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Nasal epithelial myoepithelial carcinoma: An unusual cause of epiphora, a case report and review of the literature.

Flam JO, Brook CD, Sobel R, Lee JC, Platt MP - Allergy Rhinol (Providence) (2015)

Bottom Line: Eight cases of EMC of the nasal cavity were identified in the literature, none of the patients presented with epiphora.The case presented here resulted in resolution of the patient's symptoms and no evidence of disease after surgical excision.Epithelial myoepithelial is a rare salivary gland malignancy that can arise in the nasal cavity.

View Article: PubMed Central - PubMed

Affiliation: Boston University School of Medicine, Boston, Massachusetts, USA.

ABSTRACT

Introduction: Epithelial myoepithelial carcinoma (EMC) of the nasal cavity is a rare tumor, and here we describe the first case of EMC of the nasal cavity presenting with epiphora. A case presentation and review of the literature is provided.

Methods: A case report is described of a 63-year-old man who presented with unilateral epiphora and was found via a thorough history and physical examination to have a nasal tumor. The physical examination consisted of an ocular examination, including probing and irrigation, and a detailed nasal examination (anterior rhinoscopy, nasal endoscopy). The nasal examination was prompted by the patient's report of concurrent nasal symptoms during history taking. Immunohistochemistry subsequently identified the nasal tumor as EMC. A literature search was performed to gain insights into similar malignancies of the nasal cavity.

Results: Eight cases of EMC of the nasal cavity were identified in the literature, none of the patients presented with epiphora. The case presented here resulted in resolution of the patient's symptoms and no evidence of disease after surgical excision.

Conclusion: Epithelial myoepithelial is a rare salivary gland malignancy that can arise in the nasal cavity. Unilateral epiphora with concurrent nasal symptoms should prompt nasal cavity examination for the possibility of an obstructive tumor.

No MeSH data available.


Related in: MedlinePlus

Outer myoepithelial cells stain positive for α smooth muscle actin (magnification×100).
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Figure 6: Outer myoepithelial cells stain positive for α smooth muscle actin (magnification×100).

Mentions: Endoscopic excisional biopsy of the primary mass was performed with the patient under general anesthesia. On gross examination, the primary tumor consisted of tan hemorrhagic tissue. Hematoxylin and eosin staining showed an uncapsulated epithelial neoplastic proliferation that infiltrated the submucosa. The mass consisted of a tubular glandular growth composed of a dual population of cells: inner epithelial-appearing cells and outer myoepithelial-appearing cells with a clear cytoplasm. Oncocytic cytoplasmic changes were observed in some of the epithelial-appearing cells and clusters of predominantly myoepithelial cells without tubular glandular structures were noted. There was infiltration of the tumor into the submucosa without perineural or lymphovascular invasion. Immunohistochemistry definitively confirmed the identity of the epithelial- and myopithelial-appearing cells. Both cell populations were positive for cytokeratin 5/6 (Fig. 5) and cytokeratin 903, and variably positive for S-100. The epithelial cells were identified by dedicated CAM 5.2 staining, whereas the myoepithelial cells were identified by dedicated α smooth muscle actin (Fig. 6), p63, and calponin staining. Ki67 staining showed a proliferation rate of 5–10%. Overall, these findings were consistent with an epithelial-myoepithelial carcinoma.


Nasal epithelial myoepithelial carcinoma: An unusual cause of epiphora, a case report and review of the literature.

Flam JO, Brook CD, Sobel R, Lee JC, Platt MP - Allergy Rhinol (Providence) (2015)

Outer myoepithelial cells stain positive for α smooth muscle actin (magnification×100).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4541636&req=5

Figure 6: Outer myoepithelial cells stain positive for α smooth muscle actin (magnification×100).
Mentions: Endoscopic excisional biopsy of the primary mass was performed with the patient under general anesthesia. On gross examination, the primary tumor consisted of tan hemorrhagic tissue. Hematoxylin and eosin staining showed an uncapsulated epithelial neoplastic proliferation that infiltrated the submucosa. The mass consisted of a tubular glandular growth composed of a dual population of cells: inner epithelial-appearing cells and outer myoepithelial-appearing cells with a clear cytoplasm. Oncocytic cytoplasmic changes were observed in some of the epithelial-appearing cells and clusters of predominantly myoepithelial cells without tubular glandular structures were noted. There was infiltration of the tumor into the submucosa without perineural or lymphovascular invasion. Immunohistochemistry definitively confirmed the identity of the epithelial- and myopithelial-appearing cells. Both cell populations were positive for cytokeratin 5/6 (Fig. 5) and cytokeratin 903, and variably positive for S-100. The epithelial cells were identified by dedicated CAM 5.2 staining, whereas the myoepithelial cells were identified by dedicated α smooth muscle actin (Fig. 6), p63, and calponin staining. Ki67 staining showed a proliferation rate of 5–10%. Overall, these findings were consistent with an epithelial-myoepithelial carcinoma.

Bottom Line: Eight cases of EMC of the nasal cavity were identified in the literature, none of the patients presented with epiphora.The case presented here resulted in resolution of the patient's symptoms and no evidence of disease after surgical excision.Epithelial myoepithelial is a rare salivary gland malignancy that can arise in the nasal cavity.

View Article: PubMed Central - PubMed

Affiliation: Boston University School of Medicine, Boston, Massachusetts, USA.

ABSTRACT

Introduction: Epithelial myoepithelial carcinoma (EMC) of the nasal cavity is a rare tumor, and here we describe the first case of EMC of the nasal cavity presenting with epiphora. A case presentation and review of the literature is provided.

Methods: A case report is described of a 63-year-old man who presented with unilateral epiphora and was found via a thorough history and physical examination to have a nasal tumor. The physical examination consisted of an ocular examination, including probing and irrigation, and a detailed nasal examination (anterior rhinoscopy, nasal endoscopy). The nasal examination was prompted by the patient's report of concurrent nasal symptoms during history taking. Immunohistochemistry subsequently identified the nasal tumor as EMC. A literature search was performed to gain insights into similar malignancies of the nasal cavity.

Results: Eight cases of EMC of the nasal cavity were identified in the literature, none of the patients presented with epiphora. The case presented here resulted in resolution of the patient's symptoms and no evidence of disease after surgical excision.

Conclusion: Epithelial myoepithelial is a rare salivary gland malignancy that can arise in the nasal cavity. Unilateral epiphora with concurrent nasal symptoms should prompt nasal cavity examination for the possibility of an obstructive tumor.

No MeSH data available.


Related in: MedlinePlus