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Journal = Reports
Section = Otolaryngology

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6 pages, 1770 KiB  
Case Report
Parotid Epithelial–Myoepithelial Carcinoma, Lymph Node Metastasis After 9 Years: A Case Report
by Maria Rita Bianco, Cosimo Galletti, Antonino Maniaci, Giovanni Torrice and Eugenia Allegra
Reports 2024, 7(4), 99; https://doi.org/10.3390/reports7040099 - 15 Nov 2024
Viewed by 417
Abstract
Background and Clinical Significance: Epithelial–myoepithelial carcinoma (EMC) is a rare, low-grade malignant tumor of the salivary glands. It is characterized by a low malignancy potential, as indicated by its low rate of lymph node involvement and distant metastasis, and has a local [...] Read more.
Background and Clinical Significance: Epithelial–myoepithelial carcinoma (EMC) is a rare, low-grade malignant tumor of the salivary glands. It is characterized by a low malignancy potential, as indicated by its low rate of lymph node involvement and distant metastasis, and has a local recurrence rate of approximately 50%. Due to the rarity of EMC and the limited data available in the literature, there are no established treatment or follow-up guidelines. Case Presentation: We report the case of an 83-year-old man who presented with swelling in the left submandibular region, occurring 9 years following an initial diagnosis of EMC in the ipsilateral parotid gland. After radiological examinations and an ultrasound-guided fine-needle aspiration biopsy, the patient underwent surgical excision of the lesion with a histological diagnosis of recurrence/metastasis of low-grade epithelial–myoepithelial carcinoma. Conclusions: This is the first documented case of loco-regional lymph node metastasis 9 years after an initial diagnosis of EMC of the parotid gland. Based on our experience, EMC of the parotid gland, even when diagnosed at an early stage, seems to require a long follow-up period. Full article
(This article belongs to the Section Otolaryngology)
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Figure 1
<p>MRI image: a nodulation of approximately 2.3 × 1.6 cm is observed, solid with an internal central area showing fluid signal.</p>
Full article ">Figure 2
<p>H&amp;E-stained section. (<b>A</b>) (2 HPF magnification) shows an expansive, invasive nodular neoplasia characterized by bland central necrosis and hemorrhagic areas, surrounded by a hypercellular peripheral zone. (<b>B</b>) (40 HPF magnification) shows some histological and cytological details of neoplasia composed of myoepithelial epithelioid, plasmacytoid or spindle cell, single or aggregate in nests, or solid and trabecular structures.</p>
Full article ">Figure 3
<p>Immunohistochemical neoplasia panel of antibodies (10 HPF). (<b>A</b>) shows intense membrane cytokeratin 7 staining of the neoplastic cell. (<b>B</b>) shows cytoplasmatic smooth muscle actin staining of the neoplastic cell. (<b>C</b>) shows diffuse cytoplasmatic and nuclear S100 staining of the neoplastic cell.</p>
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