Myoepithelial carcinoma arising in a pleomorphic adenoma of the parotid gland: report of a case with cytopathologic findings

Acta Cytologica
Anil V ParwaniSyed Z Ali

Abstract

Carcinoma arising in a mixed tumor, or carcinoma ex pleomorphic adenoma (CEPA), is an uncommon primary salivary gland neoplasm. Among the various types of carcinomas that can be seen histologically in a CEPA, myoepithelial carcinoma is one of the rarest forms. A 76-year-old woman presented with an incidental parotid/parapharyngeal mass. Computed tomography-guide fine needle aspiration (FNA) showed a biphasic neoplasm with epithelial and stromal components consistent with pleomorphic adenoma (PA). However, in addition, a distinct population of discohesive atypical and pleomorphic cells with high nuclear/cytoplasmic ratio was noted in the background. In the cytopathologic diagnosis a suspicion was raised about a possible CEPA. Subsequent resection of the parotid mass confirmed the presence of low grade myoepithelial carcinoma arising in a PA. Although uncommon, CEPA should be suspected on FNA when atypical cytomorphologic characteristics are observed. In rare cases a myoepithelial carcinoma also arises in a preexisting PA, necessitating an accurate interpretation for more definitive therapy.

Citations

Aug 11, 2019·Diagnostic Cytopathology·Mana Taweevisit, Paul S Thorner
Nov 26, 2016·Innate Immunity·James M BattistiMichael F Minnick
Mar 1, 2012·Annals of Saudi Medicine·Emad RaddaouiSaleh F Al-Dhahri
Feb 3, 2021·Cytopathology : Official Journal of the British Society for Clinical Cytology·Felicia-Elena MargineanJerzy Klijanienko

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