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Virchows Archiv A

, Volume 423, Issue 5, pp 389–396 | Cite as

Malignant myoepithelioma of salivary glands: Clinicopathological features of ten cases

  • Silvana Di Palma
  • Marco Guzzo
Case Reports

Abstract

Malignant myoepithelioma of the salivary gland is discussed in terms of its clinical behaviour, morphological features and the frequent pre-existence of a pleomorphic adenoma. The study comprised six female and four male patients aged 14–63 years (mean age 38.9 years). Two tumours presented as intraoral lesions and eight were located in the parotid gland. Tumour cells displayed a morphological spectrum ranging from round epithelioid cells to spindle-shaped and stellate cells. Most cells displayed reactivity for high molecular weight keratins and in four tumours there was strong immunoreactivity for smooth muscle actin. Malignant myoepithelioma seems to arise in two different clinical settings: either de novo or in a recurrent pleomorphic adenoma. De novo malignant myoepitheliomas arise in normal salivary gland, tend to be more aggressive and have a short clinical history. Recurrences may not develop or may occur as a single event within a short time interval, and métastases develop in the lungs. Malignant myoepitheliomas arising in recurrent pleomorphic adenomas have a long clinical history, are characterized by multiple recurrences and have to be distinguished from aggressive carcinomas arising in these adenomas. In contrast, the tumours described in the present series arising in pleomorphic adenomas showed local aggressiveness and metastases did not occur until decades after the first treatment. The general opinion that all malignant tumours that arise from pleomorphic adenomas are highly aggressive is not confirmed by the present study.

Key words

Malignant myoepithelioma Pleomorphic adenoma Myoepithelial cell 

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References

  1. Barnes L, Appel BN, Perez H, El-Attar AM (1985) Myoepitheliomas of the head and neck: case report and review. J Surg Oncol 28:21–28Google Scholar
  2. Batsakis JG (1985) Myoepithelioma. Ann Otol Rhinol Laryngol 94:523–524Google Scholar
  3. Chaudhry AP, Satchidanand S, Peer R, Cutler LS (1982) Myoepithelial cell adenoma of the parotid gland: a light and ultrastructural study. Cancer 49:288–293Google Scholar
  4. Crissman JD, Wirman JA, Harris A (1977) Malignant myoepithelioma of the parotid gland. Cancer 40:3042–3049Google Scholar
  5. Dardick I (1985) Malignant myoepithelioma of parotid salivary gland. Ultrastruct Pathol 9:163–168Google Scholar
  6. Dardick I, Cavell S, Boivi M, et al (1989a) Salivary gland myoepithelioma variants. Histological, ultrastructural, and immunocytological features. Virchows Arch [A] 416:25–42Google Scholar
  7. Dardick I, Thomas MJ, Nostrand AWP van (1989 b) Myoepithelioma — new concepts of histology and classification. A light and electron microscopic study. Ultrastruct Pathol 13:187–224Google Scholar
  8. Di Palma S, Pilotti S, Rilke F (1991) Malignant myoepithelioma of the parotid gland arising in a pleomorphic adenoma. Histopathology 19:273–275Google Scholar
  9. El-Naggar A, Batsakis JG, Luna MA, Goepfert H, Tortoledo ME (1989) DNA content and proliferative activity of myoepithelioma. J Laryngol Otol 103:1192–1197Google Scholar
  10. Franquemont DW, Mills SE (1993) Plasmacytoid monomorphic adenoma of the salivary glands. Absence of myogenous differentiation and comparison to spindle cell myoepithelioma. Am J Surg Pathol 17:146–153Google Scholar
  11. Herrera GA (1990) Light microscopic, ultrastructural and immunocytochemical spectrum of malignant lacrimal and salivary gland tumors, including malignant mixed tumors. Pathobiology 58:312–322Google Scholar
  12. Ibrahim R, Bird DJ, Sieler MW (1990) Malignant myoepithelioma of the larynx with massive metastatic spread to the liver: an ultrastructural and immunocytochemical study. Ultrastruct Pathol 15:69–76Google Scholar
  13. Khan LB, Schoub LS (1973) Myoepithelioma of the palate. Histochemical and ultrastructural observations. Arch Pathol 95:209–212Google Scholar
  14. Leifer C, Miller AS, Putong PB, Harwick RD (1974) Myoepithelioma of the parotid gland. Arch Pathol 98:312–319Google Scholar
  15. Lins JEW, Gnepp DR (1986) Myoepithelioma of the palate in a child. Int J Pediatr Otorhinolarnygol 11:5–13Google Scholar
  16. LiVolsi VA, Perzin KH (1977) Malignant mixed tumors arising in salivary glands. I. Carcinomas arising in benign mixed tumors: a clinicopathologic study. Cancer 39:2209–2230Google Scholar
  17. Luna MA, Mackay B, Gamez-Araujo J (1973) Myoepithelioma of the palate. Report of a case with histochemical and electron microscopic observations. Cancer 32:1429–1435Google Scholar
  18. Moberger JG, Eneroth C-M (1968) Malignant mixed tumor of the salivary glands: special reference to the histological structure in metastases. Cancer 21:1198–1211Google Scholar
  19. Nagao K, Matsuzaki O, Saiga H, et al (1981) Histopathologic studies on carcinoma in pleomorphic adenoma of the parotid gland. Cancer 48:113–121Google Scholar
  20. Nesland JM, Olafsson J, Sobrinho-Simoes M (1981) Plasmacytoid myoepithelioma of the palate. A case report with ultra-structural findings and review of the literature. J Oral Pathol 10:14–21Google Scholar
  21. Sciubba JJ, Brannon RB (1982) Myoepithelioma of salivary glands: report of 23 cases. Cancer 49:562–572Google Scholar
  22. Sciubba JJ, Goldstein BH (1976) Myoepithelioma. Review of the literature and report of a case with ultrastructural confirmation. Oral Surg 42:328–338Google Scholar
  23. Seifert G (1991) World Health Organization international histological classification of tumours. Histological typing of salivary gland tumours, 2nd edn. Springer, Berlin Heidelberg New YorkGoogle Scholar
  24. Singh R, Cawson RA (1988) Malignant myoepithelial carcinoma (myoepithelioma) arising in a pleomorphic adenoma of the parotid gland. An immunohistochemical study and review of the literature. Oral Surg Oral Med Oral Pathol 66:65–70Google Scholar
  25. Spiro RH, Huvos AG, Strong EW (1977) Malignant mixed tumor of salivary origin. A clinicopathologic study of 146 cases. Cancer 39:388–396Google Scholar
  26. Stromeyer FW, Haggitt RC, Nelson JF, Hardman JM (1975) Myoepithelioma of minor salivary gland origin. Light and electron microscopical study. Arch Pathol 99:242–245Google Scholar
  27. Takeda Y (1992) Malignant myoepithelioma of minor salivary gland origin. Acta Pathol Jpn 42:518–522Google Scholar
  28. Tanimura A, Nakamura Y, Nagayama K, Tanaka S, Hashisuka H (1985) Myoepithelioma of the parotid gland. Report of two cases with immunohistochemical technique for S-100 protein and electron microscopic observation. Acta Pathol Jpn 35:409–417Google Scholar
  29. Thompson SH, Bender S, Richards A (1985) Plasmacytoid myoepithelioma of a minor salivary gland. J Oral Maxillofac Surg 43:285–288Google Scholar
  30. Tortoledo ME, Luna MA, Batsakis JG (1984) Carcinomas ex pleomorphic adenoma and malignant mixed tumors. Arch Otolaryngol 110:172–176Google Scholar
  31. Toto PD, Hsu D-J (1986) Product definition in a case of myoepithelioma. Oral Surg Oral Med Oral Pathol 62:169–174Google Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • Silvana Di Palma
    • 1
  • Marco Guzzo
    • 2
  1. 1.Division of Anatomic Pathology and CytologyIstituto Nazionale per lo Studio e la Cura dei TumoriMilanItaly
  2. 2.Head and Neck Surgical Oncology DivisionIstituto Nazionale per lo Studio e la Cura dei TumoriMilanItaly

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