Malignant Myoepithelioma of the Parotid Gland: Literature Review on the Occasion of Our Report of a Case

George Kyrgias, Μaria-Aggeliki Kalogeridi, John Tzitzikas, Vassilios Kouloulias

.

DOI: 10.4236/ijcm.2012.31011                

Abstract

Malignant myoepitheliomas are rare malignant salivary gland neoplasms which usually occur in the parotid gland. Very little material on this topic has been published. This tumour represents a therapeutic challenge since there are no specific recommendations or guidelines. We present a case of malignant myoepithelioma arising de novo in the parotid gland. We discuss our therapeutic approach and considerations on appropriate post-surgical treatment. Then we provide a review of international literature on this interesting and rare oncological entity.

Keywords

Malignant Myoepithelioma; Parotid, Radiotherapy; Rare Neoplasms; Review

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	T. Nagao, I. Sugano, Y. Ishida, Y. Tajima, O. Matsuzaki, A. Konno, Y. Kondo, et al., “Salivary Gland Malignant Myoepithelioma: A Clinicopathologic and Immunohistochemical Study of Ten Cases,” Cancer, Vol. 83, No. 7, 1998, pp. 1292-1299. doi:10.1002/(SICI)1097-0142(19981001)83:7<1292::AID-CNCR4>3.0.CO;2-L
[2]	J. J. Sciubba and R. B. Brannon, “Myoepithelioma of the Salivary Glands: Report of 23 Cases,” Cancer, Vol. 49, No. 3, 1982, pp. 562-572. doi:10.1002/1097-0142(19820201)49:3<562::AID-CNCR2820490328>3.0.CO;2-6
[3]	L. Barnes, B. N. Appel, H. Perez and A. M. El-Attar, “Myoepithelioma of the Head and Neck: case Report and Review,” Journal of Surgical Oncology, Vol. 28, No. 1, 1985, pp. 21-28. doi:10.1002/jso.2930280107
[4]	M. F. Acikalin, O. Pasaoglu, H. Cakli, K. Gurbuz and F. Canaz, “Malignant Myoepithelioma of the palate: A Case Report with Review of the Clinopathological Characteristics,” Yonsei Medical Journal, Vol. 50, No. 6, 2009, pp. 848-851. doi:10.3349/ymj.2009.50.6.848
[5]	G. Yu, D. Ma, K. Sun, T. Li and Y. Zhang, “Myoepithelial Carcinoma of the Salivary Glands: Behaviour and Management,” Chinese Medical Journal, Vol. 116, No. 2, 2003, pp. 163-165.
[6]	F. W. Stromeyer, R. C. Haggitt, J. F. Nelson and J. M Hardman, “Myoepithelioma of Minor Salivary Gland Origin. Light and Electron Microscopical Study,” Archives of Pathology, Vol. 99, No. 5, 1975, pp. 242-245.
[7]	J. D. Crissman, J. A. Wirman and A. Harris, “Malignant Myoepithelioma of the Parotid Gland,” Cancer, Vol. 40, No. 6, 1997, pp. 3042-3049. doi:10.1002/1097-0142(197712)40:6<3042::AID-CNCR2820400642>3.0.CO;2-N
[8]	S. DiPalma, L. Alasio and S. Pilotti, “Fine Needle Aspiration (FNA) Appearances of Malignant Myoepithelioma of the Parotid Gland,” Cytopathology, Vol. 7, No. 5, 1996, pp. 357-365. doi:10.1111/j.1365-2303.1996.tb00315.x
[9]	R. Singh and R. A. Cawson, “Malignant Myoepithelial Carcinoma (Myoepithelioma) Arising in a Pleomorphic Adenoma of the Parotid Gland. An Immunohistochemical Study and Review of the Literature,” Oral Surgery, Oral Medicine, Oral Pathology, Vol. 66, No. 1, 1988, pp. 65- 70. doi:10.1016/0030-4220(88)90069-2
[10]	T. R. Klumpp, R. M. Mohr, C. L. Silverman, C. K. Tanq, I. B. Elfenbein and I. Dardick, “Malignant Myoepithelioma of the Parotid Gland: Case Report and Review of the Literature,” Journal of Laryngology and Otology, Vol. 109, No. 10, 1995, pp. 995-998.
[11]	L. T. Chow, W. H. Chow and J. C. Lee, “Monomorphic EPithelioid Variant of Malignant Myoepithelioma of the Parotid Gland: Cytologic Features in Fine Needle Aspiration (FNA),” Cytopathology, Vol. 7, No. 4, 1996, pp. 279- 287. doi:10.1046/j.1365-2303.1996.40482404.x
[12]	M. Sironi, G. Taccagni and A. Assi, “A Cytologic, Immunocytochemical and Ultrastructural Study of a Malignant Parotid Gland Myoepithelioma,” Cytopathology, Vol. 8, No. 1, 1997, pp. 53-62. doi:10.1046/j.1365-2303.1997.41275412.x
[13]	Y. Daneshbod, S. Negahban, B. Khademi and K. Daneshbod, “Epithelial Myoepithelial Carcinoma of the Parotid Gland with Malignant Ductal and Myoepithelial Components Arising in a Pleomorphic Adenoma: A Case Report with Cytologic, Histologic and Immunohistochemical Correlation,” Acta Cytologica, Vol. 51, No. 5, 2007, pp. 807-813. doi:10.1159/000325847
[14]	F. Angiero, D. Sozzi, R. Seramondi and M. G. Valente, “Epithelial-Myoepithelial Carcinoma of the Minor Salivary Glands: Immunohistochemical and Morphological Features,” Anticancer Research, Vol. 29, No. 11, 2009, pp. 4703-4709.
[15]	B. D. Gun, S. O. Ozdamar, B. Bahadir and L. Uzun, “Salivary Gland Myoepithelioma with Focal Capsular Invasion,” Ear, Nose, and Throat Journal, Vol. 88, No. 7, 2009, pp. 1005-1009.
[16]	N. Siddaraju, B. A. Badhe, M. Goneppanavar and M. M. Mishra, “Preoperative Fine Needle Aspiration Cytologic Diagnosis of Spindle Cell Myoepithelioma of the Parotid Gland: A Case Report,” Acta Cytologica, Vol. 52, No. 4, 2008, pp. 495-499. doi:10.1159/000325561
[17]	A. Shinozaki, T. Nagao, H. Endo, N. Kato, M. Hirokawa, K. Mizobuchi, M. Komatsu, et al., “Sebaceous Epithelial-Myoepithelial Carcinoma of the Salivary Gland: Clinicopathologic and Immunohistochemical Analysis of 6 Cases of a New Histologic Variant,” The American Journal of Surgical Pathology, Vol. 32, No. 6, 2008, pp. 913-923. doi:10.1097/PAS.0b013e318160852a
[18]	Q. L. Liao, L. H. Li, R. Q. Lai, X. D. Chen, J. W. Chen and Y. M. Zhou, “Clinical and Pathologic Features of Malignant Myoepithelioma of Salivary Glands,” Chinese Journal of Pathology, Vol. 34, No. 4, 2005, pp. 211-214.
[19]	A. N. Erkan, N. Bal, F. Caylakli and F. Kiroglu, “Epithelial-Myoepithelial Carcinoma of the Submandibular Gland: A Case Report,” Kulak Burun Bogaz Ihtis Derg, Vol. 17, No. 3, 2007, pp. 167-170.
[20]	J. V. Nayak, J. T. Molina, J. C. Smith, B. F. Branstetter IV, J. L. Hunt and C. H. Snyderman, “Myopithelial Neoplasia of the Submandibular Gland: Case Report and Therapeutic Considerations,” Archieves of Otolaryngology Head & Neck Surgery, Vol. 129, No. 3, 2003, pp. 359-362.
[21]	S. Yang, L. Li, M. Zeng, X. Zhu, J. Zhang and X Chen, “Myoepithelial Carcinoma of Intraoral Minor Salivary Glands: A Clinicopathological Study of 7 Cases and Review of the Literature,” Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontics, Vol. 110, No. 1, 2010, pp. 85-93. doi:10.1016/j.tripleo.2010.02.023
[22]	S. R. oumarova, Z. Lovasova, M. Vankova and L. Sokol, “Radiotherapy in Malignant Myoepithelioma of the Soft Palate-Case Report,” Case Reports in Oncology, Vol. 17, No. 2, 2009, pp. 116-120. doi:10.1159/000228546
[23]	H. Kuwabara, H. Uda, K. iyabe, K. Saito and T. Shibanushi, “Malignant Plasmacytoid Myoepithelioma of the Palate: Histological Observations Compared to Benign Predominant Plasmacytoid Myoepithelial Cells in Pleomorphic Adenoma of the Palate,” Ultrastructuaral Pathology, Vol. 22, No. 2, 1998, pp. 153-160. doi:10.3109/01913129809032271
[24]	M. Guzzo, G. Cantu and S. Di Palma, “Malignant Myoepithelioma of the Palate: Report of Case,” Journal of Oral and Maxillofacical Surgery, Vol. 52, No. 10, 1994, pp. 1080-1082. doi:10.1016/0278-2391(94)90183-X
[25]	L. G. Patrocinio, P. G. Damasceno and J. A. Patrocinio, “Malignant Myoepithelioma of the HArd Palate: 9-Year Follow-Up,” Brazilian Journal of Otorhinolaryngology, Vol. 75, No. 4, 2009, p. 620. doi:10.1590/S1808-86942009000400025
[26]	R. Ibrahim, D. J. Bird and M. W. Sieler, “Malignant Myoepithelioma of the LArynx with Massive Metastatic Spread to the Liver: An Ultrastructural and Immunocytochemical Study,” Ultrastructural Pathology, Vol. 15, No. 1, 1991, pp. 69-76. doi:10.3109/01913129109021305
[27]	G. H. Yu, G. M. Qu, L. L. Kong, X. B. Pan, W. Wang and J. W. Lv, “Primary Myoepithelial Carcinoma of the Larynx: Case Report and Review of the Literature,” Pathology Research and Practice, Vol. 207, No. 2, 2011, pp. 127-130. doi:10.1016/j.prp.2010.10.006
[28]	K. Ramachandran, M. Venugopal, R. Suma and K. C. Naseer, “Malignant Myoepithelioma of the Parapharyngeal Space—A Case Report,” Indian Journal of Otolaryngology and Head & Neck Surgery, Vol. 60, No. 2, 2008, pp. 174-176. doi:10.1007/s12070-008-0042-9
[29]	G. Magliulo, G. Pulice, M. Fusconi and G. Cuiuli, “Malignant Myoepithelioma of the Rhinopharynx: Case Report,” Skull Base, Vol. 15, No. 2, 2005, pp. 113-116. doi:10.1055/s-2005-870596
[30]	R. Nilles, T. Lenartz and E. Kaiserling, “Myoepithelial Carcinoma of the Nasopharynx. Case Report and Review of the Literature,” HNO, Vol. 41, No. 8, 1993, pp. 396- 400.
[31]	F. Nofal, “Spindle Cell CArcinoma of the Nasopharynx,” The Journal of Laryngology and Otology, Vol. 97, No. 1, 1983, pp. 1057-1063. doi:10.1017/S0022215100095979
[32]	U. Tuncel, G. Ergul, S. Ozlugedik and A. Unal, “Myoepithelial Carcinoma in the Nasopharynx: An Unusual Localization,” Yonsei Medicine Journal, Vol. 45, No. 1, 2004, pp. 161-165.
[33]	M. Hata, K. Tokuuye, Y. Shioyama, S. Nomoto, Y. Inadome, N. Fukumitsu, H. Nakayama, et al., “Malignant Myoepithelioma in the Maxillary Sinus: Case Report and Review of the Literature,” Anticancer Research, Vol. 29, No. 2, 2009, pp. 497-501.
[34]	A. Dirier, A. Guzel, B. Karadayi, S. O. Ozekinci and M. Tatli, “Malignant Myoepithelioma of the External Auditory Canal: A Case Report,” International Journal of Clinical Practice, Vol. 63, No. 2, 2009, pp. 336-337. doi:10.1111/j.1742-1241.2006.01021.x
[35]	T. Terada, “Malignant Myoepithelioma of the Breast,” Pathology International, Vol. 61, No. 2, 2011, pp. 99-103. doi:10.1111/j.1440-1827.2010.02638.x
[36]	L. Hegyi, K. Thway, R. Newton, P. Osin, A. Nerurkar, A. J. Hayes and C. Fisher, “Malignant Myoepithelioma Arising in Adenomyoepithelioma of the Breast and Coincident Multiple Gastrointestinal Stromal Tumours in a Patient with Neurofibromatosis Type 1,” Journal of Clinical Pathology, Vol. 62, No. 7, 2009, pp. 653-655. doi:10.1136/jcp.2008.063628
[37]	Z. M. Fang, R. V. Tse, V. M. Marjoniemi, S. Kozlov, M. F. Lavin, H. Chen, J. H. Kearsley, et al., “Radioresistant Malignant Myoepithelioma of the Breast with High Level of Ataxia Telangiectasia Mutated Protein,” Journal of Medical Imaging and Radiation Oncology, Vol. 53, No. 2, 2009, pp. 234-239.
[38]	J. S. Park, K N. Ryu, C. S. Han and Y. K. Park, “Malignant Myoepithelioma of the Humerus with a Satellite Lesion: A Case Report and Literature Review,” British Journal of Radiology, Vol. 83, No. 991, 2010, pp. e161- e164. doi:10.1259/bjr/64670838
[39]	M. Alberghini, G. Pasquinelli, L. Zanella, G. Pignatti, S. Benini, P. Bacchini and F. Bertoni, “Primary Malignant Myoepithelioma of the Distal Femur,” APMIS, Vol. 115, No. 4, 2007, pp. 376-380. doi:10.1111/j.1600-0463.2007.apm_569.x
[40]	J. C. Clark, S. J. Galloway, S. M. Schlicht, R. P. McKellar and P. F. Choong, “Myoepithelioma within the Carpal Tunnel: A Case Report and Review of the Literature,” International Seminars in Surgical Oncology, Vol. 6, 2009, p. 15. doi:10.1186/1477-7800-6-15
[41]	Z. Stojsic, D. Brasanac, I. Boricic and D. Bacetic, “Clear Cell Myoepithelial Carcinoma of the Skin. A Case Report,” Journal of Cutaneous Pathology, Vol. 36, No. 6, 2009, pp. 680-683. doi:10.1111/j.1600-0560.2008.01095.x
[42]	M. S. Mukhina, N. A. Maksimova, N. S. Safina and I. A. Chizh, “Malignant VUlvar Soft Tissue Myoepithelioma,” Arkhiv Patolgii, Vol. 71, No. 2, 2009, pp. 18-19.
[43]	S. Lauro, L. Trasatti, G. Larosa, F. Calabretta, C. R. Di Gioia and A. Vecchione, “Myoepithelial Carcinoma of Parotid Gland: A Case Report,” Anticancer Research, Vol. 23, No. 3C, 2003, pp. 3041-3044.
[44]	S. Di Palma, S. Pilotti and F. Rilke, “Malignant Myoepithelioma of the Parotid Gland Arising in a Pleomorphic Adenoma,” Histopathology, Vol. 19, No. 3, 1991, pp. 273-275. doi:10.1111/j.1365-2559.1991.tb00034.x
[45]	S. Di Palma and M. Guzzo, “Myoepithelial Carcinoma with Predominance of Plasmacytoid Cells Arising in a Pleomorphic Adenoma of the Parotid Gland,” Histopathology, Vol. 33, No. 5, 1998, p. 485. doi:10.1046/j.1365-2559.1998.0491b.x
[46]	J. Li, Z. Tian, M. Brandwein-Gensler, H. Y. Pan, L. Li, A. R. Liu, “De Novo Salivary Malignant Myoepithelioma: Pathologic Diagnosis of 19 Cases,” Chinese Journal of Stomatology, Vol. 39, No. 4, 2004, pp. 287-290.
[47]	A. T. Savera, A. Sloman, A. G. Huvos and D. S. Klimstra, “Myoepithelial Carcinoma of the Salivary Glands: A Clinicopathologic Study of 25 Patients,” The American Journal of Surgical Pathology, Vol. 24, No. 6, 2000, pp. 761- 774. doi:10.1097/00000478-200006000-00001
[48]	I. Dardick, S. Cavell, M. Boivin, D. Hoppe, W. R. Parks, J. Stinson, S. Yamada, et al., “Salivary Gland Myoepithelioma Variants Histological, Ultrastructural and Immunocytological Features,” Virchows Archiv, Vol. 416, No. 1, 1989, pp. 25-42. doi:10.1007/BF01606467
[49]	F. Darvishian and O. Lin, “Myoepithelial Cell-Rich Neoplasms: Cytologic Features of Benign and Malignant Lesions,” Cancer, Vol. 102, No. 6, 2004, pp. 355-361. doi:10.1002/cncr.20642
[50]	M. H. Maurer, S. Gartenschlager, C. Dietrich, “Giant Epithelial-Myoepithelial Carcinoma of the Parotid Gland,” Clinical Imaging,Vol. 33, No. 3, 2009, pp. 237-239. doi:10.1016/j.clinimag.2008.11.013
[51]	S. Wang, H. Shi, L. Wang and Q. Yu, “Myoepithelioma of the Parotid Gland: CT Imaging Findings,” American Journal of Neuroradiology, Vol. 29, No. 7, 2008, pp. 1372-1375. doi:10.3174/ajnr.A1109
[52]	M. W. Lee, S. Y. Nam, H. J. Choi, J. H. Choi, K. C. Moon and J. K. Koh, “Myoepithelioma of Parotid Gland Presenting as Infra-Auricular Subcutaneous Mass,” Journal of Cutaneous Pathology, Vol. 32, No. 3, 2005, pp. 240-244. doi:10.1111/j.0303-6987.2005.00293.x
[53]	M. Jain, S. Thomas and S. Singh, “Epithelial Myoepithelial Carcinoma of Minor Salivary Gland-Low Grade Malignant Tumor Presenting with Nodal Metastasis,” Indian Journal of Pathology and Microbiology, Vol. 49, No. 3, 2006, pp. 399-401.
[54]	S. Di Palma and M. Guzzo, “Malignant Myoepithelioma of Salivary Glands: Clinicopathological Features of Ten Cases,” Virchows Arch, Vol. 423, No. 50, 1993, pp. 389-396. doi:10.1007/BF01607152
[55]	L. Alos, A. Cardesa, J. A. Bombi, C. Mallofre, A. Cuchi and J. Traserra, “Myoepithelial Tumours of Salivary Glands: A Clinicopathologic, Immunohistochemical, Ultrastructural and Flow-Cytometric Study,” Seminars in Diagnostic Pathology, Vol. 13, No. 2, 1996, pp. 138-147