Epithelial-myoepithelial carcinoma of the submandibular gland: a case report

Yıl 2007, Cilt: 17 Sayı: 3, 167 - 170, 23.05.2007

Alper Nabi Erkan Nebil Bal Fatma Çaylaklı Fikret Kıroğlu

Öz

Epithelial-myoepithelial carcinomas are rare, low- grade, malignant salivary gland tumors. They are mostly seen in the parotid gland. The submandibular gland is a rare localization. A 54-year-old woman presented with a painless lump on the left side of the neck. Examination showed a mass with smooth sur- face in the left submandibular region. Fine needle aspiration cytology of the mass was reported as malignant epithelial tumor metastasis. Computed tomography of the neck showed left submandibular gland hypertrophy. Left submandibular gland exci- sion with functional neck dissection was performed.The histopathological diagnosis was epithelial- myoepithelial carcinoma of the submandibular gland with one lymph node metastasis. Postoperative radiotherapy was administered. There was no evi- dence for recurrence during a two-year follow-up.

Anahtar Kelimeler

Diagnosis, differential, myoepithelioma/pathology, salivary gland neoplasms/pathology, submandibular gland neoplasms/pathology

Submandibuler bezde epitelyal-miyoepitelyal karsinom: Olgu sunumu

Öz

Epitelyal-miyoepitelyal karsinomlar nadir görülen, malign karakterli, düşük dereceli tükürük bezi tümör- leridir. En sık parotis bezinde görülen bu tümörlerin submandibuler bezde gelişimi nadirdir. Boyun sol ta- rafında ağrısız şişlik yakınmasıyla başvuran 54 ya- şındaki kadın hastanın KBB muayenesinde sol sub- mandibuler bölgede düzgün yüzeyli şişlik saptandı. Bu şişlikten yapılan ince iğne aspirasyon sitolojisi malign epitelyal tümör metastazı olarak bildirildi ve boyun tomografisinde sol submandibuler bezde bü- yüme saptandı. Hastaya sol submandibuler bez ek- sizyonu ile birlikte fonksiyonel boyun diseksiyonu ya- pıldı. Histopatoloji sonucu submandibuler bezin epi- telyal-miyoepitelyal karsinomu olarak bildirilen ve bir adet lenf nodu metastazı saptanan hastaya ameliyat sonrası radyoterapi uygulandı. İki yıllık takiplerde hastada herhangi bir nükse rastlanmadı

Anahtar Kelimeler

Ayırıcı tanı, miyoepitelyoma/patoloji, tükürük bezi tümörleri/patoloji, submandibuler bez neoplazileri/patoloji

Kaynakça

• Seifert G, Sobin LH, editors. Epithelial-myoepithelial carcinoma. In: World Health Organization International Histological Classification of Tumours. Histological typ- ing of salivary gland tumours. 2nd ed. Berlin: Springer- Verlag; 1991. p. 23-4.
• Donath K, Seifert G, Schmitz R. Diagnosis and ultra- structure of the tubular carcinoma of salivary gland ducts. Epithelial-myoepithelial carcinoma of the inter- calated ducts. [Article in German] Virchows Arch A Pathol Pathol Anat 1972;356:16-31.
• Ellis GL, Auclair PL. Tumors of the salivary glands. In: Rosai J, Sobin LH, editors. Atlas of tumor pathology. Series 3. Washington DC: Armed Forces Institute of Pathology; 1995. p. 228-238, 268-281.
• Fonseca I, Soares J. Epithelial-myoepithelial carcinoma of the salivary glands. A study of 22 cases. Virchows Arch A Pathol Anat Histopathol 1993;422:389-96.
• Noel S, Brozna JP. Epithelial-myoepithelial carcinoma of salivary gland with metastasis to lung: report of a case and review of the literature. Head Neck 1992;14:401-6.
• Arora VK, Misra K, Bhatia A. Cytomorphologic fea- tures of the rare epithelial-myoepithelial carcinoma of the salivary gland. Acta Cytol 1990;34:239-42.
• Palmer RM. Epithelial-myoepithelial carcinoma: an immunocytochemical study. Oral Surg Oral Med Oral Pathol 1985;59:511-5.
• Tralongo V, Daniele E. Epithelial-myoepithelial carci- noma of the salivary glands: a review of literature. Anticancer Res 1998;18(1B):603-8.
• Tas A, Yagiz R, Altaner S, Koten M, Karasalihoglu AR. A case of epithelial-myoepithelial carcinoma of the parotid gland. Kulak Burun Bogaz Ihtis Derg 2003;10:171-4.
• Nistal M, Garcia-Viera M, Martinez-Garcia C, Paniagua R. Epithelial-myoepithelial tumor of the bronchus. Am J Surg Pathol 1994;18:421-5.
• Ostrowski ML, Font RL, Halpern J, Nicolitz E, Barnes R. Clear cell epithelial-myoepithelial carcinoma aris- ing in pleomorphic adenoma of the lacrimal gland. Ophthalmology 1994;101:925-30.
• Horinouchi H, Ishihara T, Kawamura M, Kato R, Kikuchi K, Kobayashi K, et al. Epithelial myoepithelial tumour of the tracheal gland. J Clin Pathol 1993;46:185-7.
• Luna MA, Batsakis JG, Ordonez NG, Mackay B, Tortoledo ME. Salivary gland adenocarcinomas: a clin- icopathologic analysis of three distinctive types. Semin Diagn Pathol 1987;4:117-35.
• Kaneko H, Muramatsu T, Ogiuchi H, Shimono M. Epithelial-myoepithelial carcinoma arising in the sub- mandibular gland: a case report with immunohisto- chemical study. J Oral Maxillofac Surg 2000;58:98-102.
• Corio RL, Sciubba JJ, Brannon RB, Batsakis JG. Epithelial-myoepithelial carcinoma of intercalated duct origin. A clinicopathologic and ultrastructural assessment of sixteen cases. Oral Surg Oral Med Oral Pathol 1982;53:280-7.
• Cramer H, Layfield L, Lampe H. Fine needle aspiration of salivary gland lesions. In: Schmidt WA, editor. Cytopathology annual. New York: Williams & Wilkins; 1993. p. 181-206.
• Deere H, Hore I, McDermott N, Levine T. Epithelial- myoepithelial carcinoma of the parotid gland: a case report and review of the cytological and histological features. J Laryngol Otol 2001;115:434-6.
• Batsakis JG, el-Naggar AK, Luna MA. Epithelial- myoepithelial carcinoma of salivary glands. Ann Otol Rhinol Laryngol 1992;101:540-2.
• Lau DP, Goddard MJ, Bottrill ID, Moffat DA. Epithelial-myoepithelial carcinoma of the parotid gland. An unusual cause of ear canal stenosis. J Laryngol Otol 1996;110:493-5.
• Kaya S. Tükrük bezi hastalıkları. 1. baskı. Ankara: Gü- neş Kitabevi; 1997.
• Simpson RH, Clarke TJ, Sarsfield PT, Gluckman PG. Epithelial-myoepithelial carcinoma of salivary glands. J Clin Pathol 1991;44:419-23.
• Hamper K, Brugmann M, Koppermann R, Caselitz J, Arps H, Askensten U, et al. Epithelial-myoepithelial duct carcinoma of salivary glands: a follow-up and cytophotometric study of 21 cases. J Oral Pathol Med 1989;18:299-304.