title: Radiation-induced epithelial-myoepithelial carcinoma in a patient previously treated with mantle-field radiation therapy for Hodgkin lymphoma.
abstract: BACKGROUND
  Radiation-induced salivary gland tumors are well described in the literature, with mucoepidermoid cancer being the most common histologic entity. Epithelial-myoepithelial carcinoma is a rare tumor accounting for <1% of all tumors in the salivary glands.
  
  
  RESULTS
  We describe the first case of radiation-induced epithelial-myoepithelial carcinoma in the English-language medical literature. A 48-year-old man presented with right-sided mandibular pain and trismus, 25 years after mantle-field radiation therapy (RT) for Hodgkin lymphoma. He underwent excision of a right submandibular mass, which revealed a diagnosis of epithelial-myoepithelial carcinoma. Although typically a low-grade tumor, the histology revealed extensive necrosis and high mitotic activity. The patient required multiple resections and adjuvant therapy after multiple recurrences over a 4-year period.
  
  
  CONCLUSIONS
  Reports of epithelial-myoepithelial carcinoma are relatively rare and this case highlights the importance of long-term follow-up and increased awareness of the risks of salivary gland tumors in this population.
authors.affiliation: Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Justin M
authors.initials: JM
authors.lastname: Mann
authors.affiliation: Department of Otolaryngology and Communication Sciences, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Robert M
authors.initials: RM
authors.lastname: Kellman
authors.affiliation: Department of Radiation Oncology, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Seung S
authors.initials: SS
authors.lastname: Hahn
authors.affiliation: Department of Pathology, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Gustavo L
authors.initials: GL
authors.lastname: de la Roza
authors.affiliation: Department of Hematology/Oncology, SUNY Upstate Medical University, Syracuse, New York.
authors.forename: Ajeet
authors.initials: A
authors.lastname: Gajra
mesh_terms: D002277:Carcinoma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017024:Chemotherapy, Adjuvant / Q000379:methods; D006689:Hodgkin Disease / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009208:Myoepithelioma / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D037981:Neck Dissection / Q000379:methods; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects*; D012086:Reoperation; D013365:Submandibular Gland Neoplasms / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D013997:Time Factors
keywords: Hodgkin lymphoma; epithelial-myoepithelial carcinoma; radiation-induced malignancy; salivary gland tumors