Epithelial-myoepithelial carcinoma

From Libre Pathology
Jump to: navigation, search
Epithelial-myoepithelial carcinoma
Diagnosis in short

Epithelial-myoepithelial carcinoma. H&E stain.

LM biphasic tumour with (1) epithelial layer, and (2) myoepithelial layer; variable architecture (solid, cystic, tubular, papillary); +/- spindle cells
LM DDx adenoid cystic carcinoma (tubular variant), pleomorphic adenoma, tubular variant.
IHC CAM5.2 +ve (epithelial comp.), p63 +ve (myoepithelial comp.)
Site salivary gland - usually parotid gland

Signs salivary gland mass
Prevalence very rare
Clin. DDx other salivary gland masses

Epithelial-myoepithelial carcinoma, abbreviated EMCa, is a rare malignant salivary gland tumour.

Should not be confused with myoepithelial carcinoma.

General

  • Rare ~1% of salivary gland tumours.[1]
  • Female:male = 1.5:1.[2]
  • Usually older people - 50s or 60s.
  • Usually parotid gland ~ 60% of cases.[2]
  • Prognosis: usually good; 5-year and 10-year survival over 90% and 80% respectively.[2]

Notes:

Microscopic

Features:

  • Biphasic tumour:[2]
    1. Epithelial layer.
    2. Myoepithelial layer - key feature.
  • Architecture: variable (solid, cystic, tubular, papillary).
  • +/-Spindle cells.
  • Basement membrane-like material; may mimic adenoid cystic carcinoma.

Notes:

  • Usually few mitoses.

DDx:

Images

www:

IHC

  • CAM5.2 +ve -- epithelial component.
  • p63 +ve -- myoepithelial component.

See also

References

  1. Tralongo, V.; Daniele, E.. "Epithelial-myoepithelial carcinoma of the salivary glands: a review of literature.". Anticancer Res 18 (1B): 603-8. PMID 9568184.
  2. 2.0 2.1 2.2 2.3 Seethala, RR.; Barnes, EL.; Hunt, JL. (Jan 2007). "Epithelial-myoepithelial carcinoma: a review of the clinicopathologic spectrum and immunophenotypic characteristics in 61 tumors of the salivary glands and upper aerodigestive tract.". Am J Surg Pathol 31 (1): 44-57. doi:10.1097/01.pas.0000213314.74423.d8. PMID 17197918.
  3. Seifert, G. (Sep 1998). "Are adenomyoepithelioma of the breast and epithelial-myoepithelial carcinoma of the salivary glands identical tumours?". Virchows Arch 433 (3): 285-8. PMID 9769134.
  4. Nakashima, Y.; Morita, R.; Ui, A.; Iihara, K.; Yazawa, T. (Jul 2018). "Epithelial-myoepithelial carcinoma of the lung: a case report.". Surg Case Rep 4 (1): 74. doi:10.1186/s40792-018-0482-8. PMID 29987577.
  5. [http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/fs-emc-cytopath-feat.html "Cytopathologic Features of Epithelial-myoepithelial Carcinoma"]. http://www.pathologyimagesinc.com/sgt-cytopath/epith-myoepith-ca/cytopathology/fs-emc-cytopath-feat.html. Retrieved January 18, 2011.