to 4% of MEC could be detected in the jaw, which is named intraosseous mucoepidermoid carcinoma (IMC). IMC is usually a low-grade carcinoma. Uni- or multilocular radiographic lesions should be differential diagnosed with ameloblastoma, odontogenic cysts, and glandular odontogenic cyst (GOC). Radical surgery may prefer for a favorable prognosis. Whereas IMC can recur long after the operation, a long-term follow-up system should be implemented. Owing to its rarity and controversial issues, we report a case report and review the literature to discuss its clinical features, treatments, radiological, and histological characteristics.Patient concerns:The patient presented with a 2-month history of mild pain in the lower left posterior jaw without history of surgery or trauma to the mandible.Diagnoses:Routine postoperative pathology showed that the mass was consistent with a mandibular mucoepidermoid carcinoma.Intervention:Radical surgery and digital mandibular reconstruction were performed.Outcome:Postoperative imaging showed that the height of the mandible and the symmetry of the mandible were satisfactory. The patient was also satisfied with her appearance. Follow-up has been established.Lessons:Effective surgical treatment allows patients to have a favorable prognosis. A long-term follow-up system should be practiced, because local recurrences and regional metastasis could happen even after decades.

Intraosseous Mucoepidermoid Carcinoma of the Anterior Mandible: A Case Report

“…A positive mucin stain is also diagnostic for intraosseous mucoepidermoid carcinoma [ 11 ]. Fusion of TORC1/MAML2 and MECT1:MAML2 genes in intraosseous mucoepidermoid carcinoma was reported by studies by Li et al [ 7 ] and Brookstone and Huvos [ 8 ] and thus they can be used as tumor markers. Intraosseous mucoepidermoid carcinoma can metastasize to the surrounding lymph nodes but rarely to the lung, skin, breast, and cervix [ 8 , 9 ].…”

“…As it can be easily misdiagnosed as ameloblastoma, keratocystic Odontoceti Christmas tumor, glandular odontogenic cyst, or malignant salivary gland tumor, we must look for some important characteristic features of this tumor, including: (1) the lesion should have an epithelial and a mucinous component; (2) bone margin destruction and cortical bone expansion may be seen; (3) cortical plates are intact; (4) absence of an accompanying lesion in the salivary gland; (5) exclusion of any other primary tumor, the histology of which could resemble the central tumor, and (6) histopathological findings confirming the tumor [ 6 ]. Radiologically, a CT scan is the preferred diagnostic modality as it provides information on the extent and size of the tumor [ 7 ]. Brookestone and Huvos proposed a three-grade system for the classification of intraosseous mucoepidermoid carcinoma: grade 1- lesions without cortical plate expansion or rupture, grade 2 - lesions with cortical plate expansion but not rupture, and grade 3 - lesions with cortical plate rupture and metastasis to nodes [ 8 ].…”

A Huge Lesion in the Maxillary Posterior Region Diagnosed High Grade Mucoepidermoid Carcinoma of Minor Salivary Glands: A Case Report

“…Li et all. (10) have reported that low-grade lesions generally (%76.2) display symptoms and in addition, the swelling is %91.1 of all symptoms. Generally, high-grade lesions show many different symptoms.…”

“…However, adjuvant therapy is indicated in the presence of positive margins, metastasis to the lymph nodes, or residual disease (18). The latest review of Li et al (10) reported that %33.3 of high-grade MEC were performed only in surgery and %60 of them were operated on surgery + radiotherapy. The local recurrence rate may be reduced by aggressive surgical excision.…”

Huge Inflammatory Dentigerous Cyst: Case Report

“…Also, there may be a potential for the development of an intraosseous mucoepidermoid carcinoma [12], usually derived from the mucus cells that may be present in the dentigerous cyst lining [13,14].…”