• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제37권6호
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• pp.505-509
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• 2011

Epithelial-myoepithelial carcinoma (EMC) is a low-grade malignant salivary gland neoplasm that was first described in 1972. EMC occurs in the older age group, there is a female predilection and mainly involves the parotid gland. Most authors recommend superficial parotidectomy as a treatment for low-grade malignant tumor in the superficial lobe of parotid gland. The treatment of epithelial-myoepithelial tumors typically includes surgical excision aimed at achieving a R0 resection. This paper reports a case of EMC of the parotid gland treated only by a conservational surgical excision. The lesion was exposed by the retromandibular approach and detached. After the parotid gland envelop was exposed, the mass was observed and was easy to remove due to capsulation. The preoperative diagnosis was a pleomorphic adenoma on the left parotid gland. The tumor was removed surgically with a conservative extracapsular dissection. The postoperative diagnosis was EMC, so superficial parotidectomy or radiation therapy was considered. Nevertheless, the patient was observed and no additional treatment was attempted because the patient was old and a successfully excision of the tumor had been achieved.

• 대한세포병리학회지
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• 제16권2호
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• pp.67-74
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• 2005

Although fine needle aspiration cytology (FNAC) has become one of the primary tools for diagnosing salivary gland lesions, some of these methods continue to confuse pathologists. The most common problems occur so-called basaloid neoplasms. Basal cell adenomas are frequently misdiagnosed as pleomorphic adenomas, and in worse cases, as adenoid cystic carcinomas. The cytologic diagnostic accuracy of basaloid neoplasms could be increased by a better understanding of the histology and the nature of the tumor cells. These are displayed well in aspiration smears. A consideration of differential points on the basis of the epithelial-stromal relationship is offered in this paper.

• 대한세포병리학회지
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• 제19권1호
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• pp.52-56
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• 2008

Epithelial-myoepithelial carcinoma (EMC) is a low grade malignant neoplasm that commonly occurs in the parotid gland. Recently, we investigated a case of EMC that occurred in the external auditory canal (EAC) in a 35-year-old male, and this tumor was initially diagnosed as pleomorphic adenoma. The difficulty associated with diagnosing EMC by aspiration cytology arises from both the rare incidence of this tumor and the overlapping spectrum of cytological features found in various salivary gland tumors, such as pleomorphic adenoma, basal cell adenoma and adenoid cystic carcinoma.

• 대한두개안면성형외과학회지
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• 제20권5호
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• pp.336-340
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• 2019

Myoepithelioma was recognized as a histological distinct entity by the World Health Organization (WHO) in 1991. Myoepithelial cells are believed to be of ectodermal origin. In salivary glands, the myoepithelial cells that surround the intercalated ducts are spindled, which is in contrast to the large stellate ones that envelop the acini. Myoepithelioma is a benign salivary gland tumor that consists entirely of myoepithelial cells. A 53-year-old man presented with a 1-year history of a painless mass originating from the right parotid gland. The mass grew rapidly reaching a size of approximately 6 cm. The patient had no facial paralysis. The authors performed right parotidectomy. Immunohistochemistry study of this tumor showed that it was positive for vimentin, positive for S-100, focally positive for pancytokeratin, and focally positive for p63 and that it had a Ki-67 labeling index (below 10%). Additionally, the tumor was negative for epithelial membrane antigen, negative for actin, negative for desmin, negative for CD34 and negative for anaplastic lymphoma kinase. The authors present a case of benign spindle cell myoepithelioma of the parotid gland in a 53-year-old man diagnosed after immunohistochemistry study, describing its importance, along with a brief review of the literature.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제28권1호
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• pp.1-12
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• 2006

Pleomorphic adenoma is the most common benign tumor in salivary glands, and occurred in frequency of 60% in parotid gland tumors, and 50% in submandibular gland tumors, and 25% in sublingual gland tumors. Histopathologically, pleomorphic adenoma is composed of epithelial cells and mesenchymal tissues, and called 'mixed tumor' because of morphological divergency. The cell structures of luminal area are composed of polyhedral and cuboidal secretory epithelial cells and modified myoepithelial cells around it, and mesenchymal tissue is composed of some myoepithelial cells and stromal tissue. In stromal tissue, myxoid change, chondroid change, or hyalinization can be seen even if bone tissue. In many studies, tumor cells of pleomorphic adenoma containing modified myoepithelial cell participate in synthesis of glycosaminoglycans. In this study, tissue sample of pleomorphic adenoma of human salivary gland were obtained from 20 surgical specimens, and all specimens were routinely fixed in 10% formalin and embedded. Serial 4-8${\mu}m$ thick sections were cut from paraffin blocks. The histopathologic evaluation was done with light microscopy. And, with immunohistochemical staining, characteristics of glycosaminoglycan were observed. And, for biochemical analysis of glycosaminoglycan, isolation of crude glycosaminoglycan from tumor tissue and immuno-blot analysis were carried out. With transmission electromicroscopy, tumor cells and biologic behavior of pleomorphic adenoma were observed with distribution and expression of glycosaminoglycan in tumor cells, The results were obtained as follows: 1. In immunohistochemical study, chondroitin 4-sulfate is highly postively stained in myxoid stromal tissue, and chondroitin 6-sulfate is highly positively stained in chondroid mesenchymal tissue, both glycosaminoglycans are positively stained in non-luminal cell of ductal area. 2. Dermatan sulfate and keratan sulfate is positively stained in periductal non-luminal tumor cells. 3. In immunohistochemical study, heparan sulfate is weakly stained in luminal cells and non-luminal cells around duct, and chondroid mesenchymal tissue. 4. In transmission electromicroscopic view, the tumor cells are composed of modified myoepithelial cells, and contain many microfilaments and well developed rough endoplasmic reticulum. 5. In Immuno-Blot analysis, the expression of glycosaminoglycans is expressed mostly in chondroitin 6-sulfate and chondroitin 4-sulfate. From the results obtained in this study, tumor cells of pleomorphic adenoma are composed of modified myoepithelial cells, and glycosaminoglycans of chondroitin 4-sulfate and chondroitin 6-sulfate mostly participate in the development of pleomorphic adenoma, but dermatan sulfate, keratan sulfate and heparan sulfate glycosaminoglycans were expressed variably.

• 대한두경부종양학회지
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• 제40권1호
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• pp.33-36
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• 2024

Pleomorphic adenoma (PA) is a commonly occurring benign tumor originating in the salivary glands. The incidence is mostly in the parotid glands (85%) followed by minor salivary glands (10%). Pleomorphic adenoma from minor salivary glands of the lips is a rare neoplasm. Here, we present a case of a patient with PA in the upper lip, reporting a common neoplasm in a rare site. A 82-year-old male with a slowly progressing swelling that occurred 20years ago on the upper white lip. This tumor is not associated with pain and tenderness. The mass was about 1.5x1.5cm sized, circumscribed, sessile and firm on the external upper lip without oral side bulging (Fig. 1). The tumor was removed completely with a elliptical incision under local anesthesia. The encapsulated mass was measured 0.9x0.9x0.6cm. On histology, a well-circumscribed growth was seen comprising epithelial and stromal components. The epithelial component formed glandular structures lined by round-to oval cells having small nuclei, pink cytoplasm and myoepithelial basal cell layer while the stroma had a fibromyxoid appearance(Fig. 2). Postoperatively wound was well healed without recurrence after 6months. Pleomorphic adenoma of the upper lip is a rare neoplasm, especially not intraoral growth. For aesthetic good result, the mass was removed without hesitation. It is required a high index of suspicion and a long-term follow-up because it could recur and rarely be transformed into malignancy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제36권3호
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• pp.177-185
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• 2010

Introduction: Epidermal growth factor receptor (EGFR) is expressed in human epithelial tumors including salivary cancers, and known to be correlated with tumor progression and poor clinical courses in some epithelial tumors. In this study, we determined the therapeutic effect of the anti-EGFR monoclonal antibody Erbitux (C225, cetuximab) in combination with the DNA topoisomerase I inhibitor irinotecan (CPT-11) on human salivary adenoid cystic carcinoma (SACC) cells growing in nude mice. Materials and Methods: At first, immunocytochemical analysis for the expression of EGFR and phosphorylated EGFR (pEGFR) on a human salivary ACC cell line (ACC3). To determine the in vivo effects of Erbitux and CPT-11, nude mice with orthotopic parotid tumors were randomized to receive intraperitoneal Erbitux (1 mg) two times per week, intraperitoneal Irinotecan (50 mg/kg) once per week, Erbitux plus CPT-11, or placebo. (control) Tumor volume and weight were measured. And mechanisms of in vivo activity of Erbitux and/or CPT-11 were determined by immunohistochemical/ immunofluorescent analyses. Results: Immunocytochemical staining of ACC3 demonstrated that EGFR was expressed and phosphorylated. CPT-11 inhibited ACC tumor growth in nude mice. Tumors of mice treated with CPT-11 and CPT-11 plus Erbitux exhibited increased tumor cell apoptosis and decreased microvessel density, which correlated with a decrease in the tumor volume in nude mice. But, CPT-11 seems not to be synergistic with Erbitux in our ACC3 model system. Conclusion: These results suggest that anti-EGFR monoclonal antibody and the DNA topoisomerase I inhibitor will be effective in the treatment of recurred or metastatic lesions of salivary ACC.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제29권2호
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• pp.131-134
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• 2003

상피근상피암은 타액선, 특히 이하선에 호발하는 매우 드문 악성 종양으로 내측의 상피세포와 외측의 투명한 근상피세포의 2열구조로 구성되어 있는 것이 특징이고. 비교적 국소 재발 및 전이를 잘하는 것으로 보고 되었다. 저자들은 드문 타액선 종양인 상피근 상피암을 이하선에서 경험하였기에 문헌 고찰과 함께 보고하였으며, 본 증례의 경우 향후 재발 및 전이 여부 파악 위해 주기적인 경과 관찰이 필요하리라 사료된다.

• 대한세포병리학회지
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• 제13권2호
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• pp.74-77
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• 2002

Lymphoepithelial carcinoma, also known as malignant lymphoepithelial lesion or lymphoepithelioma, is a rare tumor in salivary glands. Lymphoepithelial carcinoma has a characteristic histological findings comprising irregularly-shaped nests of malignant epithelial cells within a lymphocyte-rich stroma, occasionally forming lymphoid follicles. We recently experienced a case of fine needle aspiration cytology (FNAC) of lymphoepithelial carcinoma of parotid gland in a 61-year-old male. The FNAC yielded a hypercellular smear of many irregular clusters of malignant epithelial cells in the background of lymphoid stroma.

• 대한세포병리학회지
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• 제13권1호
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• pp.42-46
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• 2002

Epithelial-myoepithelial carcinoma(EMC) is a rare, low grade malignant tumor of the salivary glands. The EMC has a distinctive histological appearance comprising ductal structures with an inner epithelial cell component and an outer layer of myoepithelial cells which show plump clear cytoplasm. The cytologic features of the EMC have been rarely described. A correct cytological diagnosis to this rare tumor is difficult with high false negative rate. We report a case of EMC in which fine needle aspiration cytologic findings were misinterpreted as a pleomorphic adenoma.