title: Low-grade mucoepidermoid carcinoma of the palate-a previously unreported case of metastasis to the liver.
abstract: Intraoral low-grade mucoepidermoid carcinoma (MEC) is not known to metastasize to the liver. This type of malignant salivary gland tumor is comparatively rare and has a well-defined set of parameters guiding histolopathologic grading into low to high grade. Although distant and regional lymph node metastases have been reported in about 15% of all MEC cases, tumors diagnosed as low grade have only very rarely been implicated. We present a case, as yet unreported, in which cervical lymph node and hepatic metastatic spread occurred from a primary low-grade MEC of the hard palate. A 33-year-old man presented with a 4-week history of painful, right-sided palatal ulceration crossing the midline. Imaging revealed cervical lymph node involvement and metastatic liver deposits. Tissue diagnosis supported a low-grade palatal MEC with histologic identical hepatic metastases. We examined the clinical features of this rare case, reviewed the published data, and discuss the histologic features and treatment of such patients.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK. kerryherd1@doctors.org.uk
authors.forename: M Kerry
authors.initials: MK
authors.lastname: Herd
authors.forename: Vaidayanathan
authors.initials: V
authors.lastname: Murugaraj
authors.forename: Sukhvinder Singh
authors.initials: SS
authors.lastname: Ghataura
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brennan
authors.forename: Rajiv
authors.initials: R
authors.lastname: Anand
mesh_terms: D000328:Adult; D001706:Biopsy; D018277:Carcinoma, Mucoepidermoid / Q000556:secondary*; D017809:Fatal Outcome; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D064847:Multimodal Imaging; D060787:Neoplasm Grading; D009361:Neoplasm Invasiveness; D019226:Oral Ulcer / Q000473:pathology; D010157:Palatal Neoplasms / Q000473:pathology*; D021362:Palate, Hard / Q000473:pathology; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed