Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2021) – 132.50
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI (2021) – 0.5
Average rejection rate (2022) – 79.69%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download PDF

Dental and Medical Problems

2016, vol. 53, nr 2, April-June, p. 282–290

doi: 10.17219/dmp/61145

Publication type: clinical case

Language: English

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Creative Commons BY-NC-ND 3.0 Open Access

Myoepithelioma of the Parotid Gland – Diagnosis and Surgical Treatment Difficulties: a Case Study

Myoepitelioma przyusznicy – rozpoznanie i trudności w leczeniu chirurgicznym: opis przypadku

Ludmila Halczy-Kowalik1,D,F, Andrzej Wiktor2,A,C, Lukasz Warmbier2,B,E

1 Pomeranian Medical University of Szczecin, Szczecin, Poland

2 Clinic of Maxillofacial Surgery, Pomeranian Medical University, Szczecin, Poland


In the article, a rare case of parotid gland neoplasm pre-surgically diagnosed as fibrous histiocytoma which midsurgically displayed the features of malignancy was reported. On the basis of histopathological and immunohistochemical examination, the neoplasm was diagnosed as myoepithelioma. Discrepancies between the pre-surgical examination results and the biological features of the neoplasm, and also the expectations in relation to the immunohistochemical examination were emphasized. On the basis of recent literature, possibilities were reported of pre-surgical assessment of a tissue fragment complemented with immunohistochemical examination, as well as a smear assessment acquired during FNAB complemented with immunocytochemical examination. Histopathological examination of the fragments stained with H-E, as a basic examination, and the complementing role of immunocytochemical and immunohistochemical examinations, were emphasized. Understanding that myoepithelioma is a neoplasm with a clinical course not always possible to foresee on the basis of its morphology led us to seek the reports of myoepitheliomas whose aggressive growth did not correlate with the diagnosis of a benign tumor in the literature. The reports found on the tumors were mentioned in the article, and they correlate with the findings in our patient. There was a remarkable lack of the influence of certain pre-surgical diagnostics on surgery planning and its course. Since 2011 in our hospital, immunocytochemical and immunohistochemical examinations have been performed with all neoplasms formed of myoepithelial cells.

Key words

salivary gland tumors, myoepithelioma, fibrous histiocytoma, diagnosis difficulties, surgical treatment difficulties

Słowa kluczowe

guzy ślinianek, myoepitelioma, fibrohistiocytoma, trudności diagnostyczne, trudności w leczeniu chirurgicznym

References (32)

  1. Ferri E., Pavon I., Armato E., Cavaleri S., Capuzzo P., Ianniello F.: Myoepithelioma of a minor salivary gland of the cheek: case report. Acta Otorhinolaryngol. Ital. 2006, 26, 43–46.
  2. Fujikura T., Okubo K.: Nasal myoepithelioma removed through endonasal endoscopic surgery. J. Nippon Med. Sch. 2010, 77, 273–276.
  3. Hornick J.L., Fletcher C.D.M.: Cutaneous myoepithelioma: a clinicopathologic and immunohistochemical study of 14 cases. Hum. Pathol. 2004, 35, 14–24.
  4. Simpson R.H.W., Jones H., Beasley P.: Benign myoepithelioma of the salivary glands: a true entity? Histopathol. 1995, 27, 1–9.
  5. Kutzner H., Mentzel T., Kaddu S., Soares L.M., Sangueza O.P.: Cutaneous myoepithelioma an under-recognized cutaneous neoplasm composed of myoepithelial cells. Am. J. Surg. Pathol. 2001, 25, 348–355.
  6. Barnes L., Appel B.N., Perez H., El-Attar A.M.: Myoepithelioma of the head and neck: case report and review. J. Surg. Oncol. 1985, 28, 21–28.
  7. Burke T., Sahin A., Johnson D.E., Ordonez N.G., Mackay B.: Myoepithelioma of the retroperitoneum. Ultrastruct Pathol. 1995,19, 269–274.
  8. Romero-Guadarrama M.B., de Ruiz P.A., Cruz-Ortiz H., Rodríguez-Martínez H.A.: Salivary gland myoepitheliomas: cytological, histological, immunohistochemical and electromicroscopical studies of four cases. Rev. Med. Hosp. Gen Mex. 2001, 64, 147–151.
  9. Wang X.D., Meng L.J., Hou T.T., Zheng C., Huang S.H.: Frequency and distribution pattern of minor salivary gland tumors in northeastern Chinese population: a retrospective study of 485 patients. J. Oral Maxillofac. Surg. 2015, 73, 81–91.
  10. Nagao T., Sugano I., Ishida Y., Tajima Y., Matsuzaki O., Konno A., Kondo Y., Nagao K.: Salivary gland malignant Myoepithelioma. A clinicopathologic and immunohistochemical study of ten cases. Cancer, 1998, 83, 1292–1299.
  11. Karli R.: Myoepitheliomas are rare tumors of the parotid gland: a case report and review of the literature. Univers J. Med. Dent. 2012, 1,1, 1–4.
  12. Politi M., Toro C., Zerman N., Mariuzzi L., Robiony R.: Myoepithelioma of the parotid gland: case report and review of literature. Oral Oncology EXTRA, 2005, 41, 104–108.
  13. Dodd L.G., Caraway N.P., Luna M.A., Byers R.M.: Myoepithelioma of the parotid. Report of a case initially examined by fine needle aspiration biopsy. Acta Cytol. 1994, 38, 417–421.
  14. Wiley E.L., Stewart D., Brown M., Albores-Saavedra J.: Fibrous histiocytoma of the parotid gland. Am. J. Clin. Pathol. 1992, 97, 512–516.
  15. Kariya S., Aoji K., Kuyama K., Akagi H., Fukazawa M., Nishizaki K.: Malignant fibrous histiocytoma of the parotid gland. Auris Nasus Larynx, 2003, 30, 315–318.
  16. Alba-Garcia J.R., Armengot-Carceller M., Zapater-Latorre E., Pérez-Valles A., Basterra-Alegria J.: Malignant fibrohistiocytoma of the parotid region. Report of a case. Med. Oral Patol. Oral Cir. Bucal. 2008, 13, 148–150.
  17. Khalkhali K., Azizi M.R., Atighechi S.: A fibrous histiocytoma of intermediate malignancy arisen from the parotid gland. Arch. Iran Med. 2007, 10, 100–103.
  18. Gun B.D., Ozdamar S.O., Bahadir B., Uzun L.: Salivary gland myoepithelioma with focal capsular invasion. Ear Nose Throat J. 2009, 88, 1005–1009.
  19. Hunt K.T., Stevens M.R., Abdelsayed R.A., Nguyen C.T.: Benign Myoepithelioma of floor of mouth with mandibular involvement: a case report and literature review. J. Oral Maxillofac. Surg. 2011, 69, 3001–3005.
  20. Park T.H., Seo S.H.: Diagnostic challenges of Myoepithelioma arising from a minor salivary gland. J. Oral Maxillofac. Surg. 2011, 69, 2830–2832.
  21. Savera A.T., Sloman A., Huvos A.G., Klimstra D.S.: Myoepithelial carcinoma of the salivary glands: a clinicopathologic study of 25 patients. Am. J. Surg. Pathol. 2000, 24, 761–774.
  22. Chhieng D.C., Paulino A.F.: Cytology of myoepithelial carcinoma of the salivary gland. Cancer Cytopathol. 2002, 96, 32–36.
  23. Di Palma S., Alasio L., Pilotti S.: Fine needle aspiration (FNA) appearances of malignant myoepithelioma of the parotid gland. Cytopathol. 1996, 7, 357–365.
  24. Hornick J.L., Fletcher C.D.: Myoepithelial tumors of soft tissue: a clinicopathologic and immunohistochemical study of 101 cases with evaluation of prognostic parameters. Am. J. Surg. Pathol. 2003, 27, 1183–1196.
  25. Zhu S., Schuerch C., Hunt J.: Review and updates of immunohistochemistry in selected salivary gland and neck tumors. Arch. Pathol. Lab. Med. 2015, 139, 55–56.
  26. Kapoor A., Rajput P.S., Bagri P.K., Beniwal S., Kumar V., Kumar H.S.: Myoepithelioma of parotid: a case report and review of literature. J. Oral Res. Rev. 2014, 6, 53–56.
  27. Nagao T., Sato E., Inoue R., Oshiro H., Takahashi R.H., Nagai T., Yoshida M., Suzuki F., Obikane H., Yamashina M.: Immunohistochemical analysis of salivary gland tumors: application for surgical pathology practice. Acta Histochem. Cytochem. 2012, 45, 269–282.
  28. Das D.K., Haji B.E., Ahmed M.S., Hossain M.N.: Myoepithelioma of the parotid gland initially diagnosed by fine needle aspiration cytology and immunocytochemistry: a case report. Acta Cytol. 2005, 49, 65–70.
  29. Ogawa I., Nishida T., Miyauchi M., Sato S., Takata T.: Dedifferentiated malignant myoepithelioma of the parotid gland. Pathol. Int. 2003, 53, 704–709.
  30. Tara D., Miller M.D., McCalmont T., Tope W.D.: Recurrent cutaneous Myoepithelioma treated using Mohs micrographic surgery: case report and review of the literature. Dermatol. Surg. 2009, 35, 139–143.
  31. Dardick I., Thomas M.J., van Nostrand A.W.: Myoepithelioma – new concepts of histology and classification: a light and electron microscopic study. Ultrastruct. Pathol. 1989, 3, 187–224.
  32. Mahdi Y., Zouaidia F., Zouhair A., Azouz M., Znati K., Jahid A., Berrada M., Bernoussi Z., Mansouri F., el Yaacoubi M., Mahassini N.: Combined myoepithelial carcinoma and myoepithelioma in soft tissue: a case report and review of the literature. J. Med. Case Rep. 2014, 8, 317–322.