Alshammari Amjad, Aljufairi Eman, Alsayed Anwaar
Department of Pathology, Ministry of Health, Kingdom of Saudi Arabia.
Department of Pathology, King Hamad University Hospital, Kingdom of Bahrain.
J Surg Case Rep. 2022 Feb 21;2022(2):rjac039. doi: 10.1093/jscr/rjac039. eCollection 2022 Feb.
Mucoepidermoid carcinoma is the most common malignant tumour of salivary glands. Oncocytic variant is rare and could be mistaken for benign entities like oncocytoma and Warthin tumour on cytology. We present a case of a 67-year-old female presented with left parotid gland mass, which was diagnosed as a benign oncocytoma on cytologic examination. Later, the patient underwent left parotidectomy where the histologic examination revealed a malignant oncocytic mucoepidermoid carcinoma. The distinction between these entities is essential to get a proper management for the patient. On cytology alone, it is quite difficult to differentiate; however, histologic examination shows malignant features including infiltrative borders, lymphovascular invasion and perineural invasion excluding a benign tumour. The presence of mucin is an important clue to suspect oncocytic mucoepidermoid carcinoma. Ancillary studies can help reach a wright diagnose, as oncocytic mucoepidermoid carcinoma is positive for P63 and has MAML2 translocation.
黏液表皮样癌是唾液腺最常见的恶性肿瘤。嗜酸细胞变体罕见,在细胞学检查中可能被误诊为嗜酸细胞瘤和沃辛瘤等良性病变。我们报告一例67岁女性,表现为左侧腮腺肿块,细胞学检查诊断为良性嗜酸细胞瘤。后来,患者接受了左侧腮腺切除术,组织学检查显示为恶性嗜酸细胞黏液表皮样癌。区分这些病变对于患者的正确治疗至关重要。仅靠细胞学检查很难鉴别;然而,组织学检查显示出恶性特征,包括浸润性边界、脉管侵犯和神经周围侵犯,可排除良性肿瘤。黏液的存在是怀疑嗜酸细胞黏液表皮样癌的重要线索。辅助检查有助于做出正确诊断,因为嗜酸细胞黏液表皮样癌P63呈阳性且存在MAML2易位。