Mucoepidermoid carcinoma: a five-decade journey.
Several decades after a comprehensive description of mucoepidermoid carcinoma (MEC), there is no uniformly accepted grading system. The most recent debate regarding the histologic grading of MECs, centers on the wide range of reported prevalence of cyclic AMP response element-binding protein (CREB)-regulated transcription coactivator (CRTC1-MAML2) rearrangement in high-grade (HG) MECs. We hypothesize that difficulties in morphologic classification may partially explain problems in grading MECs. We believe that HG MECs, as diagnosed over the last several decades, represent a blend of true MECs with unrelated clinicopathologic entities. To examine the historic aspects of this problem, and to identify neoplasms that most commonly mimic "high-grade" MEC, we reviewed 46 cases of alleged MEC diagnosed in our department from 1956 to 1974. The diagnosis of MEC was confirmed in 22 cases and was changed in 24 cases. Compared to cases of confirmed MEC, cases with changed diagnoses had higher incidence of lymph node metastases, perineural invasion, and shorter overall survival. Adenosquamous carcinoma, squamous cell carcinoma, and salivary duct carcinoma emerged as the most common mimics of HG MEC. The single most common diagnostic issue in these cases is the level of keratinization acceptable for MEC. Twenty cases of confirmed MEC were tested for CRTC1-MAML2 rearrangement and 5 low-grade MECs, 7 intermediate grade MECs, and 2 cases of HG MEC were translocation-positive.
Department of Pathology, Presbyterian Hospital, University of Pittsburgh Medical Center, PUH A616.2, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
Jacinthe
J
Chenevert
Leon E
LE
Barnes
Simion I
SI
Chiosea
D000328:Adult; D018196:Carcinoma, Adenosquamous / Q000473:pathology; D018277:Carcinoma, Mucoepidermoid / Q000145:classification / Q000235:genetics* / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D004268:DNA-Binding Proteins / Q000235:genetics; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017404:In Situ Hybridization, Fluorescence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009687:Nuclear Proteins / Q000235:genetics; D012189:Retrospective Studies; D018987:Salivary Ducts / Q000473:pathology; D015534:Trans-Activators; D014157:Transcription Factors / Q000235:genetics; D014178:Translocation, Genetic
C500984:CRTC1 protein, human; D004268:DNA-Binding Proteins; C471297:MAML2 protein, human; D009687:Nuclear Proteins; D015534:Trans-Activators; D014157:Transcription Factors
Genes Chromosomes Cancer. 2006 May;45(5):470-81
16444749
Virchows Arch A Pathol Pathol Anat. 1972;356(1):16-31
4340536
Genes Chromosomes Cancer. 2007 Jul;46(7):708-15
17437281
Adv Anat Pathol. 2006 Nov;13(6):293-307
17075295
Am J Surg Pathol. 2000 Apr;24(4):579-86
10757407
Virchows Arch. 2008 Jun;452(6):629-35
18239938
Histopathology. 2004 Jun;44(6):570-9
15186272
Mod Pathol. 1998 Nov;11(11):1033-8
9831198
JAMA. 1971 Jan 18;215(3):454-5
5107393
Cancer Genet Cytogenet. 2008 Jan 15;180(2):135-9
18206539
Clin Cancer Res. 2006 Jul 1;12(13):3902-7
16818685
J Mol Diagn. 2004 Aug;6(3):205-10
15269296
Otolaryngol Head Neck Surg. 1981 Mar-Apr;89(2):235-43
6787518
Am J Surg Pathol. 2007 Jan;31(1):44-57
17197918
J Laryngol Otol. 1983 Sep;97(9):825-35
6886543
Cancer. 1968 Dec;22(6):1140-55
4303164
Ann Surg. 1945 Nov;122(5):820-44
17858687
Am J Clin Pathol. 2011 May;135(5):753-9
21502430
Oral Surg Oral Med Oral Pathol. 1983 Aug;56(2):157-66
6578478
Oral Surg Oral Med Oral Pathol. 1990 Apr;69(4):461-9
2326038
Am J Surg. 1978 Oct;136(4):461-8
707726
Cancer. 1953 Nov;6(6):1065-133
13106826
Virchows Arch. 2009 Apr;454(4):457-66
19271235
Arch Klin Exp Ohren Nasen Kehlkopfheilkd. 1968;192(1):100-5
4301301
Am J Surg Pathol. 2010 Aug;34(8):1106-21
20588178
J Pathol. 1985 May;146(1):51-8
4009321
Cancer Genet Cytogenet. 1994 Jun;74(2):77-83
8019965