Epithelial-Myoepithelial carcinoma of the lacrimal gland - Case report and review of literature

Objective@#To describe the clinicopathologic features and outcome of a patient with epithelial-myoepithelial carcinoma of the lacrimal gland who underwent modified lateral orbitotomy with en toto removal of the lesion and adjuvant radiotherapy.@*Methods@#This is a case report.@*Results@#A 31-year-old Filipino male seafarer presented with a 2-month history of an enlarging left superotemporal orbital mass and inferonasal displacement of the globe. Magnetic resonance imaging revealed a superotemporal extraconal mass within the lacrimal sac fossa with evidence of osseous infiltration of the superolateral orbital rim. Modified lateral orbitotomy was performed with en toto removal of the lesion and the clinically infiltrated adjacent lateral bony margin. Histopathologic diagnosis of epithelial-myoepithelial carcinoma of the lacrimal gland was made based on the classic and distinct biphasic morphology and was confirmed with immunohistochemistry studies (cytokeratin-7, S-100, and p63). Systemic surveillance using positron emission tomography and computed tomography scan with contrast revealed no evidence of regional or distant metastasis. Adjuvant radiotherapy of the orbital area was performed for increased local control. Twelve months postoperatively, the patient showed no evidence of tumor recurrence.@*Conclusion@#Epithelial-myoepithelial carcinoma of the lacrimal gland is a rare condition, and this is the first documented case from the Philippines. Accurate diagnosis is necessary for appropriate treatment. It should be included in the differential diagnosis of infiltrative lesions in the lacrimal gland fossa.

Giant myoepithelial carcinoma of the nuchal region: a case report and literature review / 临床耳鼻咽喉头颈外科杂志

Myoepithelioma, also known as malignant myoepithelioma, is a rare malignant tumor originating from myoepithelial cell. This article reports a patient with a huge tumor in the neck and left elbow who underwent fine needle aspiration under local anesthesia. The pathological diagnosis was a myoepithelioma. Under general anesthesia, giant tumors in the lower neck, posterior cranial fossa, neck, and left elbow were removed, and postoperative pathology showed that they were all myoepithelial tumors. Immunohistochemistry showed AE1/AE3 (+), P63 (+), CK7 (+), CK5 (+), and CD138 (+). The clinical characteristics and diagnosis and treatment process of this case are reported and relevant literature is reviewed.

Carcinoma Mioepitelial Ex-Adenoma Pleomórfico de Glándula Parótida: Reporte de un Caso y Análisis Inmunohistoquímico

RESUMEN: El carcinoma mioepitelial es una rara neoplasia maligna de las glándulas salivales; puede originarse de novo o desarrollarse en un adenoma pleomórfico preexistente o un mioepitelioma. Las características histológicas e inmunohistoquímicas de un caso de carcinoma mioepitelial de glándula parótida originado por la transformación maligna de un adenoma pleomórfico primario previo se investigaron en este trabajo. Se demostró la presencia de mitosis, pleomorfismo nuclear, áreas necróticas, mioepiteliocitos con una marcación con p63 superior al 75 % y un índice proliferativo de 15 %, características que pueden desencadenar un desenlace adverso. Resulta clave el examen periódico de la paciente que dará una probabilidad superior de curación y sobrevida y de investigar eventuales recurrencias o metástasis.

ABSTRACT: Myoepithelial carcinoma is a rare malignant neoplasm of the salivary glands; it may originate de novo or develop into a pre-existing pleomorphic adenoma or myoepithelioma. The histological and immunohistochemical characteristics of a case of myoepithelial carcinoma of the parotid gland originated by the malignant transformation of a previous primary pleomorphic adenoma were investigated in this work. The presence of mitosis, nuclear pleomorphism, necrotic areas, myoepitheliocytes with a p63 labeling greater than 75 % and a proliferative index of 15 % were demonstrated, characteristics that can trigger an adverse outcome. The periodic examination of the patient is essential, which will give a higher probability of cure and survival and to investigate eventual recurrences or metastases.

Expression of thymidylate synthase in salivary adenoid myoepithelial cells and its clinical significance / 南方医科大学学报

OBJECTIVE@#To evaluate the expression of thymidylate synthase (TS) in myoepithelial cells (MECs) of salivary adenoid tissues and explore its clinical significance.@*METHODS@#Immunohistochemical staining EnVision method was used to detect the expression of TS, P63, Calponin, CK5/6 and S-100 in 32 salivary gland specimens, including 10 non-neoplastic and salivary inflammation specimens, 11 mixed tumor specimens, 5 basal cell carcinoma specimens and 6 adenoid cyst carcinoma specimens. The specificity and sensitivity of TS as a specific molecular marker of salivary muscle epithelial cells were evaluated in comparison with P63, Calponin, CK5/6 and S-100.@*RESULTS@#The expression pattern of TS in all the salivary gland tissue specimens was identical with that of p63. TS and P63 both showed strong immunohistochemical expressions in MECs of salivary adenoid tissue specimens. Calponin, CK5/6, and S-100 showed cytoplasmic/membranous expressions in the MECs. In addition, TS exhibited weak or moderate cytoplasmic expression in a few salivary gland epithelial cells, cancer cells and scattered stromal cells, with negative expression in the cell nuclei. The expression of TS in the MECs of all the salivary adenoid specimens was highly consistent with those of P63, Calponin, CK5/6 and S-100 (>0.05) Except for CK5/6 expression in Salivary inflammation and Salivary gland specimens. Kappa>0.75. The specificity and sensitivity of TS as a molecular marker of MECs were both 100%.@*CONCLUSIONS@#TS is a new specific marker of MECs for differential diagnosis of salivary gland tumors.

A Rare Case of Pulmonary Epithelial-myoepithelial Carcinoma: Case Report and Literature Review / 中国肺癌杂志

BACKGROUND@#Pulmonary epithelial-myoepithelial carcinoma is a very rare type of salivary gland lung tumor. No standard treatment plan yet. This article intends to analyze the clinical characteristics of pulmonary epithelial-myoepithelial carcinoma and discuss the diagnosis and treatment of pulmonary epithelial-myoepithelial carcinoma.@*METHODS@#The clinical data of a patient with pulmonary epithelial-myoepithelial carcinoma were analyzed and other relevant clinical literatures were reviewed.@*RESULTS@#Epithelial cells immunohistochemically expressed cytokeratin and myoepithelial cells immunohistochemically expressed SMA and S-100. The next-generation sequencing was mainly HRAS gene mutation and the express of PD-L1 protein was negative.@*CONCLUSIONS@#Most of the patients with Pulmonary epithelial-myoepithelial carcinoma have a good prognosis. Diagnosis mainly depends on microscopic examination and immunohistochemistry. The treatment of pulmonary epithelial-myoepithelial carcinoma is mainly surgical resection. The effect of radiotherapy and chemotherapy is not clear.

Adenoma pleomorfo de la glándula submandibular: reporte de un caso y revisión de la literatura / Pleomorphic adenoma of the submandibular gland: report of a case and review of literature

Los tumores de las glándulas salivales constituyen alrededor de 5% de las neoplasias de cabeza y cuello. El adenoma pleomorfo es el tumor benigno más frecuente de las glándulas salivales, representa aproximadamente 60% de todas las neoplasias salivales, está compuesto fundamentalmente por una proliferación de células mioepiteliales y por un amplio espectro de componentes de tejido epitelial y mesenquimal, rodeado por una nítida cápsula fibrosa. Alrededor de 80% de los adenomas pleomorfos aparecen en la parótida, 10% en la glándula submandibular y 10% en las glándulas salivales menores de la cavidad oral. La edad media de presentación es a los 46 años, pero la edad oscila entre la tercera y la quinta década de la vida. No obstante, ha sido encontrado en individuos de todas las edades, presentando una ligera predilección por el sexo femenino. Respecto a su sitio de origen, el adenoma pleomorfo es asintomático, de crecimiento lento y consistencia firme. La tomografía axial computarizada (TAC) y la resonancia magnética nuclear (RMN) son de gran utilidad para evaluar la extensión de la lesión, así como el compromiso de estructuras importantes. La biopsia por aspiración con aguja fina (BAAF) es un método útil para el diagnóstico de este tipo de neoplasias. El tratamiento de este tipo de lesiones consiste en la remoción quirúrgica de la tumoración junto con la glándula afectada. Menos de 1% de los casos de adenomas pleomorfos sufren transformación maligna, especialmente los que han presentado múltiples recidivas (AU)

The tumors of the salivary glands constitute about 5% of the neoplasms of the head and neck. The pleomorphic adenoma is the most frequent benign tumor of the salivary glands, represents approximately 60% of all salivary neoplasms, is composed mainly of a proliferation of myoepithelial cells and a wide spectrum of components of epithelial and mesenchymal tissue, surrounded by a sharp fibrous capsule. About 80% of pleomorphic adenomas appear in the parotid, 10% in the submandibular gland and 10% in the minor salivary glands of the oral cavity. The average age of presentation is 46 years, but age ranges between the third and fifth decade of life. However, it has been found in individuals of all ages, presenting a slight female predilection. Regarding its site of origin, the pleomorphic adenoma is asymptomatic, slow growing and firm consistency. Computed tomography (CT) and nuclear magnetic resonance (NMR) are very useful to evaluate the extent of the injury as well as the commitment of important structures. Fine needle aspiration biopsy (FNAB) is a useful method for the diagnosis of this type of neoplasm. The treatment of this type of injuries consists in the surgical removal of the tumor together with the affected gland. Less than 1% of cases of pleomorphic adenomas suffer malignant transformation, especially those that have presented multiple recurrences (AU)

Adenomioepitelioma de mama. Presentación de un caso / Adenomyoepithelioma of the breast. A case presentation

RESUMEN El adenomioepitelioma es un tumor de la mama poco frecuente, generalmente de comportamiento benigno, de histología variable, que puede simular otras lesiones epiteliales, mioepiteliales y bifásicas de la mama. Patológicamente es un desorden raro caracterizado por la proliferación simultánea de las células del epitelio ductal y células mioepiteliales. Es más común en las glándulas salivales o en la piel, raras veces es encontrado en el tejido mamario. Afecta fundamentalmente al sexo femenino, alrededor de los 50 años de edad. Clínicamente se presenta por una pequeña masa palpable que ocupa cuadrantes centrales de la mama. El tratamiento de elección es la exéresis amplia de la lesión. Es frecuente la recidiva local y en algunas ocasiones puede tener degeneración maligna. Se presentó una paciente 13 años de edad, que acudió al Servicio de Cirugía del Hospital "Dr. Mario Muñoz Monroy" , municipio Colón, provincia de Matanzas con un tumor de consistencia dura; pero no pétreo, de 8-10 cm de diámetro, en cuadrantes inferiores y región retroareolar de la mama derecha. El estudio sonográfico informó la presencia de una imagen hipoecoica, de forma oval. Se realizó exéresis de la lesión. El estudio patológico e inmunohistoquímico aportó un adenomioepitelioma de la mama. La paciente no presentó complicaciones postoperatorias. Actualmente se sigue por consulta a 7 años de la cirugía.

ABSTRACT Adenomyoepithelioma is a very rare and generally benign tumor of varying histology that can simulate other epithelial, myoepithelial and biphasic lesions of the breast. Pathologically it is rare disorder characterized by the simultaneous proliferation of ductal epithelium and myoepithelial cells. It is more common in salivary glands and in skin. Rarely found in mammal tissue, it mainly affects women, aged around 50 years, and clinically presents like a palpable mass occupying central breast quadrants. The treatment of choice is the extensive excision of the lesion. Local recidivisms is very frequent, and sometimes they could have malignant degeneration. The authors present the case of a female patient, aged 13 years, who assisted the service of Surgery of the Hospital "Dr. Mario Muñoz Monroy", municipality of Colon, province of Matanzas with a tumor of hard consistence, of 8-10 cm diameter, in lower quadrants and retro alveolar region of the right mamma. The sonographic study informed the presence of a hypoechoic, oval image. The lesion was excised. The pathological and immunohistochemical study showed a breast adenomyoepithelioma. The patient did not have post-surgery complications. Currently she is followed in consultation after seven years of the surgery.

Epithelial-Myoepithelial Carcinoma of the Inferior Turbinate: A Case Report

Expression of ?-smooth muscle actin in benign and malignant salivary gland tumors: An immunohistochemical study

Background and Objectives: Myoepithelial cells (ME) are known to contribute in the patterning of salivary gland neoplasms (SGN) and possess cytoplasmic smooth muscle actin (SMA) revealed by alpha SMA (?-SMA). The present study aimed to assess the expression of ?-SMA in selected benign and malignant SGN (pleomorphic adenoma printarticle.asp?issn=0377-4929;year=2018;volume=61;issue=4;spage=479;epage=484;aulast=Ravi, mucoepidermoid carcinoma (MEC), adenoid cystic carcinoma (ACC), and polymorphous low-grade adenocarcinoma (PLGA). Materials and Methods: The intensity and pattern of expression of ?-SMA were studied in 25 cases of SGN's ACC (n = 7), MEC (n = 8), PA (n = 8), and PLGA (n = 2), and correlated with the histological patterns. Results: Maximum expression of ?-SMA in the epithelial compartment was seen in ACC, followed by PA, whereas MEC and PLGA showed completely negative staining. The connective tissue expression was mild in ACC and MEC. The myxoid stroma of PA with “melting” pattern was weakly positive for ?-SMA. The stroma in PLGA showed complete negativity. In ACC, ?-SMA-positive cells were lining the cribriform spaces, small islands, and dispersed within large islands. Small nests showed complete positivity for ?-SMA. Interpretation and Conclusion: In ACC, ?-SMA expression supports the involvement of ME in epithelial organization explaining the histological patterns seen. In PA, the expression correlates with the predominantly secretory nature of ME. The absence of epithelial positivity in MEC and PLGA suggest that ME has less role to play in their histogenesis. The weak stromal positivity observed in MEC and ACC may be attributed to the positive immunoreactivity of myofibroblasts playing a role in modulating the course of SGN's.

Dedifferentiation of oncocytic epithelial–myoepithelial carcinoma to mucoepidermoid carcinoma in parotid gland: A rare case report

Epithelial–myoepithelial carcinomas (EMCs) account for <1% of all salivary gland malignancies. Till now, 23 cases of dedifferentiated EMC have been reported to the best of our knowledge. However, dedifferentiation of oncocytic EMC to mucoepidermoid carcinoma is extremely rare. A 38-year-old female presented with right post aural swelling 4 cm × 2 cm in size for 6 months. Surgical excision was carried out, and we received partly skin-covered tissue 5 cm × 2 cm in size. Sections examined showed features of oncocytic EMC dedifferentiating into mucoepidermoid carcinoma. Myoepithelial component showed oncocytic change which was highlighted by p63.

Adenoma pleomórfico de vulva / Vulvar Pleomorphic Adenoma

El adenoma pleomórfico (AP) es el tumor benigno más prevalente de las glándulas salivales mayores; sin embargo, esta no es su localización anatómica exclusiva. Las células mioepiteliales, tapizan la membrana basal de las porciones terminales de diferentes tejidos glandulares exocrinos incluyendo los salivales, lacrimales, mamarios y sudoríparos; por esta razón, no es insólito que este tumor se origine en tejidos glandulares diferentes a los salivales. El adenoma pleomórfico de la vulva es un hallazgo infrecuente, con pocos casos reportados en la literatura, siendo este caso el primero reportado en Colombia y Latinoamérica(AU)

Pleomorphic Adenoma is the most prevalent benign tumor among the major salivary glands; nevertheless, this is not the exclusive anatomic localization. Myoepithelial cells cover the basal membrane of the terminal portions of different exocrine glandular tissues including the salivary glands, lacrimal glands, mammary tissue and sweat glands. Consequently, it is not rare that this kind tumor originate in tissues different from the salivary glands. The vulvar pleomorphic adenoma is an uncommon finding, with few reported cases in literature. Actuality this the first case reported in Colombia and Latin America(AU)

Carcinoma parotídeo epitelial-mioepitelial: presentación de un caso y revisión de la literatura / Parotid epithelial-myoepithelial carcinoma: case presentation and literature review

Se presenta caso de paciente de sexo femenino de 53 años de edad con tumor parotídeo izquierdo de larvada evolución, con crecimiento progresivo y otalgia ipsilateral en los últimos meses, estudiado previamente con tomografía de cuello con contraste y resonancia magnética que destacan masa del lóbulo profundo de la parótida de características imagenológicas benignas. Se realizó parotidectomía del lóbulo profundo con resección tumoral preservando el nervio facial casi en su totalidad con excepción de rama marginal, la biopsia de la pieza quirúrgica fue informada como carcinoma epitelialmioepitelial de bajo grado, un tumor infrecuente de las glándulas salivales. Se decidió completar la parotidectomía superficial y realizar vaciamiento ganglionar selectivo lateral ipsilateral, complementando el tratamiento con radioterapia. Además se presenta una revisión de la literatura correspondiente.

We present a case of a 53 years old female patient with a left parotid tumor, with slow evolution, progressive growth and ipsilateral otalgia during later months. She was previously studied by tomography of the neck with contrast and magnetic resonance, which showed the mass of the deep lobe to have benign imaging characteristics. A parotidectomy of deep lobe was performed, with tumoral resection, preserving the facial nerve with the exception of the marginal branch. The biopsy was informed as epithelial-myoephitelial carcinoma, a rare salivary gland tumor. We completed the parotidectomy with neck dissection and Radiotherapy complementary was made. Besides we presented a literature review.

DNA Aneuploidy in Malignant Salivary Gland Neoplasms is Independent of USP44 Protein Expression

Chromosomal instability, leading to aneuploidy, is one of the hallmarks of human cancers. USP44 (ubiquitin specific peptidase 44) is an important molecule that plays a regulatory role in the mitotic checkpoint and USP44 loss causes chromosome mis-segregation, aneuploidy and tumorigenesis in vivo. In this study, it was investigated the immunoexpression of USP44 in 28 malignant salivary gland neoplasms and associated the results with DNA ploidy status assessed by image cytometry. USP44 protein was widely expressed in most of the tumor samples and no clear association could be established between its expression and DNA ploidy status or tumor size. On this basis, it may be concluded that the aneuploidy of the salivary gland cancers included in this study was not driven by loss of USP44 protein expression.

Resumo Instabilidade cromossômica acarretando aneuploidia é um dos fatores marcantes de neoplasias malignas humanas. USP44 (peptidase específica de ubiquitina 44) é uma importante molécula que exerce um papel regulador no ciclo celular e sua perda pode acarretar em segregação cromossômica deficiente, aneuploidia e desenvolvimento de tumores in vivo. Neste estudo, investigou-se a expressão imuno-histoquímica da proteína USP44 em 28 neoplasias malignas de glândulas salivares, associando-se os resultados com o estado de ploidia do DNA avaliado por citometria de fluxo. A proteína USP44 apresentou ampla expressão na maioria das amostras avaliadas e não foi observada associação entre a expressão protéica e o estado de ploidia do DNA ou extensão do tumor. Baseando-se nos resultados, concluiu-se que a aneuploidia das neoplasias malignas de glândulas de salivares incluídas neste estudo não foi influenciada pela perda de expressão da proteína USP44.

A retrospective study of the treatment for epithelial-myoepithelial carcinoma / 中华放射肿瘤学杂志

Objective To evaluate the risk of locoregional recurrence (LRR) and the influencing factors for long-term survival in patients with epithelial-myoepithelial carcinoma (EMCa).Methods A retrospective analysis was performed for 18 EMCa patients, who received initial therapy or initial adjuvant therapy in our hospital from 1999 to 2015, to investigate their survival.Among these patients, 8(44%) underwent surgery alone, 9(50%) received adjuvant radiotherapy, and 1(6%) received radical concurrent chemoradiotherapy.Locoregional recurrence-free survival (LRFS) and overall survival (OS) rates were compared between these groups.The Kaplan-Meier mtthod was used to calculated survival rates and log-rank test was used to compare the LRFS.Results With a median follow-up time of 46 months, 5 patients developed LRR, and the 5-year LRFS and OS rates were 69% and 93%, respectively.The patients treated with radiotherapy had a significantly higher 5-year LRRFS rate than those not treated with radiotherapy (71% vs.57%, P=0.569).Conclusions LRR is the main failure mode of EMCa treatment, and further improving local control is the key to improved survival.

Research progress on myoepithelial carcinoma / 中国肿瘤临床

Myoepithelial carcinoma is a rare malignant tumor. The primary site of this tumor is the salivary glands. With the rapid ad-vancement in immunohistochemical examination and pathological examination, the number of clinical cases of the most common type of myoepithelial carcinoma of the salivary glands, as well as rare primary sites of myoepithelial carcinoma, reported in the litera-ture has increased. Based on related cases reported in the literature, various studies worldwide, and our personal practical experience, this article summarized advancements in the research on myoepithelial carcinoma, including etiology, pathology, clinical characteris-tics, diagnosis, and treatments, as well as myoepithelial carcinoma features of various rare primary sites. This article aims to provide useful evidence for oncologists in diagnosing and treating myoepithelial carcinoma.

Clinicopathological study of 12 cases of salivary myoepithelial carcinoma / 临床与实验病理学杂志

Purpose To study the clinical features,pathological manifestation and immunohistochemical phenotype and improve the diagnosis and treatment of myoepithelial carcinoma in salivary glands.Methods Histomorphology and immunohistochemical phenotype were analyzed after the sections were stained with routine HE and immunohistochemical methods,and the relevant literatures were reviewed.Results The tumours were predominantly composed of pale-stained clear cells.In some cases,plasma-like cells,epithelioid cells and spindle cells were also seen.The cells were arranged in nest,solid or cords.Mitosis was easily seen,cytological atypia was obvious and necrosis existed in 4 cases.The results of immunohistochemical staining showed that CK was expressed in all cases.EMA was expressed in 8 cases.p63 and CK5/6 were expressed in 11 cases.S-100 was expressed in 10 cases.vimentin was expressed in 4 cases.Calponin was expressed in 2 cases.SMA was expressed in one case.The proliferation index of Ki-67 was 5％ to 40％.Conclusion The histological changes of myoepithelial carcinoma cells are diverse,and pathological and immunohistochemical methods are helpful for improving the rate of right diagnosis.Sugery is the main treatment for myoepithelial carcinoma.

Carcinoma ex pleomorphic adenoma composed of three malignant components in parotid gland:A case report and literature review / 吉林大学学报(医学版)

Objective:To investigate the diagnosis and prognosis of one patient with carcinoma ex pleomorphic adenoma (CXPA)composed of three malignant components in parotid gland,and to raise the clinicians'awareness of the disease.Methods:A patient was presented to hospital because of the mass in left parotid gland region for more than 30 years and the accompanied pain lasted for one month.After color ultrasonography,the left parotid gland tumor resection was performed. Results: The operation was successful. The postoperative pathological diagnosis results comfirmed as CXPA,it was composed of three malignant components,including non-specific adenocarcinoma,ductal carcinoma,and myoepithelial carcinoma.Conclusion:CXPA composed of three malignant components at the same time are extremely rare.CXPA is difficult to diagnose and its prognosis is poor.The clinicians are supposed to improve the understanding of CXPA.

MUC-1 expression in pleomorphic adenomas using two human milk fat globule protein membrane antibodies (HMFG-1 and HMFG-2)

Pleomorphic adenoma (PA) is the most common salivary gland tumor and its microscopic features and histogenesis are a matter of debate. Human milk fat globule protein membrane (HMFG) monoclonal antibodies (MoAbs) comprise a set of antibodies against the mucin 1 (MUC-1) protein detected in several salivary gland tumors. Objective The aim of this study was to assess the immunoexpression of the PA neoplastic cells to MUC-1 protein using HMFG-1 and HMFG-2 MoAbs, contrasting these results with those from normal salivary gland tissue. Material and Methods Immunohistochemical detection of MUC-1 protein using HMFG-1 and HMFG-2 MoAbs was made in 5 mm thick, paraffin embedded slides, and the avidin-biotin method was used. Results Positivity to HMFG-1 and HMFG-2 MoAbs was found in ductal, squamous metaplastic and neoplastic myoepithelial cells, keratin pearls and intraductal mucous material. Two kinds of myoepithelial cells were identified: classic myoepithelial cells around ducts were negative to both MoAbs, and modified myoepithelial cells were positive to both MoAbs. This last cellular group of the analyzed tumors showed similar MUC-1 immunoexpression to ductal epithelial cells using both HMFG antibodies. Intraductal mucous secretion was also HMFG-1 and HMFG-2 positive. Conclusions Our results showed there are two kinds of myoepithelial cells in PA. The first cellular group is represented by the different kinds of neoplastic myoepithelial cells and is HMFG-positive. The second one is HMFG-negative and represented by the neoplastic myoepithelial cells located around the ducts. .

Papilloma with myoepithelial hyperplasia in breast: a rare cytology diagnosis.

Papillary neoplasm of breast with myoepithelial hyperplasia is a rare entity. Interpretation of papillary lesions of the breast remains a challenging task because of the wide morphologic spectrum encountered in benign, atypical and malignant subtypes. We present an interesting and rare case of a 37 year old female reported to surgical out-patient department with complaints of lump in right breast for 2 years. Mammogram diagnosis was Intraductal malignancy with Birads score V. Fine needle aspiration cytology of the lesion did not reveal features of malignancy and a diagnosis of papillary neoplasm with myoepithelial hyperplasia was rendered. Excision biopsy of the lump showed multiple papillomatosis with marked myoepithelial hyperplasia. The diagnosis of this entity by Fine needle aspiration cytology is crucial as it is a rare diagnosis and it can mimic malignancy, radiologically and clinically. It is imperative to rule out malignancy in such cases as it changes the treatment plan dramatically.

Epithelial-myoepithelial carcinoma of salivary glands, report of 23 cases / 中国耳鼻咽喉头颈外科

OBJECTIVE Epithelial-myoepithelial carcinoma (EMC) is a rare malignant neoplasm of the salivary glands. The aim of the study was to investigate the diagnosis, treatment and prognosis of EMC of the parotid gland.METHODSThe clinical data of 23 cases of EMC of the parotid gland from 1999 to 2013 were analyzed retrospectively. Of all the patients, 13 cases received radical surgery only, 9 cases received postoperative radiotherapy, and one case received postoperative chemotherapy. Kaplan-Meier survival curve was used to analyze the clinical data. RESULTSThe overall survival rate at 5-year was 81.0% and the overall no recurrence survival rate at 5-year was 67.3%. The recurrence rate was 39.1% (9/23). The 5-year no recurrence survival rate of radical surgery group was 55.6%, compared with 80.0% in the combined modality therapy group, there was no significant deference (χ2=2.232, P=0.135).CONCLUSIONThe postoperative recurrence rate of EMC is high. Radical surgery could be the main treatment of EMC, when the surgical margin couldn't be achieved, adjuvant radiotherapy or chemotherapy might be helpful.