Mucoepidermoid Resembling Squamous Cell Carcinoma in the Premaxilla: A Diagnostic Challenge

  • Tuang Geng Ju Hospital Selayang
  • Jeyasakthy Saniasiaya ORL Department, Hospital Selayang
  • Masaany Mansor
  • Zainal Azmi Zainal Abidin

Abstract

Salivary gland malignancy represents a rare yet diverse entity that covers a heterogenous spectrum of neoplasm of various clinical behavior, ranging from protracted, indolent to aggressive, life-threatening manner. Accurate histopathological diagnosis is imperative in terms of prognostication and further management planning. Herein, we report a case of an intermediate grade mucoepidermoid carcinoma of premaxilla masquerading as squamous cell carcinoma. Despite repeated biopsies, histological examinations failed to establish an accurate diagnosis. The patient eventually underwent wide surgical excision of the primary lesion with simultaneous bilateral supra - omohyoid neck dissection. Diagnosis dilemma encountered along with subsequent management are further discussed.

References

Qureshi SM, Janjua OS, Janjua SM. Mucoepidermoid carcinoma: a clinico-pathological review of 75 cases. Int J Oral Maxillofac Pathol. 2012; 3:5-9.

Thorat S, Nilesh K, Baad R, et al. Low-grade mucoepidermoid carcinoma of the hard palate presenting as non-healing ulcer: report and review. IJCMR.2016; 3:3543-5.

Woolner LB, Pettet JR, Kirklin JW. Mucoepidermoid tumors of major salivary glands. Am J Clin Pathol.1954; 24:1350-62.

Foote FW, Frazell EL. Tumours of the major salivary gland. Cancer.1953; 6:1065-133.

Sudhakar S, Velugubanthla RG, Erva S, et al. Management of mucoepidermoid carcinoma of the palate utilizing 18F-FDG PET/CT. J Clin Imaging Sci 2014; 4: 1-5

Sobral APV, Loducca SVL, Kowalski LP, et al. Immunohistochemical distinction of high-grade mucoepidermoid carcinoma and epidermoid carcinoma of the parotid region. Oral Oncol 2002; 38: 437-440

Darling R, McCammon S, Resto V, et al. Mucoepidermoid carcinoma in the head and neck. Grand Rounds Presentation, the University of Texas Medical Branch at Galveston, department of otolaryngology 2014

Clinical practice guidelines in oncology. National Comprehensive Cancer Network 2018: 2; 17-21

Sook S, McGurk M, Vaz F. Management of salivary gland tumours: United Kingdom national multidisciplinary guidelines. J Laryngol Otol 2016; 130(2): 142-149

Kowalski LP, Sanabra A. Elective neck dissection in oral carcinoma: a critical review of the evidence. Acta Otorhinolaryngol Ital 2007; 27: 113-117

Liu XQ,Lao X, Liang L, et al. Neck observation versus elective neck dissection in management of clinical T1/2N0 oral squamous cell carcinoma: a retrospective study of 232 patients. Chinese Journal of Cancer Research 2017; 29(3): 179-188

Published
2019-09-21