Document Detail

Epithelial-myoepithelial carcinoma with high grade transformation.
MedLine Citation:
PMID:  20679885     Owner:  NLM     Status:  MEDLINE    
Epithelial-myoepithelial carcinoma (EMC) is a rare salivary gland tumor of presumed intercalated duct origin with a low risk of metastasis and mortality. Factors shown to affect behavior include positive margins, vascular invasion, necrosis, and myoepithelial anaplasia. The latter category and dedifferentiated EMCs have been separated on the basis of presumed myoepithelial versus ductal origin, respectively. Three additional cases of typical EMC with transition to high-grade carcinoma are presented. Two of the tumors were stained with CAM5.2, 34betaE12, cytokeratin 14, p63, S100, calponin, smooth muscle actin, and muscle-specific actin. All tumors showed a gradual transition to a high-grade carcinoma from an EMC, each composed of clear cells even in the high-grade regions. One case also showed a discrete area with ductal lumina and another had plasmacytoid morphology. Squamous differentiation was seen in all cases as well. A consistent immunostaining pattern was not noted. Areas with focal lumina were diffusely positive for CAM5.2 only. Areas with clear cells showed patchy S100 positivity only, whereas cytokeratin 14 and 34betaE12-stained squamous pearls. The case with plasmacytoid morphology was diffusely positive for p63. No immunoexpression was noted with smooth muscle actin, muscle-specific actin, or calponin. It was not possible to convincingly separate the high-grade component in these cases into ductal dedifferentiated EMC versus myoepithelial. Recently, there has been a move to abandon the term "dedifferentiation" in favor of "high-grade transformation" in other salivary gland malignancies. We report these 3 such cases, review the literature and propose that these lesions be regarded as "EMC with high-grade transformation."
Paromita Roy; Martin J Bullock; Bayardo Perez-Ordoñez; Irving Dardick; Ilan Weinreb
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The American journal of surgical pathology     Volume:  34     ISSN:  1532-0979     ISO Abbreviation:  Am. J. Surg. Pathol.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-27     Completed Date:  2010-09-14     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7707904     Medline TA:  Am J Surg Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1258-65     Citation Subset:  IM    
Department of Pathology, University Health Network, Toronto, Ontario, Canada.
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MeSH Terms
Aged, 80 and over
Cell Transformation, Neoplastic
Lymph Nodes / pathology
Middle Aged
Myoepithelioma / metabolism,  pathology*,  surgery
Parotid Neoplasms / metabolism,  pathology*,  surgery
Tumor Markers, Biological / metabolism
Reg. No./Substance:
0/Tumor Markers, Biological

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