Abstract
Mucoepidermoid carcinoma is the most common malignant tumor of the parotid gland. Its clinical behavior is determined by the relative ratio of mucous and epidermoid cells with pathologic high-grade tumors containing a greater proportion of epidermoid cells. Sclerosing mucoepidermoid carcinoma is a rarely reported variant with unclear long-term clinical behavior. A 23-year-old female was found to have a deep lobe parotid mass on imaging studies. Preoperative evaluation was non-diagnostic. Intraoperatively, the tumor was found to be adherent to the lower division of the facial nerve and portions of the posterior digastric muscle. Frozen section specimens showed only squamous metaplasia with background inflammatory fibrosis. Final pathological analysis demonstrated multiple solid and cystic nests and glands within a background of dense, sclerotic, collagenized stroma and inflammatory infiltrate consistent with low-grade sclerosing mucoepidermoid carcinoma. Sclerosing mucoepidermoid carcinoma is a very rare salivary gland tumor with uncertain behavior. Complete surgical excision with tumor-free margins with preservation of the facial nerve (in the absence of clinical invasion) is recommended. Postoperative radiation therapy is suggested for positive or close margins given the adherent nature of the tumor and the risk of recurrence and distant disease found in some case reports. Patients should be followed closely with serial MRI imaging studies of the tumor bed with complete clinical evaluation of the regional lymphatics and chest to evaluate for evidence of recurrence or metastasis.
Similar content being viewed by others
References
Abrams AM, Melrose RJ, Howell FV (1973) Necrotizing sialometaplasia. Cancer 32:130–135
Aydin O, Yilmaz T, Ozer F, Sarac S, Sokmensuer (2002) Necrotizing sialometaplasia of parotid gland: a possible vasculitic cause. Int J Pediatr Otorhinolaryngol 64:171–174
Chan JK, Saw D (1987) Sclerosing mucoepidermoid tumor of the parotid gland: report of a case. Histopathology 11:203–207
Chan JK, Albores-Saavedra J, Battifora H, Carcangiu ML, Rosai J (1991) Sclerosing mucoepidermoid thyroid carcinoma with eosinophilia. Am J Surg Pathol 15:438–448
Chung J, Lee SK, Gong G, Kang DY, Park JH, Kim SB, Ro JY (1999) Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid glands: a case report with clinical manifestation of recurrent neck mass. J Korean Med Sci 14:338–341
Fadare O, Hileeto D, Gruddin YL, Mariappan MR (2004) Sclerosing mucoepidermoid carcinoma of the parotid gland. Arch Pathol Lab Med 128:1046–1049
Favia G, Pratelli D, Maiorano E (1996) Necrotizing sialometaplasia. The clinico-pathological analysis of 6 cases. Minerva Stomatol 45:121–127
Hanna EY, Suen JY (1998) Salivary gland neoplasms. In: Cummings CW, Fredrickson JM, Harker LA, Krause CJ, Schuller DE (eds) Otolaryngology—head and neck surgery, 3rd edn. Mosby, St. Louis, p 1255
Hunt JL, LiVolsi VA, Barnes EL (2004) p63 Expression in sclerosing mucoepidermoid carcinoma with eosinophilia arising in the thyroid. Mod Pathol 17:526–529
Johns ME, Goldsmith MM (1989) Incidence, diagnosis, and classification of salivary gland tumors. Oncology 3:47–56
Muller S, Barnes L, Goodurn J (1997) Sclerosing mucoepidermoid carcinoma of the parotid. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 83:685–690
Rice DH (1999) Malignant salivary gland neoplasms. Otolaryngol Clin North Am 32:875–885
Sandmeier D, Bouzourene H (2002) Necrotizing sialometaplasia: a potential pitfall. Histopathology 40:200–206
Shehadeh NJ, Vernick J, Lonardo F, Madan SK, Jacobs JR, Yoo GH, Kim HE, Ensley JF (2004) Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid: a case report and review of the literature. Am J Otolaryngol 25:48–53
Sim SJ, Ro JY, Ordonez NG, Cleary KR, Ayala AG (1997) Sclerosing mucoepidermoid carcinoma with eosinophilia of the thyroid: report of two patients, one with distant metastasis, and review of the literature. Hum Pathol 28:1091–1096
Sinha SK, Keogh IJ, Russell JD, O’Keane JC (1999) Sclerosing mucoepidermoid carcinoma of minor salivary glands: a case report. Histopathology 35:279–287
Solomon AC, Baloch ZW, Salhany KE, Mandel S, Weber RS, LiVolsi VA (1999) Thyroid sclerosing mucoepidermoid carcinoma with eosinophilia. Arch Pathol Lab Med 124:446–449
Urano M, Abe M, Horibe Y, Kuroda M, Mizoguchi Y, Sakurai K, Naito K (2002) Sclerosing mucoepidermoid carcinoma with eosinophilia of the salivary glands. Pathol Res Pract 198:305–310
Author information
Authors and Affiliations
Corresponding author
Additional information
There is no grant support for this project. This report has not been presented at any scientific meeting.
Rights and permissions
About this article
Cite this article
Heavner, S.B., Shah, R.B. & Moyer, J.S. Sclerosing mucoepidermoid carcinoma of the parotid gland. Eur Arch Otorhinolaryngol 263, 955–959 (2006). https://doi.org/10.1007/s00405-006-0088-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00405-006-0088-9