P63 Positive Mucoepidermoid Tumor of the Lacrimal Sac with Associated Papilloma.

We report a case of a 44-year-old man who presented with a left medial canthal mass and epiphora. Imaging was suggestive of a mass continuous with the nasolacrimal sac. Subsequent surgical exploration revealed a mass adherent to bone with invasion of the lacrimal system. Histological examination revealed a squamous/transitional cell papilloma overlying a low-grade mucoepidermoid carcinoma (MEC). Complete surgical resection was completed and pathology confirmed the diagnosis. This is the first case in which a MEC has been reported concurrently with an overlying papilloma, providing support for the hypothesis that MECs arise from papillomas in the lacrimal sac. Additionally, the tissue stained positive for p63, which is congruent with MEC immunoreactivity in the salivary gland. The description of these unique histopathological findings may assist in definitive diagnosis and improve our understanding of the pathophysiology underlying lacrimal sac MEC tumors.

Characterization of stem-like cells in mucoepidermoid tracheal paediatric tumor.

Stem cells contribute to regeneration of tissues and organs. Cells with stem cell-like properties have been identified in tumors from a variety of origins, but to our knowledge there are yet no reports on tumor-related stem cells in the human upper respiratory tract. In the present study, we show that a tracheal mucoepidermoid tumor biopsy obtained from a 6 year-old patient contained a subpopulation of cells with morphology, clonogenicity and surface markers that overlapped with bone marrow mesenchymal stromal cells (BM-MSCs). These cells, designated as MEi (mesenchymal stem cell-like mucoepidermoid tumor) cells, could be differentiated towards mesenchymal lineages both with and without induction, and formed spheroids in vitro. The MEi cells shared several multipotent characteristics with BM-MSCs. However, they displayed differences to BM-MSCs in growth kinectics and gene expression profiles relating to cancer pathways and tube development. Despite this, the MEi cells did not possess in vivo tumor-initiating capacity, as proven by the absence of growth in situ after localized injection in immunocompromised mice. Our results provide an initial characterization of benign tracheal cancer-derived niche cells. We believe that this report could be of importance to further understand tracheal cancer initiation and progression as well as therapeutic development.

Carcinoma mucoepidermoide de glândulas salivares menores / Mucoepidermoid carcinoma of minor salivary glands

Introdução: Os carcinomas mucoepidermoides (CME) representam cerca de 5% de todos os tumores das glândulas salivares. Trata-se de uma lesão agressiva e deve ser considerada como hipótese de diagnóstico em lesões proliferativas da mucosa oral. O diagnóstico precoce e o correto manejo dessa neoplasia são fatores determinantes do prognóstico. Ressecção local ampla e eventualmente a radioterapia pós-operatória são o tratamento de escolha. Objetivo: Relatar o caso de uma paciente com carcinoma mucoepidermoide de cavidade oral, exteriorando-se pela boca, sendo submetida a exérese cirúrgica e radioterapia, evoluindo para óbito no quarto mês do início do tratamento. Relato do Caso: CT, 47anos, branca, foi encaminhada ao serviço de ORL do HSJA após episódio de sangramento importante em cavidade oral. Relatou o surgimento de uma massa com crescimento rápido e expansivo em topografia de fossa canina há +/- 06 meses, associado a emagrecimento de 10 kg. Paciente desidratada, hipocorada, apresentando tumoração pediculada de +/- 06 cm, consistência firme, indolor à palpação, sangrante. Etilista e tabagista crônica. Linfonodos cervicais não palpáveis. Diante do caso optou por fazer a ressecção cirúrgica do tumor e realizar o exame histopatológico que confirmou carcinoma mucoepidermoide de glândulas salivares menores. A paciente foi encaminhada ao serviço de radioterapia; porém, abandonou o tratamento e evoluiu com óbito 4 meses após. Comentários Finais: Neste caso, o crescimento rápido e agressivo da lesão, o tamanho do tumor e o abandono do tratamento proposto foi determinante no prognóstico da paciente.

Introduction: The Mucoepidermoid Carcinomas (MEC) represent about 5% of all tumors in the salivary glands. It is an aggressive lesion and must be considered as a diagnosis hypothesis in the oral mucosa proliferative lesions. The early diagnosis and the correct management of this neoplasm are key factors for the prognosis. Wide local resection and eventually postoperative radiotherapy is the choice treatment. Objective: To report the case of a patient with mucoepidermoid carcinoma of oral cavity, exteriorizing through the mouth and being submitted to surgical exeresis and radiotherapy that evolved to death on the fourth month from beginning of the treatment. Case Report: CT, 47 years old, white woman was forwarded to the ORL service of the HSJA after a critical bleeding episode in oral cavity. She reported the appearing of a mass with fast and expansive growth in a topography of canine fossa for +/- 06 months, associated to the loss of 10 kg. Patient dehydrated, pale with pediculated tumoration of +/- 06 cm, firm consistency, painless upon palpation and bleeding. Chronic alcoholic and smoker. Non-palpable cervical lymph nodes. Faced with the case we opted for a surgical resection of the tumor and the performance of histopathological exam that confirmed mucoepidermoid carcinoma of minor salivary glands. The patient was sent to the radiotherapy service; but she abandoned the treatment and evolved with death 4 months after. Final Comments: In this case, the fast and aggressive growth of the lesion, the size of the tumor and the abandonment of the proposed treatment was determinant for the patient's prognosis.

Subungual tumors: clinicopathologic correlation with US and MR imaging findings.

Various types of tumors can affect the subungual space, including benign solid tumors (glomus tumor, subungual exostosis, soft-tissue chondroma, keratoacanthoma, hemangioma, lobular capillary hemangioma), benign cystic lesions (epidermal and mucoid cysts), and malignant tumors (squamous cell carcinoma, malignant melanoma). Imaging plays an important role in the detection and differentiation of subungual tumors because of their small size, nonspecific clinical manifestations, and functional significance. Ultrasonography (US)-in particular, high-resolution US with color Doppler studies-provides useful information regarding tumor size, location, shape, and internal characteristics (cystic, solid, or mixed), but it is limited in the further characterization of tissue. Magnetic resonance (MR) imaging has an important role in categorizing tumors according to their anatomic location, pathologic origin, and signal characteristics. There is some overlap between the US and MR imaging features of subungual tumors; however, certain features can allow accurate diagnosis and expedite management when correlated with clinical and pathologic findings.

Tumor mucoepidermoide de glándula salival menor / Mucoepidermoid tumor of salivary minor gland

Las glándulas salivares menores se presentan en mayor proporción en el paladar. Es allí donde los tumores benignos o malignos de las mismas aparecen con mayor frecuencia. El carcinoma mucoepidermoide (CM) es el segundo en frecuencia, tras el cilindroma, que puede aparecer en este tipo de glándulas. Su diagnóstico precoz y tratamiento quirúrgico se hacen necesarios dada su tendencia a la invasión tisular local o la formación de metástasis a distancia (AU)

Mucoepidermoid tumors of the lung: analysis of 11 cases.

BACKGROUND: Mucoepidermoid tumors (METs) of the trachea and bronchi are rare. They derive from the minor salivary gland tissue of the proximal tracheobronchial tree, and their clinical behaviors are still controversial. Herein, we analyze 11 cases of MET to investigate its clinicopathological characteristics. METHODS: The medical records and pathological examinations of patients diagnosed with MET from May, 1995 to May, 2001 at the Division of Thoracic Surgery in Taipei Veterans General Hospital were retrospectively reviewed. RESULTS: There were 11 patients (7 male and 4 female) aged from 19 to 79 years, with a peak at the seventh and eighth decade. The mean age at diagnosis was 58.9 years, and 9 of these 11 patients were symptomatic. No surgical mortality occurred. Three patients with low-grade tumors were all young females (less than 30 years). They were all alive without evidence of disease recurrence until the date of analysis, whereas the 5-year survival of 8 patients with high-grade tumors was only 25%. Six patients with high-grade tumors received adjuvant therapy, but their prognoses remained poor. CONCLUSIONS: In the current study, METs occurred more frequently in male patients. Young female patients were preponderant to have low-grade tumors and therefore associated with better prognosis. Histological grading of the MET and the ability to achieve an anatomic resection are 2 most important factors that affect prognosis. Adjuvant therapy seems not to be effective in patients with high-grade MET.

Minor salivary glands: causing major problems.

Tumours arising in the parapharyngeal space (PPS) are rare and account for approximately 0.5% of all head and neck neoplasms. These neoplastic processes represent a wide variety of both benign (80%) and malignant lesions arising from the diverse range of structures within and surrounding the PPS. The PPS is typically conceptualized as a potential neck space in the shape of an inverted cone with its base at the skull base and apex at the greater cornu of the hyoid. Because of this unique structure, lesions must often grow to a considerable size before symptoms become apparent and clinical detection is possible. A rare case of mucoepidermoid tumour of the minor salivary glands arising in the prestyloid parapharyngeal space is described. The complex anatomical and pathological considerations within this region present a substantial challenge to the head and neck surgeon in the evaluation and management of these lesions.

[A rare case of bronchial mucoepidermoid tumor]. / Vzácný prípad mukoepidermoidního tumoru bronchu.

The authors describe a rare case of a mucoepidermoid bronchial tumour in a young patient. The main clinical manifestation was relapsing bronchopneumonia behind the stenosis. The authors analyze in detail the histological characteristics of the tumour and its behaviour and present a review of the literature.

[The problem of lymph nodes in malignant epithelial tumors of the parotid gland]. / Il problema linfonodale nei tumori epiteliali maligni della parotide.

Cervical lymph-node treatment in parotid gland epithelial malignancies is still debated. According to Literature, three different strategies (surgery, radiotherapy, "wait and see") have all been proposed theoretically, particularly when dealing with N0 cases. The present study was designed to evaluate the results of different lymphonode treatment strategies in 57 parotid gland carcinomas followed at the ENT Clinic of the University of Ferrara. The most frequent hystological patterns appeared to be the adenoidcystic carcinoma (33.3%) and the mucoepidermoid tumor (21.1%). Total parotidectomy was the treatment of choice in all cases. Ipsilateral neck dissection was performed in 14 cases (24.5%), 5 cases being N0. In 27 patients (47.4%) postsurgical radiotherapy was applied: in 7 cases on T and in 20 on both T and N.T recurrences were 7, while those of N and of both T and N were respectively 2 and 2. No occult metastases were found in N0 dissected patients. The results obtained led the Authors to the following conclusions: -neck dissection is fundamental in treatment of clinical adenopathies in any parotid gland malignancy: -postsurgical radiotherapy on the neck is the treatment of choice in all N0 carcinomas except in cases of acinic cell and mucoepidermoid carcinomas, where a "wait and see" policy seems to be more suitable.

Unilateral hyperlucency with left lower lobe mass in a patient with bronchial asthma.

Mucoepidermoid tumors are rare bronchial adenomas whose clinical presentation can mimic that of bronchial asthma. Bronchial adenoma should be included in the differential diagnosis of a patient with a persistent radiographic abnormality and clinical features of bronchial asthma. We present an adolescent female with a history suggestive of bronchial asthma and a persistent left lower lobe atelectasis, who later was found to have a low-grade mucoepidermoid tumor.