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Myoepithelioma within the carpal tunnel: a case report and review of the literature.

Clark JC, Galloway SJ, Schlicht SM, McKellar RP, Choong PF - Int Semin Surg Oncol (2009)

Bottom Line: No mitoses were noted.In this case, wide local excision would have significantly compromised dominant hand function, and therefore a marginal excision was deemed appropriate in the context of bland histological features.Surgical margins noted in future case reports will aid clinical decision making.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedics and Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Australia. sarcoma@bigpond.net.au.

ABSTRACT
Myoepitheliomas of the extremity are rare and usually benign, while a minority display malignant features. This case demonstrates the diagnosis and management of myoepithelioma within the carpal tunnel. Clinical and radiological tumour features were evaluated. Hematoxylin and eosin stained tumour sections were examined, and immunohistochemistry was performed. Histology revealed a nodular mass of epithelioid cells in clusters within a myxoid/chondroid stroma. No mitoses were noted. Cytokeratins, neuron-specific enolase, synaptophysin, glial fibrillary acidic protein, and S100 were positive on immunohistochemistry. A literature review revealed very few prior reports of myoepithelioma in the wrist, and limited data concerning any relationship between recurrence and quality of surgical margins. In this case, wide local excision would have significantly compromised dominant hand function, and therefore a marginal excision was deemed appropriate in the context of bland histological features. Surgical margins noted in future case reports will aid clinical decision making.

No MeSH data available.


Related in: MedlinePlus

Histopathology of the excisional biopsy specimen demonstrates a) lobules of chondroid/myxoid matrix with embedded vacuolated cells and plasmacytoid cells (100×), b) these same cell populations are shown at high-power (400×), c) positive cytokeratin AE1-3 staining (200×), and d) weak GFAP staining (200×).
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Figure 3: Histopathology of the excisional biopsy specimen demonstrates a) lobules of chondroid/myxoid matrix with embedded vacuolated cells and plasmacytoid cells (100×), b) these same cell populations are shown at high-power (400×), c) positive cytokeratin AE1-3 staining (200×), and d) weak GFAP staining (200×).

Mentions: Histological examination revealed a nodular lesion composed of large epithelioid cells, singly and in clusters floating in a loose myxoid/chondroid stroma (Fig. 3a, b). The cells contained abundant eosinophilic cytoplasm, some of which were multivacuolated or "physaliferous". The nuclei showed mild atypia but no mitoses were seen.


Myoepithelioma within the carpal tunnel: a case report and review of the literature.

Clark JC, Galloway SJ, Schlicht SM, McKellar RP, Choong PF - Int Semin Surg Oncol (2009)

Histopathology of the excisional biopsy specimen demonstrates a) lobules of chondroid/myxoid matrix with embedded vacuolated cells and plasmacytoid cells (100×), b) these same cell populations are shown at high-power (400×), c) positive cytokeratin AE1-3 staining (200×), and d) weak GFAP staining (200×).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2748076&req=5

Figure 3: Histopathology of the excisional biopsy specimen demonstrates a) lobules of chondroid/myxoid matrix with embedded vacuolated cells and plasmacytoid cells (100×), b) these same cell populations are shown at high-power (400×), c) positive cytokeratin AE1-3 staining (200×), and d) weak GFAP staining (200×).
Mentions: Histological examination revealed a nodular lesion composed of large epithelioid cells, singly and in clusters floating in a loose myxoid/chondroid stroma (Fig. 3a, b). The cells contained abundant eosinophilic cytoplasm, some of which were multivacuolated or "physaliferous". The nuclei showed mild atypia but no mitoses were seen.

Bottom Line: No mitoses were noted.In this case, wide local excision would have significantly compromised dominant hand function, and therefore a marginal excision was deemed appropriate in the context of bland histological features.Surgical margins noted in future case reports will aid clinical decision making.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Orthopaedics and Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Australia. sarcoma@bigpond.net.au.

ABSTRACT
Myoepitheliomas of the extremity are rare and usually benign, while a minority display malignant features. This case demonstrates the diagnosis and management of myoepithelioma within the carpal tunnel. Clinical and radiological tumour features were evaluated. Hematoxylin and eosin stained tumour sections were examined, and immunohistochemistry was performed. Histology revealed a nodular mass of epithelioid cells in clusters within a myxoid/chondroid stroma. No mitoses were noted. Cytokeratins, neuron-specific enolase, synaptophysin, glial fibrillary acidic protein, and S100 were positive on immunohistochemistry. A literature review revealed very few prior reports of myoepithelioma in the wrist, and limited data concerning any relationship between recurrence and quality of surgical margins. In this case, wide local excision would have significantly compromised dominant hand function, and therefore a marginal excision was deemed appropriate in the context of bland histological features. Surgical margins noted in future case reports will aid clinical decision making.

No MeSH data available.


Related in: MedlinePlus