RESUMO

Myoepithelioma is a benign salivary gland tumor. Central myoepitheliomas are very rare. The aim of this report was to describe a case of maxillary myoepithelioma. A 14-year-old female patient presented with an multilocular lesion in the anterior maxilla, with nearly 8 months of duration. The lesion was asymptomatic, and the patient's dental history was unremarkable. The diagnostic hypothesis was an odontogenic tumor. Biopsy specimen consisted of nests of plasmacytoid cells in a myxoid stroma without duct formation. No cellular atypia or bone and cartilage formation were noted. The neoplastic cells were positive for Pan-cytokeratin, S100, CK7, and CK8. The final diagnosis was myoepithelioma. The patient was treated by surgical excision followed by bone curettage, and no signs of recurrence were found after 8 years of treatment.

Assuntos

RESUMO

O carcinoma mioepitelial é uma doença incomum que tem origem majoritariamente nas glândulas salivares. A sua ocorrência no pulmão é um achado extremamente raro e acredita-se ter origem nas glândulas brônquicas submucosas do trato respiratório inferior. Marcado pela sua grande diversidade citológica e arquitetônica, que recapitula as características celulares e imunofenotípicas das células mioepiteliais, é uma neoplasia tipicamente de alto grau e comportamento agressivo, sendo facilmente confundida com outras neoplasias torácicas e representando um desafio diagnóstico. Não há diretrizes estabelecidas para o tratamento ­ a cirurgia parece ser a melhor alternativa, uma vez que o papel da quimioterapia e radioterapia é incerto. Este é um estudo observacional descritivo retrospectivo em modelo de relato de caso realizado através de avaliação do prontuário de um paciente com diagnóstico de carcinoma mioepitelial pulmonar matriculado no INCA no período de setembro a novembro de 2023. Para a discussão do tema, esse trabalho também contou com uma revisão da literatura médica utilizando os dados obtidos através das plataformas Pubmed, Scielo e Google acadêmico. Após extensa pesquisa, encontramos apenas 21 casos publicados de carcinoma mioepitelial pulmonar e acreditamos que a dificuldade técnica envolvida no diagnóstico, sobreposta as barreiras de tecnologia e conhecimento do passado, possam ter contribuído para subestimar o número de casos dessa neoplasia. Nesse contexto, o carcinoma mioepitelial pulmonar primário deve ser incluído no diagnóstico diferencial das neoplasias torácicas. Embora mais estudos sejam necessários para esclarecimento dos aspectos moleculares e estratégias terapêuticas, o tratamento individualizado é uma estratégia clínica promissora para neoplasias torácicas em geral e os eventos moleculares subjacentes devem ser investigados para encontrar os potenciais alvos terapêuticos

Myoepithelial carcinoma is an uncommon disease that originates mainly in the salivary glands. Its occurrence in the lung is an extremely rare finding and is believed to originate from the submucosal bronchial glands of the lower respiratory tract. Marked by its great histological and architectural diversity, which recapitulates the cellular and immunophenotypic characteristics of myoepithelial cells, it is a typically high-grade neoplasm with aggressive behavior, being easily confused with other thoracic neoplasms and representing a diagnostic challenge. There are no established guidelines for treatment ­ upfront surgery appears to be the best alternative, as the role of chemotherapy and radiotherapy is uncertain. This is a retrospective descriptive observational study using a case report model carried out by evaluating the medical records of a patient diagnosed with pulmonary myoepithelial carcinoma enrolled at INCA from september to november 2023. To discuss the topic, this work also included a review of the medical literature using data obtained from Pubmed, Scielo and Google Scholar. We found Only 21 published cases of pulmonary myoepithelial carcinoma on research platforms and we believe that the technical difficulty involved in diagnosis, combined with technology and knowledge barriers from the past, may have contributed to underestimating the number of cases of this neoplasm. In this context, primary pulmonary myoepithelial carcinoma should be included in the differential diagnosis of thoracic neoplasms. Although further studies are needed to clarify the molecular aspects and therapeutic strategies, individualized treatment is a promising clinical strategy for thoracic neoplasms in general and the underlying molecular events must be investigated to find potential therapeutic targets.

Assuntos

RESUMO

OBJECTIVES: In this systematic review, we aimed to evaluate the clinicopathological and prognosis data of patients with salivary gland myoepithelial carcinoma. MATERIALS AND METHODS: MEDLINE/PubMed, Scopus, and Embase search was performed with the keywords "myoepithelial carcinoma" "malignant myoepithelioma," and "salivary glands." Primary salivary glands myoepithelial carcinoma that fulfilled the World Health Organization diagnostic criteria were included. The Joanna Briggs Institute tool was used to assess the risk of bias. RESULTS: Forty-three studies (71 patients) met the inclusion criteria. The patients showed a mean age of 56.4 ± 19.6 years with no sex predilection. The parotid was the most affected gland (49.3%). The tumor presented as an asymptomatic (65.1%) mass (84%). The most common histological findings were the presence of clear tumor cells (39.7%) and multinodular growth patterns (60.7%). Multivariate analysis showed plasmacytoid cell type (p = 0.010) and solid growth pattern (p = 0.003) were related to decreased disease-free survival. Surgery alone was the most used treatment (53.5%). Patients with a combination of treatments showed a longer disease-free survival (p = 0.049). The 2-year and 5-year overall survival rates were 67.5% and 46.1%, respectively. CONCLUSION: Salivary gland myoepithelial carcinoma showed no sex predilection, with a higher incidence in the parotid gland. Cell type, growth pattern, and treatment type may be related to a lower disease-free survival. Overall, salivary gland myoepithelial carcinoma presented low recurrence and metastasis rates. Registration and protocol: This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 checklist and registered in the International Prospective Register of Systematic Reviews (PROSPERO) database (CRD42022311512).

Assuntos

RESUMO

The most significant interest in veterinary oncology is occupied by tumors of a mixed nature, which are represented by the direct interaction of epithelial and mesenchymal components. According to some data, the formation of cell lineage of mesenchymal cells occurs due to the transformation of epidermal basket cells surrounding the glandular epithelium. In this case, the formation of a cartilage anlage with its further transformation into differentiated bone tissue occurs. The article contains information about the structure and features of the location and interaction of mixed tumors' glandular and stromal components in female dogs (n=29). It was revealed that in addition to simple mixed neoplasms, tumors with proplasia of the mesenchymal component into highly differentiated cartilage or bone tissue were also often registered. To confirm subcellular changes in the expression of certain types of proteins, such as a-SMA and vimentin, an IHC study was used. The expression of the studied biomarkers was established in mesenchymal fibroblastic differon cells and myoepithelial cells. The intensity of immunoreactive material expression ranged from moderate (2+) to strong (3+), indicating changes in myoepithelial cells' genotype during the formation of mixed mammary neoplasms.(AU)

Assuntos

RESUMO

Mammary neoplasms are the most frequently diagnosed tumours in female dogs and are classified into various histological types, including solid carcinomas. We proposed a subclassification of solid carcinomas based on morphological and immunohistochemical characteristics, and correlated the subtypes with prognostic factors. A total of 135 cases of solid mammary carcinoma were selected from 3,400 canine mammary neoplasms in the archives of the Laboratory of Comparative Pathology, Institute of Biological Sciences, Federal University of Minas Gerais, Brazil. Epidemiological and survival data were obtained, and immunolabelling for chromogranin A, pancytokeratin, cytokeratin 14, Ki67 and p63 was performed. Solid carcinomas were classified into six subgroups: malignant adenomyoepithelioma (68/135), carcinoma with solid pattern (22/135), malignant myoepithelioma (16/135), basaloid carcinoma (14/135), neuroendocrine carcinoma (10/135) and solid papillary carcinoma (5/135). Shorter survival time was associated with the presence of lymphatic invasion (P = 0.009) in the initial clinical staging (I-III). When considering all clinical stages (I-V), vascular invasion (P <0.001) and the presence of regional metastasis (P = 0.004) were important prognostic factors. Basaloid carcinoma and solid papillary carcinoma did not reach the median survival time for early-stage cases, and malignant myoepithelioma had the highest median survival in advanced stages. Carcinoma with a solid pattern was associated with a higher number of regional metastases. Distinguishing the various histological and immunophenotypic subtypes that exhibit a solid arrangement, using histological and immunohistochemical criteria, is essential for understanding the behaviour of these neoplasms and for the selection of more appropriate and specific therapies.

Assuntos

Assuntos

RESUMO

Myoepithelial tumors of soft tissue are rare mesenchymal neoplasms that overlap with their salivary gland and skin counterparts at both the histopathologic and molecular levels. EWSR1 gene rearrangements with various fusion partners represent a common genetic event in myoepithelial tumors of soft tissue, whether benign or malignant, and may prove useful as a diagnostic tool in difficult cases. However, the number of diagnostic entities with EWSR1 gene rearrangements has grown considerably in recent years, and there is significant morphologic and immunophenotypic overlap amongst this group, underscoring the importance of fusion testing to detect fusion partners that are characteristic of discrete diagnostic entities. Herein, we report a malignant myoepithelial tumor of soft tissue/myoepithelial carcinoma with an undifferentiated round cell morphology arising in a pediatric patient with a EWSR1-ATF1 gene fusion.

Assuntos

RESUMO

Myoepithelial carcinoma is a rare pathological variant, usually expressed in salivary gland. This case report describes a case of pediatric myoepithelial carcinoma in the urinary bladder. A 4-year-old male patient was admitted to a specialized hospital in Lima, Peru for hematuria. A CT scan showed a tumor lesion in the bladder wall, and biopsy revealed myoepithelial carcinoma of urinary bladder. Six courses of chemotherapy + partial cystectomy + radiotherapy was completed. The treatment was defined based on the pathological variant and the tumor location. The patient is currently at 2 years of disease-free survival.

Assuntos

RESUMO

Introdução: As neoplasias de glândulas salivares constituem um grupo de lesões, clínica e morfologicamente diferente, capaz de determinar importantes desafios diagnósticos e terapêuticos. Apresentar dois casos de tumores benignos de glândulas salivares menores, sendo um adenoma e outro mioepitelioma, discutindo o diagnóstico diferencial e a forma de tratamento em comparação com informações da literatura. Relato de caso: Pacientes do sexo feminino, com idades semelhantes, ambas se queixavam que após o uso de uma prótese mal adaptada notou-se o aparecimento de uma lesão assintomática no palato. Diante das características clínicas das lesões, as hipóteses de diagnóstico foram de tumor de glândula salivar menor e adenoma pleomórfico, respectivamente. Diante da ausência de sinais de malignidade, o tratamento proposto foi biópsia excisional com enucleação e curetagem. O diagnóstico histopatológico foi de Tumor de Glândula Salivar Menor (Mioepitelioma Plasmocitóide), e Adenoma Pleomórfico, respectivamente. A enucleação e curetagem se mostraram eficazes e sem sinais de recidiva. Considerações finais: Tanto o adenoma como o mioepitelioma se apresentam clinicamente semelhantes sendo o diagnóstico diferencial realizado através do histopatológico, porém o tratamento conservador de enucleação e curetagem pode ser aplicado em ambas... (AU)

Introduction: The neoplasms of salivary gland constitute a group of lesions clinically and morphologically different, which are able to determine important challenges in diagnostic and therapeutic.To report two cases of benign tumors of the minor salivary glands, adenoma and myoepithelioma. Also, discussing the differential diagnosis and its treatment in comparison with literature information. Case report: Two female patients, with similar ages, both complained about the appearance of an asymptomatic lesion on the palate after using a poorly adapted prosthesis. On the clinical characteristics of the lesions, the hypothetical diagnosis was of minor salivary gland tumor and pleomorphic adenoma, respectively. In the absence of signs of malignancy, the proposed treatment was excisional biopsy with enucleation and curettage. The histopathology diagnosis was begin tumor of minor salivary glands (myoepithelioma plasmacytoid), and pleomorphic adenoma, respectively. The enucleation and curettage were effective and there were no signs of recurrence. Final considerations: Both the adenoma and myoepithelioma are clinically similar and the differential diagnosis is performed by the histopathology exam, but conservative treatment such as enucleation and curettage can be applied to both... (AU)

Assuntos

RESUMO

Background: Malignant myoepithelioma is a rare neoplasm in humans and rats, poorly reported in dogs and not previously described in rabbits. This study aimed to report a case of malignant mammary myoepithelioma in a domestic rabbit(Oryctolagus cuniculus).Case: A domestic, hybrid, female, entire, nulliparous, 7-year-old rabbit was attended in the Veterinary Hospital Prof. Ricardo Alexandre Hippler at Universidade Vila Velha (UVV) with a history of apathy, lethargy and anorexia. In the clinicalexamination a 5 cm tumour was observed in the right abdominal mammary gland (M2), along with floating smaller lesionsin M1 and M3. There were no palpable abnormalities in the axillary and inguinal lymph nodes. Complete blood count andserum biochemistry were within the normal range. Fine needle aspiration was performed for cytopathological evaluationof the tumour in M2 and it was suggestive of a malignant glandular neoplasm, with probable epithelial origin. Completestaging included chest and abdominal radiographs, but they were unremarkable. The patient was submitted to a rightunilateral mastectomy, involving resection of the inguinal lymph node. The sample was sent to the Laboratory of AnimalPathology of UVV for routine histological evaluation. Histopathological evaluation in M2 was compatible with malignantmyoepithelioma based on the literature, while nodules in M1 and M3 were classified as mammary cysts. The inguinal lymphnode showed no significant abnormalities. An immunohistochemical panel was performed in the Comparative PathologyLaboratory of the Institute of Biological Sciences of the Universidade Federal de Minas Gerais (UFMG), using immunomarkers (pan-cytokeratin, p63 and vimentin) to characterize the tumour and confirm its diagnosis. Immunohistochemistryrevealed expression of p63, and was negative for pan-cytokeratin and vimentin, which confirmed the myoepithelial origin,without involvement of the epithelial compartment...(AU)

Assuntos