Prognostic factors in myoepithelial carcinoma of salivary glands: A clinicopathologic study of 48 cases Journal Article
| Authors: | Kong, M.; Drill, E. N.; Morris, L.; West, L.; Klimstra, D.; Gonen, M.; Ghossein, R.; Katabi, N. |
| Article Title: | Prognostic factors in myoepithelial carcinoma of salivary glands: A clinicopathologic study of 48 cases |
| Abstract: | Myoepithelial carcinoma (MECA) is an underrecognized rare tumor with a diverse clinical behavior. The histologic features of this tumor are not well characterized, much less its grading, which is controversial. The objective of this study is to provide a better characterization of MECA and its prognostic factors. A total of 48 cases were retrieved from the pathology files. The cases were subjected to a detailed histopathologic, immunohistochemical, statistical, and clinical analysis. Tumors were classified as de novo MECA in 22 cases (46%) and carcinoma ex-pleomorphic adenoma (CA ex-PA) in 26 cases (54%). Tumor necrosis, high mitotic count (≥6/10 high-power fields), and severe pleomorphism were identified in 38%, 33%, and 21%, respectively. Perineural invasion, vascular invasion, and positive margins were noted in 10%, 12%, and 47%, respectively. Median follow-up was 38 months. Four patients had lymph node metastasis at presentation, 9 developed local recurrences, and 12 had distant metastases with the lung being the most common site (83%). The presence of CA ex-PA, necrosis, and vascular invasion correlated significantly with disease-free survival (P=0.02, 0.01, 0.03, respectively). No distant recurrence was noted in all 23 patients lacking necrosis in their neoplasms (median follow-up: 44 mo). MECA is a relatively aggressive tumor that is associated with a high rate of distant metastasis (27%). Compared with de novo MECA, CA ex-PA correlates with worse clinical outcome. A grading system based on the presence of tumor necrosis should be used to identify high-grade MECA and predict its clinical behavior. © 2015 Wolters Kluwer Health, Inc. All rights reserved. |
| Keywords: | necrosis; carcinoma ex-pleomorphic adenoma; myoepithelial carcinoma |
| Journal Title: | American Journal of Surgical Pathology |
| Volume: | 39 |
| Issue: | 7 |
| ISSN: | 0147-5185 |
| Publisher: | Lippincott Williams & Wilkins |
| Date Published: | 2015-07-01 |
| Start Page: | 931 |
| End Page: | 938 |
| Language: | English |
| DOI: | 10.1097/pas.0000000000000452 |
| PROVIDER: | scopus |
| PUBMED: | 25970687 |
| PMCID: | PMC4939272 |
| DOI/URL: | |
| Notes: | Export Date: 3 August 2015 -- Source: Scopus |
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