High-Grade Mucoepidermoid Carcinoma Ex-Pleomorphic Adenoma of the Parotid Gland: Case Report and Review of Literature


Background: Mucoepidermoid carcinoma ex-pleomorphic adenoma (MECxPA) is an extremely rare salivary gland malignancy. With only nine prior reported cases, this entity represents a challenging histopathological diagnosis. Methods: We present a case of a 71-year-old male with an enlarging left neck mass over several months. CT showed both a parapharyngeal space mass and a separate level II neck mass. Results: The patient underwent resection of the left parapharyngeal mass and ipsilateral selective level II-IV lymphadenectomy. The final pathologic diagnosis was metastatic high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma. Conclusions: We describe a novel presentation of high-grade mucoepidermoid carcinoma ex-pleomorphic adenoma as a metastatic parapharyngeal mass.

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A. Pollack, B. Paul, M. Sheu and G. Har-El, "High-Grade Mucoepidermoid Carcinoma Ex-Pleomorphic Adenoma of the Parotid Gland: Case Report and Review of Literature," International Journal of Otolaryngology and Head & Neck Surgery, Vol. 3 No. 1, 2014, pp. 9-13. doi: 10.4236/ijohns.2014.31003.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] B. Sergi, A. Limongelli, E. Scarano, A. R. Fetoni and G. Paludetti, “Giant Deep Lobe Parotid Gland Pleomorphic Adenoma Involving the Parapharyngeal Space. Report of Three Cases and Review of the Diagnostic and Therapeutic Approaches,” Acta Otorhinolaryngologica Italica, Vol. 28, No. 5, 2008, pp. 261-265.
[2] J. Rodriguez-Ciurana, C. Rodado, M. Saez and C. Bassas, “Giant Pleomorphic Adenoma Involving the Parapharyngeal Space: Report of a Case,” Journal of Oral and Maxillofacial Surgery, Vol. 58, No. 10, 2000, pp. 1184-1187.
[3] S. A. R. Nouraei, K. L. Hope, C. G. Kelly, N. R. McLean and J. V. Soames, “Carcinoma ex Benign Pleomorphic Adenoma of the Parotid Gland,” Plastic and Reconstructive Surgery, Vol. 116, No. 5, 2005, pp. 1206-1213.
[4] K. D. Olsen and J. E. Lewis, “Carcinoma ex Pleomorphic Adenoma: A Clinicopathologic Review,” Head Neck, Vol. 23, No. 9, 2001, pp. 705-712.
[5] J. Klijanieko, A. K. El-Naggar, V. Servois, J. Rodriguez, P. Validire and P. Vielh, “Mucoepidermoid Carcinoma ex Pleomorphic Adenoma: Nonspecific Preoperative Cytologic Findings in Six Cases,” Cancer, Vol. 84, No. 4, 1998, pp. 231-234.
[6] J. C. Jacobs, “Low Grade Mucoepidermoid Carcinoma ex Pleomorphic Adenoma: A Diagnostic Problem in Fine Needle Aspiration Biopsy,” Acta Cytologica, Vol. 38, No. 1, 1994, pp. 93-97.
[7] M. B. Pitman, “Mucoepidermoid Carcinoma ex Pleomorphic Adenoma of the Parotid Gland,” Acta Cytologica, Vol. 39, No. 3, 1995, pp. 604-606.
[8] M. W. Stanley and T. Lowhagen, “Mucin Production by Pleomorphic Adenomas of the Parotid Gland: A Cytologic Spectrum,” Diagnostic Cytopathology, Vol. 6, No. 1, 1990, pp. 49-52.
[9] M. A. Nance, R. R. Seethala, Y. Wang, et al., “Treatment and Survival Outcomes Based on Histologic Grading in Patients with Head and Neck Mucoepidermoid Carcinoma,” Cancer, Vol. 113, No. 8, 2008, pp. 2082-2089.
[10] S. Ghosh-Laskar, V. Murthy, T. Wadasadawala, et al., “Mucoepidermoid Carcinoma of the Parotid Gland: Factors Affecting Outcome,” Head Neck, Vol. 33, No. 4, 2011, pp. 497-503. http://dx.doi.org/10.1002/hed.21477

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