Misinterpreted Myoepithelial Carcinoma of Salivary Gland: A Challenging and Potentially Significant Pitfall

The American Journal of Surgical Pathology
Bin XuNora Katabi

Abstract

Myoepithelial carcinoma (MECA) is an underrecognized challenging entity with a broad morphologic spectrum. Misinterpreting MECA is not uncommon as distinguishing it from its mimics, especially cellular myoepithelial-rich pleomorphic adenoma (PA), can be difficult. We described 21 histologically challenging cases of MECAs (16 MECA ex-PA and 5 MECA de novo). All MECAs ex-PA were intracapsular or minimally invasive except for 3 cases. Eighteen (86%) were initially misinterpreted as benign neoplasms, including PA (10), atypical PA (5), and myoepithelioma (3). The remaining 3 were initially diagnosed as malignant (MECA ex-PA) but were histologically challenging. Histologic features that were found most helpful in recognizing the malignant nature of MECA included: uniformly cellular myoepithelial proliferation with an expansile nodular lobulated pattern (all cases) and alternate hypocellular and hypercellular zonal distribution (76% of cases). Among the 16 MECA patients with follow-up, 14 (87.5%) progressed: 10 developed local recurrence and 5 distant metastases. In contrast, only one of 33 patients with cellular PA (control group) recurred locally. Ten of the 14 MECAs that progressed were MECA ex-PA, and 12 (85%) had an initial beni...Continue Reading

References

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May 15, 2015·The American Journal of Surgical Pathology·Max KongNora Katabi

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Citations

Dec 12, 2020·Critical Reviews in Oncology/hematology·João Figueira ScariniFernanda Viviane Mariano
Feb 3, 2021·Surgical Pathology Clinics·Bin Xu, Nora Katabi
Feb 3, 2021·Surgical Pathology Clinics·Nora Katabi, Bin Xu
Dec 29, 2020·Histopathology·Juan C Hernandez-PreraBruce M Wenig
May 26, 2021·Cytopathology : Official Journal of the British Society for Clinical Cytology·Yonca KanberManon Auger
Jan 23, 2022·Head and Neck Pathology·Zuzanna GorskiJason K Wasserman

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