Unicystic Mucoepidermoid Carcinoma Presenting as a Salivary Duct Cyst

Qannam, Ahmed; Bello, Ibrahim O.; Alkindi, Mohammed; Al-Hindi, Maryam

doi:10.1177/1066896912454918

Cited by 7 publications

(8 citation statements)

References 7 publications

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“…As the unicystic variant of MEC arises primarily in the parotid gland, 1,2,[6][7][8] the present palatal lesion was unusual. 10 The same may be said of the oncocytic variant, [1][2][3][4][5] and only 2 such examples arising in the minor salivary gland of the palate have been reported.…”

Section: Discussionmentioning

confidence: 99%

Oncocytic Polyp in a Unicystic Mucoepidermoid Carcinoma of the Palate: A Unique Presentation

et al. 2021

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We report a palatal mucoepidermoid carcinoma (MEC) with unusual pathological features showing salivary duct cyst-like architecture, varied epithelial linings (excretory duct, mucous goblet cell, and apocrine epithelium phenotypes), scarce luminal tumor plaques, and a large intraluminal oncocytic polyp. To our knowledge, such a unicystic variant of MEC with pedicled oncocytic proliferation in the lumen is unprecedented in the literature. In this particular case, the microscopic diagnosis of MEC is problematic because of the large number of potential mimics.

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Section: Discussionmentioning

confidence: 99%

Oncocytic Polyp in a Unicystic Mucoepidermoid Carcinoma of the Palate: A Unique Presentation

et al. 2021

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“…Majority of mucous retention cysts are acquired in nature and are postulated to develop from marked cystic dilatation due to partially obstructed duct by a salivary calculi, mucous plug, strictures, neoplasm or parasites [5]. Retention of secretions may lead to development of retention cysts.…”

Section: Discussionmentioning

confidence: 99%

“…Radiology, the preliminary investigatory aid will not reveal the exact pathology since majority of salivary gland tumors (benign and malignant) present with a unilocular cystic radiographic appearance similar to mucous retention cyst [4]. FNAC may not disclose the hidden pathology, since the aspirated cystic content can be devoid of epithelial cells, when the needle does not hit the representative site [5]. Finally, the gross and the microscopic examination give a clue for definitive diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Mucus Retention Cyst of Parotid Gland: A Rare Case Report

Hassan¹,

Panhotra²,

Raj³

et al. 2020

SJMCR

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Case ReportSwellings of the major salivary gland commonly lead to the differential diagnosis which includes benign and malignant tumors that are frequently associated with cystic degeneration or entirely cystic in nature. Mucus retention cysts are true cysts that rarely involve the major salivary glands. 6% to 9% of the major salivary gland swellings present as a cystic lesion and only 2-5 % of them are non-neoplastic in nature. A 21 year-old female patient presented with swelling in right parotid region for last one and half years. CECT of the parotid region show a well-defined oval fluid density lesion measuring 2.4cmx1.9cmx3.4cm in the superficial lobe of the right parotid gland with extension into the deep lobe of the parotid gland. On FNAC, 7ml creamish fluid was aspirated which on microcopy showed foamy histiocytes in a mucoid background. A diagnosis of benign cystic lesion was made cytologically. The patient underwent right subtotal parotidectomy. Gross examination revealed a globular soft tissue piece with attached fatty tissue piece measuring 5x4x3cm. On cut section a cystic cavity identified measuring 3.5x2.7x2.0cm. Cyst cavity was filled with thick mucoid material. Microscopic examination revealed a cyst lined by cuboidal and partially by pseudostratified columnar epithelium. Interspersed mucus cells also present in lining epithelium. Lumen of cyst showed proteinaceous material. Compressed salivary gland parenchyma also seen at the periphery. No cellular atypia was seen. A diagnosis of Mucus retention cyst of right parotid gland was rendered histopathologically.

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“…Although the majority of MEC are typical in histology, unicystic MEC (UC-MEC), a rare variant of MEC, poses a great diagnostic and treatment challenge for clinicians and pathologists. To date, only 20 cases of UC-MEC have been reported in the English literature [2][3][4][5][6][7][8][9], which means that more cases are needed to study the clinicopathological features and appropriate treatment choices.…”

Section: Introductionmentioning

confidence: 99%

Unicystic Mucoepidermoid Carcinoma: A Pitfall for Clinical and Pathologic Diagnosis

Wang

Feng

et al. 2022

Journal of Oncology

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Unicystic mucoepidermoid carcinoma (UC-MEC) is a rare MEC variant, and its diagnosis is frequently problematic. This study is aimed at summarizing its clinicopathologic characteristics, treatment, and prognosis and proposing key points to avoid missed diagnosis and misdiagnosis in clinical and pathological conditions. This retrospective study included 30 UC-MEC cases, and the clinical findings were collected from the clinical medical records. Radiographic features, histologic behaviors, MAML2 rearrangement by fluorescence in situ hybridization (FISH), and follow-up data were analyzed. Moreover, glandular odontogenic cyst (GOC) and cytadenoma (CA) were used as controls. In the UC-MEC group, 19 patients were female (63%), and 11 were male (37%). The mean patient age was 39.5 (range, 7–72 years). The affected locations included the jaw (8 maxillary, 3 mandibular) and salivary glands (7 parotid, 11 palates, and 1 floor of the mouth). The chief complaint was swelling; the lesions were all cystic, among which 66.7% were well circumscribed and 33.3% poorly defined. Microscopic examination showed two UC-MEC histologic subtypes. Type A presented as a single cyst with mural thickening (8/30, 27%) lined predominantly by epidermoid cells with interspersed intermediate and mucinous cells, and type B (22/30, 73%) showed infiltrative tumor islands in the cystic wall or the surrounding tissue. FISH analysis suggested that approximately 66.7% of UC-MEC harbored a MAML2 rearrangement. During the median follow-up period of 42 months (range, 6–120 months), all type A patients and 68% of type B patients who underwent complete surgical resection lived without relapse. Seven cases with type B cancer that underwent curettage initially had local recurrence. Clinicians and pathologists hardly recognize UC-MEC owing to its cystic architecture. Specific epidermoid, mucous, and intermediate tumor cells, and MAML2 fusion testing, are essential to avoid potential diagnostic pitfalls. Prompting and completing resection surgery with negative margins would have a favorable prognosis.

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Unicystic Mucoepidermoid Carcinoma Presenting as a Salivary Duct Cyst

Cited by 7 publications

References 7 publications

Oncocytic Polyp in a Unicystic Mucoepidermoid Carcinoma of the Palate: A Unique Presentation

Oncocytic Polyp in a Unicystic Mucoepidermoid Carcinoma of the Palate: A Unique Presentation

Mucus Retention Cyst of Parotid Gland: A Rare Case Report

Unicystic Mucoepidermoid Carcinoma: A Pitfall for Clinical and Pathologic Diagnosis

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