Sclerosing Mucoepidermoid Carcinoma of the Submandibular Gland Presenting as Chronic Sialadenitis: A Case Report and Review of Literature.

Sclerosing mucoepidermoid carcinoma of the salivary gland (SMEC) is a rare subtype of mucoepidermoid carcinoma (MEC), first described in 1987 by Chan and Saw. As far as we are aware, only 30 cases have been published since then. Most cases were located in the parotid gland with some cases described in the submandibular and minor salivary glands. SMEC typically presents as a long-standing mass, with a non-specific enhancing appearance on imaging and is often non-diagnostic on fine needle aspiration, making pre-operative diagnosis very difficult. It is characterised by dense sclerosis within an otherwise typical MEC, frequently with lymphoid proliferation and eosinophils at the periphery. The histological diagnosis of SMEC can be challenging, as the sclerosis may obscure the other morphological features, which can lead to misdiagnosis. Grading can also be difficult, and the prognostic value of grading for SMEC remains unclear. Herein is described a new case of SMEC, presenting clinically as chronic sialadenitis in the left submandibular gland of a 41 year old male. A brief literature review and the issues surrounding diagnosis and grading are also discussed.

Surgical pathology of cystic lesions of the mediastinum.

BACKGROUND: Mediastinal cysts are uncommonly encountered in a pathologist's experience. AIMS: To study the incidence, location, clinical presentation and histologic subtypes of cysts in the mediastinum. MATERIALS AND METHODS: Cystic lesions of the mediastinum, surgically excised over a period of 22 years were studied after retrieval of relevant clinical data and slides. RESULTS: Thirty-nine mediastinal cysts were encountered in the study period. Most of the patients (81.5 %) were symptomatic. Histologically, foregut cysts (19 cases, 50 %) were the most common followed by teratomatous cysts (ten cases, 26.3 %) and thymic cysts (four cases, 10.5 %). Bronchogenic cysts represented 63 % of the fore-gut cysts. Unusual lesions in the form of cystic mediastinal tuberculous lymphadenitis and cystic schwannoma were seen in three patients. CONCLUSIONS: Despite varied location and histology, clinical presentation of mediastinal cysts are similar. Surgical intervention is the preferred line of management.