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Parotid gland with the neoplasia and intraparotid lymph node involvement by the neoplastic proliferation (hematoxylin and eosin, 200×).
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Figure 2: Parotid gland with the neoplasia and intraparotid lymph node involvement by the neoplastic proliferation (hematoxylin and eosin, 200×).

Mentions: Histologically, the tumor was characterized by a biphasic cell population represented by myoepithelial and ductal cells. The myoepithelial cells were large, polygonal, with clear-staining cytoplasm and irregularly shaped nuclei. The ductal elements were composed of cuboidal cells with eosinophilic cytoplasm and uniform, round voluminous nuclei. The cells appeared to grow in sheets with an organoid pattern. Atypia was mild or absent. Mitotic figure count was very low. Moreover, spread to an intraparotid lymph node was observed (Fig. 2). A diagnosis of EMC was made.

Epithelial-myoepithelial carcinoma of the parotid gland, unusual malignancy radiologically simulating a benign lesion: case report

Piscioli I, Morelli L, Falzone A, Del Nonno F, Neri M, Di Rocco ZC, Catalucci A, Donato S, Licci S - Int Semin Surg Oncol (2007)

Bottom Line: However, problems arise when facing some malignant lesions.We here describe a case of epithelial-myoepithelial carcinoma (EMC) of the parotid gland, a low grade malignant tumor, with spread to an intraparotid lymph node and with CT and MRI findings mimicking a benign lesion.All the images revealed sharply outlined profiles and a homogeneous enhancement of the nodule, suggesting a benign tumor and demonstrating that a radiological evaluation of the lesion alone may be unsatisfactory and misleading in the diagnosis of salivary gland tumours, especially in the case of low grade malignant tumors, such as EMC.

Affiliation: Department of Pathology, National Institute for Infectious Diseases "L, Spallanzani" IRCCS, Rome, Italy. licci@inmi.it.

ABSTRACT

Background: Ultrasound (US), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are widely used in the clinical diagnosis of parotid gland tumors and their efficacy in identifying benign lesions is well documented. However, problems arise when facing some malignant lesions. Only few cases of salivary gland low grade malignant tumors have been previously reported in the literature complete with the radiological features.

Case presentation: We here describe a case of epithelial-myoepithelial carcinoma (EMC) of the parotid gland, a low grade malignant tumor, with spread to an intraparotid lymph node and with CT and MRI findings mimicking a benign lesion.

Conclusion: All the images revealed sharply outlined profiles and a homogeneous enhancement of the nodule, suggesting a benign tumor and demonstrating that a radiological evaluation of the lesion alone may be unsatisfactory and misleading in the diagnosis of salivary gland tumours, especially in the case of low grade malignant tumors, such as EMC.

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