Epithelial-myoepithelial carcinoma originating from a minor salivary gland in the nasal septum

Abstract

Rationale: Epithelial-myoepithelial carcinoma is an extremely rare, malignant neoplasm that occurs most frequently in the major salivary glands and accounts for approximately 1% of all salivary gland neoplasms. Few reports have described the presence of epithelial-myoepithelial carcinoma in the sinonasal region; hence, the treatment guideline and prognosis remain unclear. Patient concerns: We reported a case of a 75-year-old woman with complaint of nasal obstruction and frequent epistaxis for 3 years. During the nasal endoscopic examination, a mass in the left nasal cavity originating from the left nasal septum that caused bleeding on touch was observed. Diagnoses: A diagnosis of epithelial-myoepithelial carcinoma was made based on the features of histopathology and immunohistochemistry of the surgical specimens. The patient was treated by surgical removal of the septal mass using the endonasal endoscopic approach. Outcomes: In the serial follow-up paranasal sinus imaging and endoscopic inspection, evidence of recurrence was absent for 18 months after surgery. Lessons: This report highlights a case of epithelial-myoepithelial carcinoma originating from a minor salivary gland in the nasal septum, one of the most unusual locations. Diagnosis of epithelial-myoepithelial carcinoma should be made based on the findings of immunohistochemistry of the operative specimen. Clinicians should consider complete surgical resection as the effective treatment of choice.

Seltene Erkrankungen der Nase, der Nasennebenhöhlen und der vorderen Schädelbasis

“…Lymph node metastases are rare and occur in less than 5% of the cases. The 5- and 10-year survival rates amount to 72.7 and 59.5%, respectively 296 .…”

“…Computertomografisch ist eine heterogen Kontrastmittel-aufnehmende Weichteil-Struktur in den beteiligten Nasennebenhöhlen darstellbar. Ossäre Destruktionen benachbarter Strukturen sind nicht typisch, können aber auftreten [296].…”

“…1 % aller Speicheldrüsenmalignome ausmacht. Noch seltener ist die Manifestation in der Nasenhaupthöhle oder den Nasennebenhöhlen, von der nur wenige Fallberichte existieren [296]. Die größte Kohortenstudie umfasst 468 Patienten mit epithelial-myoepithelialem Karzinom.…”

“…The largest cohort trial includes 468 patient with epithelial-myoepithelial carcinomas. 18 of these patients had manifestations in the sinonasal area 296 . 80% of the patients were older than 50 year.…”

Epithelial-Myoepithelial Carcinoma of The Minor Salivary Glands: Report of Two Cases with Literature Review

“…Of the 38 cases, 18 cases satistied the above-mentioned inclusion eligibility. The details are summarized in Table 1 [3,[19][20][21][22][23][24][25][26][27][28][29]. The cohort included 10 women and 8 men with a median age of 64 (range: 29-83) years.…”