Mire and Pelage-Mucoepidermoid Carcinoma Salivary Gland

Abstract

Mucoepidermoid carcinoma of salivary gland is a frequently encountered, malignant neoplasm arising from salivary gland epithelium constituted of mucous cells, intermediate cells and epidermoid cells. Tumefaction is associated with specific chromosomal translocation t(11;19)(q14-21;p12-13) and CRTC1(MECT1)-MAML2 genetic fusion. Median age of disease emergence is 49 years and a mild female preponderance is observed. Neoplasm predominantly incriminates major salivary glands as the parotid gland. Tumefaction depicts a solid, cystic or dual configuration and is composed of neoplastic epidermoid cells demonstrating solid nests, sheets or cellular cords along with varying proportion of epidermoid cells, intermediate cells or mucocytes. Tumour cells appear immune reactive to pan-cytokeratin, CK5/6, p63, p40, epithelial membrane antigen(EMA), CK7 or CK14. Membrane bound mucins appear immune reactive to MUC1, MUC2, MUC4, MUC5AC and MUC5B. Mucoepidermoid carcinoma requires segregation from neoplasms such as pleomorphic adenoma with squamous cell and mucinous cell metaplasia, necrotizing sialometaplasia, Warthin tumour with squamous metaplasia, acinic cell carcinoma, mammary analogue secretory carcinoma (MASC), primary or secondary squamous cell carcinoma or salivary duct carcinoma. Preoperative assessment with ultrasonography or fine needle aspiration cytology may be beneficially employed. Tumefaction may be subjected to comprehensive surgical eradication with excision of broad perimeter of uninvolved, circumscribing soft tissue.