Mucoepidermoid carcinoma

Mucoepidermoid carcinoma (MEC)[1] is the most common type of minor salivary gland malignancy in adults. Mucoepidermoid carcinoma can also be found in other organs, such as bronchi, lacrimal sac,[2] and thyroid gland.

Mucoepidermoid carcinoma
Mucoepidermoid carcinoma 2 - very high mag.jpg
Micrograph of a mucoepidermoid carcinoma. FNA specimen. Pap stain.
SpecialtyOncology, Maxillofacial surgery, ENT surgery

Mucicarmine staining is one stain used by pathologist for detection.[3]

Signs and symptomsEdit

Presents as painless, slow-growing mass that is firm or hard. Most appear clinically as mixed tumors. Usually occurs at 30–50 years of age. More predilection towards female sex.[citation needed]

DiagnosisEdit

HistologyEdit

This tumor is not encapsulated and is characterized by squamous cells, mucus-secreting cells, and intermediate cells.[4]

Molecular biologyEdit

Mucoepidermoid carcinomas of the salivary and bronchial glands are characterized by a recurrent t(11;19)(q21;p13) chromosomal translocation resulting in a MECT1-MAML2 fusion gene.[5] The CREB-binding domain of the CREB coactivator MECT1 (also known as CRTC1, TORC1 or WAMTP1) is fused to the transactivation domain of the Notch coactivator MAML2.[6]

A possible association with papillomavirus has been reported.[7]

PrognosisEdit

Generally, there is a good prognosis for low-grade tumors, and a poor prognosis for high-grade tumors, however recent research have found reoccurring low grade tumors also have a poor prognosis.[8]

TreatmentEdit

Surgery is the recommended treatment for localised resectable disease.[9] When the tumour is incompletely resected (positive margins) post-operative radiotherapy gives local control comparable to a complete resection (clear margins).[10]

Sometimes when surgery is not possible due to extent of disease or if a patient is too frail for surgery, or declines surgery, palliative radiotherapy may be helpful. There has been a report of a case where low dose radiotherapy achieve disease response and control for more than 4 years.[11]

In patients with metastatic disease, chemotherapy response tends to be low (27% partial response rate) and short lived.[12]

EpidemiologyEdit

Occurs in adults, with peak incidence from 20–40 years of age. A causal link with cytomegalovirus (CMV) has been strongly implicated in a 2011 research.[13]

ReferencesEdit

  1. ^ Kalhor, Neda; Moran, Cesar A. (March 9, 2018). "Pulmonary mucoepidermoid carcinoma: diagnosis and treatment". Expert Review of Respiratory Medicine. 12 (3): 249–255. doi:10.1080/17476348.2018.1428563. PMID 29338644 – via PubMed.
  2. ^ Williams, Joanna D; Agrawal, Amit; Wakely, Paul E (2003). "Mucoepidermoid carcinoma of the lacrimal sac". Annals of Diagnostic Pathology. 7 (1): 31–4. doi:10.1053/adpa.2003.50005. PMID 12616472.
  3. ^ Baloch, Zubair W; Solomon, Alyson C; Livolsi, Virginia A (2000). "Primary Mucoepidermoid Carcinoma and Sclerosing Mucoepidermoid Carcinoma with Eosinophilia of the Thyroid Gland: A Report of Nine Cases". Modern Pathology. 13 (7): 802–7. doi:10.1038/modpathol.3880140. PMID 10912941.
  4. ^ Chenevert, Jacinthe; Barnes, Leon E; Chiosea, Simion I (2011). "Mucoepidermoid carcinoma: A five-decade journey". Virchows Archiv. 458 (2): 133–40. doi:10.1007/s00428-011-1040-y. PMID 21243374.
  5. ^ Chiosea, Simion I; Dacic, Sanja; Nikiforova, Marina N; Seethala, Raja R (2012). "Prospective testing of mucoepidermoid carcinoma for the MAML2 translocation: Clinical Implications". The Laryngoscope. 122 (8): 1690–4. doi:10.1002/lary.22419. PMID 22833306.
  6. ^ Behboudi, Afrouz; Enlund, Fredrik; Winnes, Marta; Andrén, Ywonne; Nordkvist, Anders; Leivo, Ilmo; Flaberg, Emilie; Szekely, Laszlo; Mäkitie, Antti; Grenman, Reidar; Mark, Joachim; Stenman, Göran (2006). "Molecular classification of mucoepidermoid carcinomas—Prognostic significance of the MECT1–MAML2 fusion oncogene". Genes, Chromosomes and Cancer. 45 (5): 470–81. doi:10.1002/gcc.20306. PMID 16444749.
  7. ^ Isayeva, Tatyana; Said-Al-Naief, Nasser; Ren, Zhiyong; Li, Rong; Gnepp, Douglas; Brandwein-Gensler, Margaret (2012). "Salivary Mucoepidermoid Carcinoma: Demonstration of Transcriptionally Active Human Papillomavirus 16/18". Head and Neck Pathology. 7 (2): 135–48. doi:10.1007/s12105-012-0411-2. PMC 3642267. PMID 23233027.
  8. ^ Rubin, Arielle; Davis, John; Jreije, Karim; Wu, Henry; Oppenheimer, Randy (2017). "Case Report: Recurrent Mucoepidermoid Carcinoma of the Tongue in Adult Female Patient with Lung Cancer". Clinical Medicine Insights: Ear, Nose and Throat. 10: 1179550617720462. doi:10.1177/1179550617720462. PMC 5513522. PMID 28757800.
  9. ^ Verma, Jonathan; Teh, Bin S; Paulino, Arnold C (2011). "Characteristics and outcome of radiation and chemotherapy-related mucoepidermoid carcinoma of the salivary glands". Pediatric Blood & Cancer. 57 (7): 1137–41. doi:10.1002/pbc.22978. PMID 21280198.
  10. ^ Hosokawa, Y; Shirato, H; Kagei, K; Hashimoto, S; Nishioka, T; Tei, K; Ono, M; Ohmori, K; Kaneko, M; Miyasaka, K; Nakamura, M (January 1999). "Role of radiotherapy for mucoepidermoid carcinoma of salivary gland". Oral Oncology. 35 (1): 105–11. doi:10.1016/s1368-8375(98)00053-0. PMID 10211318.
  11. ^ Vulpe, H; Giuliani, M; Goldstein, D; Perez-Ordonez, B; Dawson, LA; Hope, A (29 October 2013). "Long term control of a maxillary sinus mucoepidermoid carcinoma with low dose radiation therapy: a case report". Radiation Oncology (London, England). 8: 251. doi:10.1186/1748-717X-8-251. PMC 3829377. PMID 24165756.
  12. ^ Licitra, L; Cavina, R; Grandi, C; Palma, SD; Guzzo, M; Demicheli, R; Molinari, R (August 1996). "Cisplatin, doxorubicin and cyclophosphamide in advanced salivary gland carcinoma. A phase II trial of 22 patients". Annals of Oncology. 7 (6): 640–2. doi:10.1093/oxfordjournals.annonc.a010684. PMID 8879381.
  13. ^ Melnick, Michael; Sedghizadeh, Parish P; Allen, Carl M; Jaskoll, Tina (2012). "Human cytomegalovirus and mucoepidermoid carcinoma of salivary glands: Cell-specific localization of active viral and oncogenic signaling proteins is confirmatory of a causal relationship". Experimental and Molecular Pathology. 92 (1): 118–25. doi:10.1016/j.yexmp.2011.10.011. PMID 22101257.

External linksEdit

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