Myoepithelial carcinoma

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Myoepithelial carcinoma, abbreviated MECA a rare malignant salivary gland tumour.[1]

It is the malignant counterpart of myoepithelioma and also known as malignant myoepithelioma.[2]

General

  • Rare.
  • Often misdiagnosed as "benign".[3]

Microscopic

Features:[3]

  • Myoepithelial cells - may be cytologically very bland.
  • Hypocellular centre (hyaline or myxoid) and hypercellular periphery.
  • Pushing border ("expansile nodular lobulated pattern").
  • No ductal structures.

Note:

  • Overt features of malignancy (necrosis, nuclear atypia, infiltrative growth, proliferation) absent.

DDx:

IHC

  • CAM5.2 +ve.

Molecular

  • +/-Fusions with PLAG1 gene.[4]
  • +/-EWSR1 gene rearrangement.[5]

See also

References

  1. Kong, M.; Drill, EN.; Morris, L.; West, L.; Klimstra, D.; Gonen, M.; Ghossein, R.; Katabi, N. (Jul 2015). "Prognostic factors in myoepithelial carcinoma of salivary glands: a clinicopathologic study of 48 cases.". Am J Surg Pathol 39 (7): 931-8. doi:10.1097/PAS.0000000000000452. PMID 25970687.
  2. McCluggage, WG.; Primrose, WJ.; Toner, PG. (Jul 1998). "Myoepithelial carcinoma (malignant myoepithelioma) of the parotid gland arising in a pleomorphic adenoma.". J Clin Pathol 51 (7): 552-6. PMID 9797738.
  3. 3.0 3.1 Xu, B.; Mneimneh, W.; Torrence, DE.; Higgins, K.; Klimstra, D.; Ghossein, R.; Katabi, N. (Feb 2019). "Misinterpreted Myoepithelial Carcinoma of Salivary Gland: A Challenging and Potentially Significant Pitfall.". Am J Surg Pathol. doi:10.1097/PAS.0000000000001218. PMID 30789358.
  4. Dalin, MG.; Katabi, N.; Persson, M.; Lee, KW.; Makarov, V.; Desrichard, A.; Walsh, LA.; West, L. et al. (10 2017). "Multi-dimensional genomic analysis of myoepithelial carcinoma identifies prevalent oncogenic gene fusions.". Nat Commun 8 (1): 1197. doi:10.1038/s41467-017-01178-z. PMID 29084941.
  5. Thway, K.; Bown, N.; Miah, A.; Turner, R.; Fisher, C. (Jun 2015). "Rhabdoid Variant of Myoepithelial Carcinoma, with EWSR1 Rearrangement: Expanding the Spectrum of EWSR1-Rearranged Myoepithelial Tumors.". Head Neck Pathol 9 (2): 273-9. doi:10.1007/s12105-014-0556-2. PMID 24993038.