Minor salivary gland mucoepidermoid carcinoma in children and adolescents: a case series and review of the literature

Abstract

IntroductionBecause well-documented cases of mucoepidermoid carcinomas that are of minor salivary gland origin and occur in children and adolescents have rarely been reported, little information regarding their clinical features and biologic behavior is available. This case report represents a retrospective clinical analysis of five minor salivary gland mucoepidermoid carcinomas accessioned from a 35-year period at the Louisiana State University School of Dentistry and combines the data with 15 well-documented cases from the English language literature.Case presentationThe five mucoepidermoid carcinomas in patients from birth to 19 years of age accounted for 1.3% of the accessioned minor salivary gland neoplasms. There were an additional 15 well-documented cases in the literature. Combining the data for the 20 mucoepidermoid carcinomas resulted in a mean age of 13.5 years and a 2.3:1 female-to-male ratio. Collectively, the hard palate, soft palate, and hard palate/soft palate junction accounted for 85% of the cases. Thirty-five percent of the cases presented as a fluctuant submucosal swelling with surface color alterations. The average duration was five months, and bone involvement occurred in seven cases. A histologic grade of low to intermediate predominated (95%). Surgical removal was the treatment in all cases. Thirteen cases had adequate follow-up of three years or more, and recurrence was documented in only one case. There were no cases of death or metastasis in this series.ConclusionsIn children and adolescents, mucoepidermoid carcinomas have a female predilection and occur most commonly on the hard or soft palate or both. A fluctuant submucosal lump with a bluish color is a helpful diagnostic clue. The histologic grades of most mucoepidermoid carcinomas in the first and second decades of life are low and, to a lesser degree, intermediate. Complete surgical excision is the treatment of choice and results in a recurrence rate of less than 10%.

Salivary Gland Neoplasms in Children and Adolescents

“…pp. [9][10][11][12][13][14][15][16]. Children are more often diagnosed at an early stage with malignant disease, which is low-or intermediate-grade disease compared to disease in adults [5,20] .…”

“…For minor salivary glands, benign and malignant neoplasms most commonly present in the oral cavity as a 'lump' or submucosal nodule. The majority of neoplasms are non-ulcerated, with some firm to palpation, with pink or flesh-coloured surfaces, and others are described as being fluctuant, with colour alterations ranging from a light blue hue to purple [14] .…”

Paediatric mucoepidermoid carcinoma of palate: Literature review and report of a case

“…High-grade neoplasms often require treatment of the cervical lymph nodes by a selective neck dissection, radiation, or both (Ritwik et al, 2012).…”

“…About 1% -5% of all salivary glands tumors develop in children and adolescents, and the MEC are the most common malignancy. (Ritwik et al, 2012). In 1987 only 17 cases of MEC of the palate in children had been published.…”

“…Fluctuance and a light blue color are helpful diagnostic clinical clues. MEC must be considered in the differential diagnosis of a lump or mass in a salivary glandbearing area, especially the palate (Ritwik et al, 2012). Mucoepidermoid carcinoma requires surgical excision.…”