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Myoepithelioma

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Histopathology of the Salivary Glands

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Abstract

Myoepithelioma (ME) is defined as a tumour composed of myoepithelial cells that exhibit spindle, epithelioid, plasmacytoid or clear cytoplasmic features. The tumour is composed of myoepithelial cells alone or with the addition of small numbers of ductal structures. The cells are arranged in different patterns and grow in a mucoid, collagenous or vascular stroma. Myoepitheliomas were previously thought to lack the myxoid or chondroid stroma typical of pleomorphic adenoma, but such stromal changes are nowadays recognised to be present. Myoepithelioma may hence histologically be very similar to pleomorphic adenoma, and the scarcity of duct-like structures may be the only distinguishing feature. Their significantly lower rate of recurrences and malignant change than that of pleomorphic adenomas merit their distinction as a separate entity. Myoepitheliomas have the histology and growth patterns of the myoepitheliomatous component of pleomorphic adenomas, but hence lack or have only limited (<5–10 %) differentiation of the ductal phase of this tumour. They are encapsulated or at least well-circumscribed tumours and the majority arise in the parotid gland. The proportion of parotid myoepitheliomas range from 40 to 90 % in different series and of intraoral minor salivary glands; the palatal glands are the most commonly affected. ME rarely arises in the submandibular gland and it appears as only approximately ten cases have been reported in the English literature. A few cases of ME have been described in the sinonasal tract, larynx and trachea. Myoepitheliomas account for 1–1.5 % of all salivary gland neoplasms and represent 2.2 % of all benign major salivary gland tumours and 5.7 % of benign minor salivary gland tumours. Myoepitheliomas are well known to arise in the skin and soft tissues. MEs have also been reported from the breast and bone. Only half a dozen cases of primary lung myoepithelioma have been reported but also a myoepithelioma arising in a classic lung hamartoma. The first case of an ovarian ME was recently described. A case of metachronous bilateral myoepithelioma of the nasopharynx has been reported as well as a ME of the buccal mucosa metachronous with an upper lip polymorphous low-grade adenocarcinoma. Myoepitheliomas are very rare in children and only a few cases are reported.

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Authors and Affiliations

  1. Departamento de Ciências Biomédicas e Medicina, Universidade do Algarve, Faro, Portugal

    Henrik Hellquist

  2. Department of Pathology, Medical Faculty Charles University, Plzen, Czech Republic

    Alena Skalova

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  1. Henrik Hellquist
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  2. Alena Skalova
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Hellquist, H., Skalova, A. (2014). Myoepithelioma. In: Histopathology of the Salivary Glands. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-46915-5_4

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  • DOI: https://doi.org/10.1007/978-3-540-46915-5_4

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