Benign parotid myoepithelioma with an initial diagnosis of malignancy. A case report
Abstract Introduction: The benign myoepithelioma is a rare tumor of the salivary glands. It is low grade and represents approximately 1% of the total benign lesions. Description: We present the case of a 48-year-old patient who visited the Otorhinolaryngology office for presenting a right parotid tumor. In fine needle aspiration, positivity is obtained for high-grade cystic adenoid carcinoma. Later in the histological study after the suprafacial parotidectomy, the lesion of benign myoepithelioma is diagnosed. Discussion: Fine needle aspiration for the cytological study is not very sensitive in these types of tumors, being able to give false positives and negatives, which make the myoepithelioma present a diagnostic security in the FNA around 75%. Why histological studies are needed when we observe how in the myoepithelioma a behavior similar to mixed tumor occurs, with absence of ductal structures and the existence of chromosomal alterations in 12q. Conclusions: The benign myoepithelioma can be confused by epi-myoepithelial carcinoma or with malignant myoepithelioma, presenting similarities with the latter.
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Ding J, Wang W, Peng W, Zhou X, Chen T. MRI and CT imaging characteristics of myoepithelioma of the parotid gland. Acta Radiol. 2016; 57:837-43.
https://doi.org/10.1177/0284185115609364
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https://doi.org/10.1053/joms.2001.28295
PMid:11732046
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Schneider V, Nobile A, Duvoisin B, Saglietti C, Bongiovanni M. Myoepithelioma of the parotid gland with extensive adipocytic metaplasia: Report of a case with intriguing aspects on fine needle aspiration and p63 immunohistochemical expression. Diagn Cytopathol. 2016;44:1090-3.
https://doi.org/10.1002/dc.23550
PMid:27474346
Tartaglione T, Botto A, Sciandra M, Gaudino S, Danieli L, Parrilla C, et al. Differential diagnosis of parotid gland tumours: which magnetic resonance findings should be taken in account? Acta Otorhinolaryngol Ital. 2015;35(5):314-20.
PMid:26824912 PMCid:PMC4720931
Torres Gomez FJ, Lag Asturiano E, Torres Olivera FJ, Villar Rodriguez JL. Mioepitelioma parotideo. Estudio citológico, histológico e imnunohistoquímico. Rev Esp Patol. 2004; 4: 437-42.
Weitzel M, Cohn JE, Spector H. Myoepithelioma of the Parotid Gland: A Case Report with Review of the Literature and Classic Histopathology. Case Rep Otolaryngol. 2017:4p. doi: 10.1155/2017/6036179.
https://doi.org/10.1155/2017/6036179
Chieng D, Paulino A: Cytology of the myoepithelial carcinoma of the salivary gland. Cancer. 2002;96: 36-42.
Ding J, Wang W, Peng W, Zhou X, Chen T. MRI and CT imaging characteristics of myoepithelioma of the parotid gland. Acta Radiol. 2016; 57:837-43.
https://doi.org/10.1177/0284185115609364
PMid:26508793
El Naggar A, Lovell M, Callender D. et al. Cytogenetic analysis of a primary salivary gland myoepit- helioma. Cancer Genet Cytogenet. 1999;113:9-53.
https://doi.org/10.1016/S0165-4608(98)00280-5
Fletcher C. Tumors of the salivary glands. En: Fletcher C. Diagnostic Histopathology of Tumours. 1a ed. London: Churchill Livingstone; 2000. p. 231-311.
Friedrich Reinhard E, Donath Karl. epithelial-myoepithelial carcinoma of the parotid gland with multiple distant metastases: A Case Report. J Oral Maxillofac Surg. 2000;58:690-4.
https://doi.org/10.1016/S0278-2391(00)90171-X
https://doi.org/10.1053/joms.2000.6223
Gnepp Douglas R. Diagnostic Surgical Pathology of the Head and Neck. 2a ed. London: WB. Saunder Company; 2009.
Harnsberger HR, Glastonbury CM, Michel MA, Koch BL. Diagnostic Imaging: Head and Neck. Amirsys. 2nd edition. 2011.
Inoue Yuko, Nomura Jouji, Hashimoto Masanori, Tagawa Toshiro. Epithelial myoepithelial carcinoma of the palate: a case report. J Oral Maxillofac Surg. 2001;59:1502-5.
https://doi.org/10.1053/joms.2001.28295
PMid:11732046
Li B, Yang H, Hong X, Wang Y, Wang F. Epithelial-myoepithelial carcinoma with highgrade transformation of parotid gland: A case report and literature review. Medicine. 2017; 96:88-9.
Schneider V, Nobile A, Duvoisin B, Saglietti C, Bongiovanni M. Myoepithelioma of the parotid gland with extensive adipocytic metaplasia: Report of a case with intriguing aspects on fine needle aspiration and p63 immunohistochemical expression. Diagn Cytopathol. 2016;44:1090-3.
https://doi.org/10.1002/dc.23550
PMid:27474346
Tartaglione T, Botto A, Sciandra M, Gaudino S, Danieli L, Parrilla C, et al. Differential diagnosis of parotid gland tumours: which magnetic resonance findings should be taken in account? Acta Otorhinolaryngol Ital. 2015;35(5):314-20.
PMid:26824912 PMCid:PMC4720931
Torres Gomez FJ, Lag Asturiano E, Torres Olivera FJ, Villar Rodriguez JL. Mioepitelioma parotideo. Estudio citológico, histológico e imnunohistoquímico. Rev Esp Patol. 2004; 4: 437-42.
Weitzel M, Cohn JE, Spector H. Myoepithelioma of the Parotid Gland: A Case Report with Review of the Literature and Classic Histopathology. Case Rep Otolaryngol. 2017:4p. doi: 10.1155/2017/6036179.
https://doi.org/10.1155/2017/6036179
Palomeque Vera, J. M., López De Huelva, E., Fernández Ruiz, E., Platero Sánchez-escribano, M., & Oliva Dominguez, M. (2018). Benign parotid myoepithelioma with an initial diagnosis of malignancy. A case report. Revista ORL, 10(3), 221–226. https://doi.org/10.14201/orl.18070
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