Warthin-like Mucoepidermoid Carcinoma of the Parotid Gland: Unusual Morphology and Diagnostic Pitfalls
Autor: | Reid G. Meyer, Yaoyun Tang, Xiaoyan Liao, Jinping Lai, Dongwei Zhang, Mohammed N. Islam, Xiuli Liu, Daniel L. Van Dyke |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male Cancer Research Pathology medicine.medical_specialty Biopsy Fine-Needle Diagnosis Differential 03 medical and health sciences Cytokeratin 0302 clinical medicine Predictive Value of Tests Mucoepidermoid carcinoma Mucicarmine stain Biomarkers Tumor medicine Humans In Situ Hybridization Fluorescence Neoplasm Staging medicine.diagnostic_test business.industry Warthin Tumor General Medicine Parotidectomy Cystic Change Adenolymphoma medicine.disease Immunohistochemistry Parotid Neoplasms Parotid gland stomatognathic diseases Treatment Outcome medicine.anatomical_structure Oncology 030220 oncology & carcinogenesis Carcinoma Mucoepidermoid Tomography X-Ray Computed business Fluorescence in situ hybridization |
Zdroj: | Anticancer Research. 39:3213-3217 |
ISSN: | 1791-7530 0250-7005 |
Popis: | Background Warthin-like mucoepidermoid carcinoma is a newly recognized rare entity and could be misdiagnosed as a benign Warthin tumor. We report such a case of a 36-year-old male who presented with a left parotid gland mass. Case report Fine-needle aspiration showed features suggestive of Warthin tumor. Following parotidectomy, grossly there was a 1.6 cm well-circumscribed multilobular mass with focal areas of cystic change. Microscopically, at low magnification it had histological features resembling Warthin tumor, while lining with squamoid cells with scattered mucocytes demonstrating mild cytologic atypia was observed at high magnification. Immunohistochemically, the tumor cells were positive for p40, p63, cytokeratin 5/6, cytokeratin 7, and cancer antigen 125, but negative for discovered on GIST-1 (DOG1). Mucicarmine stain highlighted intracellular mucin within mucocytes. Rearrangement of mastermind like transcriptional coactivator 2 (MAML2) (11q21) gene was shown to be present in tumor cells by fluorescence in situ hybridization, supporting the diagnosis of a low-grade Warthin-like mucoepidermoid carcinoma. The patient was disease-free 12 months after surgery. Conclusion Warthin-like mucoepidermoid carcinoma has not been widely recognized and can be misdiagnosed as Warthin tumor. Testing for MAML2 rearrangement provides essential support for diagnosis in difficult cases. |
Databáze: | OpenAIRE |
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