Dedifferentiation in low-grade mucoepidermoid carcinoma of the parotid gland

Hum Pathol. 2003 Oct;34(10):1068-72. doi: 10.1053/s0046-8177(03)00418-0.

Abstract

Mucoepidermoid carcinoma (MEC), a common malignant salivary gland neoplasm, is generally divided into low-, intermediate-, and high-grade types according to the histologic features. To our knowledge, the present report describes the first case of dedifferentiation occurring in a low-grade MEC. A 55-year-old man presented with a biphasic neoplasm of the right parotid gland composed of low-grade MEC and dedifferentiated high-grade anaplastic undifferentiated carcinoma. Immunohistochemically, carcinoembryonic antigen expression was restricted to the low-grade MEC portion. The Ki-67-labeling index was higher in the dedifferentiated component than in the low-grade component. On image cytometric analysis, the low-grade MEC was diploid, whereas the dedifferentiated carcinoma was aneuploid. Although the patient was alive 10 years after the initial diagnosis, the tumor has recurred twice, at 3 months and 7 months after the initial resection. It is important to recognize that dedifferentiation can occur in a low-grade MEC, similar to other low-grade salivary gland carcinomas.

Publication types

  • Case Reports

MeSH terms

  • Aneuploidy
  • Biomarkers, Tumor / metabolism
  • Carcinoembryonic Antigen / metabolism
  • Carcinoma / genetics
  • Carcinoma / metabolism
  • Carcinoma / pathology*
  • Carcinoma, Mucoepidermoid / genetics
  • Carcinoma, Mucoepidermoid / metabolism
  • Carcinoma, Mucoepidermoid / pathology*
  • Cell Transformation, Neoplastic*
  • Combined Modality Therapy
  • DNA, Neoplasm / analysis
  • Humans
  • Image Cytometry
  • Immunohistochemistry
  • Ki-67 Antigen / metabolism
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local
  • Neoplasms, Multiple Primary
  • Parotid Neoplasms / genetics
  • Parotid Neoplasms / metabolism
  • Parotid Neoplasms / pathology*

Substances

  • Biomarkers, Tumor
  • Carcinoembryonic Antigen
  • DNA, Neoplasm
  • Ki-67 Antigen