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The relationship between nuclear DNA content in salivary gland tumors and prognosis. Comparison of mucoepidermoid tumors and acinic cell tumors.

Differences in prognosis between salivary gland mucoepidermoid tumors and acinic cell tumors were compared by means of conventional histopathological grading and nuclear DNA content which was assessed cytochemically by a scanning cytophotometric procedure. The mucoepidermoid tumors were found to show a stronger correlation between histopathological grading and prognosis than did the acinic cell tumors. By using DNA quantification, valuable additional information could be obtained for predicting the behavior of the mucoepidermoid tumors, whereas there was no correlation between DNA content and prognosis for the acinic cell tumors. Regarding the relatively "benign" clinical course of most mucoepidermoid tumors, the term "tumor"--as proposed by the World Health Organization's classification--seems appropriate. In contrast, the more severe clinical courses of the acinic cell tumors justify the use of the term "carcinoma" instead.

Aneuploidy↗

Childhood bronchial mucoepidermoid tumors.

A very rare case of a childhood bronchial mucoepidermoid tumor is presented. A 4-year-old girl was hospitalized with prolonged pneumonia. Computed tomography of the chest showed a tumor with calcifications in the right upper lobe. Subsequently, the patient underwent right upper lobectomy. Histologically, the tumor was a low-grade mucoepidermoid tumor originating from the bronchus. Three years postoperatively there has been no evidence of disease. A review of the literature indicates that 30 cases of bronchial mucoepidermoid tumors in children have been reported. Symptoms result from associated bronchial obstruction. Children with recurrent or prolonged pneumonia should undergo aggressive diagnostic investigation by chest tomography or bronchoscopy. Appropriate therapy for childhood bronchial mucoepidermoid tumor is total resection of the lesion while sacrificing as little of the normal lung tissue as possible.

Airway Obstruction↗

Mucoepidermoid tumors of the lung.

Mucoepidermoid tumors of lung (MET) are rare tumors derived from the minor salivary gland tissue of the proximal tracheobronchial tree. The authors studied 58 cases of MET confined to the lung and used criteria derived from similar tumors of the salivary glands to separate them into low-grade and high-grade variants. The overwhelming majority of low-grade tumors behaved in a benign fashion, whereas 23% of high-grade tumors resulted in patient death. Prognostic factors which appeared to predict future aggressive behavior included high-grade classification, advanced stage at presentation, and perhaps lymph node metastases.

Adenoma, Pleomorphic↗

Mucoepidermoid tumors of the bronchus. Ultrastructural and immunohistochemical study. Histiogenic correlations.

UNLABELLED: Bronchial mucoepidermoid tumors are uncommon neoplasms, morphologically similar to their salivary gland counterpart. The histogenesis is controversial. The aim of this study is to identify myoepithelial cells and speculate on their role in the origin of these tumors. METHODS AND RESULTS: Sixteen bronchial mucoepidermoid tumor surgical specimens were formalin-fixed, paraffin-embedded and studied using a panel of nine antibodies in order to identify a myoepithelial differentiation. Additional antigens against several cytokeratins were performed in four cases and five of the biopies were studied using the electron microscopy. The different types of cells of the primary bronchial mucoepidermoid tumor (mucous luminal, intermediate and squamous) reacted strongly against AE1, CK7, 34bE12 and weakly with AE3, CK18 and CK8/18/19. S-100, alpha-smooth muscle actin, muscle actin HHF35 and alpha-actinin were consistently negative in all cell types. CD10 was positive in very few cells in just one case. CONCLUSION: The immunohistochemical and the ultrastructural study of bronchial mucoepidermiod tumors support a ductal unit origin, without a myoepithelial participation.

Adult↗

Mucoepidermoid tumor: a case report involving the operculum of an erupting permanent second molar.

The mucoepidermoid tumor (carcinoma) accounts for approximately 6% to 8% of all salivary gland tumors. Although rare in children, it is the most common "malignant" salivary gland tumor, having been reported in major and minor (intraoral) salivary gland sites as well as in the maxilla and the mandible. In children, as in adults, it most often occurs in the parotid gland, but a significant percentage is found in the palate and retromolar pad area. Presently, there is no unanimity of opinion about whether to consider all mucoepidermoid tumors malignant or what the most appropriate treatment regimen is. The following is a case report of a mucoepidermoid tumor presumably arising from the reduced enamel epithelium in soft tissue overlying an erupting mandibular second molar in an 11-year-old boy. Theoretical origins of intraoral soft tissue mucoepidermoid tumors are discussed, as well as treatment philosophy. The importance of submitting, for microscopic diagnosis, all tissue removed during surgical procedure is illustrated in this case report.

Carcinoma↗

Mucoepidermoid tumors of salivary glands. A long term follow-up study.

Mucoepidermoid tumors of salivary glands are relative rare and it has often been difficult to correlate the pathologic features and clinical aspects. The literature recommends long term follow-up studies. The object of the present study was therefore to follow this recommendation. The clinico-pathological features of 39 mucoepidermoid tumors are presented. The material was retrieved from the files of the pathological institute, Rigshospitalet, Copenhagen, during the period 1941-75. All patients, 24 males, 15 females, were followed for a minimum of 5 years. The lesions were classified into low grade (13 cases), intermediate grade (14 cases) and high grade (12 cases). The corresponding 5, 10 and 15 years cumulative survival rates were 92%, 92%, 92% for low grade, 47.4%, 47.4%, 35.5% for intermediate grade and 0%, 0%, 0% for high grade tumors. Thus we found a close correlation between pathology and clinical course. Furthermore, a 5 year observation period appeared an acceptable approach, because 17 of the 18 patients who succumbed of the disease, did so within 4 years following surgery. We consider all grades of mucoepidermoid tumors to be potential malignant. In our study one patient with a low grade tumor died of the disease.

Adolescent↗

Childhood bronchial mucoepidermoid tumors: a case report and review of the literature.

A bronchial mucoepidermoid tumor in a 13-year-old female was studied by light and electron microscopy. This is the seventh reported case of this rare bronchial neoplasm in a person less than 16 years of age and the only case, in any age group, which has been studied ultrastructurally. All reported cases of bronchial mucoepidermoid tumors in childhood have been histologically of the low grade (well differentiated) variety with a benign clinical course. Although there are histological features which distinguish this lesion from the even rarer bronchial mucous gland adenoma, the clinical features and biological potential of the two lesions in this age group appear to be identical. The optimal surgical therapy for bronchial mucoepidermoid tumors and mucous gland adenomas, when occurring in children, is identical. There must be total removal of either lesion with the sacrifice of as little normal lung as possible. When technically possible, a sleeve resection of the involved bronchus is recommended; however, in most cases, the location of the lesion requires a lobectomy for complete removal.

Adenoma↗

[Mucoepidermoid tumors of minor salivary glands. Clinical and pathologic correlations. Histoenzymologic and ultrastructural studies (author's transl)].

In a series of 331 minor salivary gland tumors (malignant in about 55,3% of cases), mucoepidermoid tumors, after cystic adenoïd carcinomas, are the most frequent malignant tumors (21,5% of cases). They are much more common in women than in men. The average age of patients at presentation (52,2 years) is higher than that of pleomorphic adenomas. They occur more frequently in buccal floor, tongue and gums. By a half-quantitative study of 71 mucoepidermoid tumors, these neoplasms are ranged in 3 main groups : differentiated epidermoid or glandular tumors, intermediate cell tumors with predominant oncocytic, clear glycogenic or basophilic cells and rare adenosquamous carcinomas. These 3 groups are well demonstrated by histoenzymological investigations, which show high level of oxydative enzymes activity in oncocytic cells and high level of ATPase and alkaline phosphatase activities around basophilic sheets. Besides, an ultrastructural study shows, in addition to well differentiated glandular or epidermoid cells, 3 forms of intermediate cells : young basophilic ribosome-rich cells and more differentiated oncocytic or glycogenic cells. The various structural features of mucoepidermoid tumors are positively correlated with clinical course and behaviour, after long term follow-up studies. Differentiated forms and intermediate clear or oxyphilic cell tumors are of low grade malignancy. Intermediate basophilic cell tumors grow rapidly or metastasize and a lethal course is often noted in these cases.

Carcinoma↗

Mucoepidermoid tumor of the lung: CT appearance.

Mucoepidermoid tumor of the lung is a rare endobronchial neoplasm with a wide spectrum of appearance. We present a case report and describe the plain film and computed tomography (CT) findings.

Airway Obstruction↗

Synchronous malignant mucoepidermoid tumor of the parotid gland and Warthin's tumor in adjacent lymph node.

A case of a malignant mucoepidermoid tumor (poorly differentiated) occurring simultaneously with a homolateral Warthin's tumor is presented. The simultaneous occurrence of two salivary gland tumors of different types is extremely rare. Only five cases have been reported in the literature. The occurrence of a malignant mucoepidermoid tumor and a Warthin's tumor in the same patient has not been previously reported.

Adenolymphoma↗

Oncocytic mucoepidermoid tumor of the bronchus.

Mucoepidermoid neoplasms of the bronchus are uncommon tumors believed to arise from bronchial mucus glands. Reported ultrastructural evaluation has been limited to two cases in a single publication. The authors report the light microscopic and ultrastructural features of a third case with similar findings. An unusual finding not previously reported was the presence of numerous typical onocytes shown by light and electron microscopy. Morphologic forms intermediate between the mucus cells, epidermoid cells, and oncocytes were identified ultrastructurally. The origin of onocytes has been of some controversy. The presence of these cells associated with a mucoepidermoid tumor of the bronchus suggests a common progenitor cell. The transitional forms identified ultrastructurally support the notion that oncocytes are the result of a metaplastic process.

Aged↗

Scintiscanning of mucoepidermoid tumor of the parotid gland.

99mTc-O4 and/or 67Ga-citrate scintigraphies were preoperatively applied to 13 cases of parotid mucoepidermoid tumor. The resected specimens were histopathologically subdivided into three types: well (6 cases), moderately (one case), and poorly differentiated (6 cases). As the other parotid neoplasms except adenolymphoma and oxyphilic adenoma, all poorly differentiated tumors showed focal defect image in 99mTc-O4 scintiscanning (4/4). They indicated a focal hot image in 67Ga-citrate scanning at a high rate (4/6). Otherwise, well differentiated tumors were scarcely pointed out in cold image and were usually indicated as a symmetrical image (5/6) in 99mTc-O4 scanning. None of them showed a focal hot image in 67Ga-citrate scanning, but two cases indicated diffuse increased uptake and another case showed a focal defect image. The clinical prognosis of mucoepidermoid tumors is extremely correlated to the degree of cell differentiation in our prospective study. For that reason, the therapeutic method should be carefully selected in the tumors suspected of low grade malignancy. Our study suggests that RI (99mTc-O4 and 67Ga-citrate) scintigraphy is helpful in evaluating the malignancy grade of mucoepidermoid tumors.

Adolescent↗

[Mucoepidermoid tumor of the mandible (author's transl)].

The diagnosis of a mucoepidermoid tumor of the mandible has been made by pathological examination. This asymptomatic tumor was discovered on a routine radiographic film. Our 44 years old male patient was treated by surgical means. We have found 62 cases in the literature; intra-osseous cases of mucoepidermoid tumor seem to be rather scarce. Let us recall the presence of salivary glands in the mandible, a possible explanation of the occurrence of intra-osseous glandular tumor.

Adult↗

Mucoepidermoid tumors of the salivary glands. Correlation of cytophotometrical data and prognosis.

The mucoepidermoid tumors of the Salivary Gland Registry, Institute of Pathology, University of Hamburg, Western Germany, were evaluated retrospectively with regard to epidemiologic data, clinical follow-up, and cytophotometric data. Clinical data were obtained in 71 cases. Tissue from 46 cases was studied by single cell scanning cytophotometric analysis. Two thirds of the tumors were located in the major salivary glands, the parotid being the most common site, one third occurred in the minor salivary glands. The age range was from 6 to 81 years; peaks were observed in the fourth and seventh decades; the sex distribution was almost equal. By means of a single cell scanning cytophotometric device, a division into "diploid" and "atypical" patterns was possible. The clinical course was well correlated with these two groups, the atypical group showing generally an unfavorable course. Especially in poorly differentiated tumors, selection of clinically aggressive tumors was possible by their atypical DNA distribution pattern. Consequently, single cell DNA assessment can be a useful supplementary tool in the clinicopathologic and prognostic evaluation of mucoepidermoid tumors of the salivary glands.

Adolescent↗

Mucoepidermoid tumor of trachea.

Mucoepidermoid carcinoma of the trachea is rare. Its occurence in a 14-year-old boy is reported here. This case illustrates the typical course of tracheal tumors with clinical manifestations of cough, wheezing, and hemoptysis, the intially reported normal chest roentgenogram, and the common failure to diagnose tracheal tumor for several months. Early use of tomographic studies and bronchoscopic examination in any person with recent onset of airway obstruction unresponsive to bronchodilator therapy is recommended.

Adolescent↗

Mucoepidermoid tumors of the lung: analysis of 11 cases.

BACKGROUND: Mucoepidermoid tumors (METs) of the trachea and bronchi are rare. They derive from the minor salivary gland tissue of the proximal tracheobronchial tree, and their clinical behaviors are still controversial. Herein, we analyze 11 cases of MET to investigate its clinicopathological characteristics. METHODS: The medical records and pathological examinations of patients diagnosed with MET from May, 1995 to May, 2001 at the Division of Thoracic Surgery in Taipei Veterans General Hospital were retrospectively reviewed. RESULTS: There were 11 patients (7 male and 4 female) aged from 19 to 79 years, with a peak at the seventh and eighth decade. The mean age at diagnosis was 58.9 years, and 9 of these 11 patients were symptomatic. No surgical mortality occurred. Three patients with low-grade tumors were all young females (less than 30 years). They were all alive without evidence of disease recurrence until the date of analysis, whereas the 5-year survival of 8 patients with high-grade tumors was only 25%. Six patients with high-grade tumors received adjuvant therapy, but their prognoses remained poor. CONCLUSIONS: In the current study, METs occurred more frequently in male patients. Young female patients were preponderant to have low-grade tumors and therefore associated with better prognosis. Histological grading of the MET and the ability to achieve an anatomic resection are 2 most important factors that affect prognosis. Adjuvant therapy seems not to be effective in patients with high-grade MET.

Adult↗

[On mucoepidermoid tumors with rare locations in laryngological areas (author's transl)].

Report of three cases of mucoepidermoid tumors with rare locations in laryngological areas (fundus of the tongue, retromolar trigonum, nasopharynx and sinuses). In two cases the tumors could be removed radically, the third case resulted in an extensive tumorous destruction of the right half of the face after a protracted course of the disease, as the consequence of which the patient died. With the aid of the literature on the subject, the location, clinical features, pathological anatomy and histology, origin, biological valence and the prognosis of mucoepidermoid tumors are discussed. It is generally agreed that they are optionally malignant tumors which can induce a locally infiltrating or destructive growth, show a tendency to recurrence and may lead to distant metastases. The recommended therapy is the radical exstirpation of the tumor.

Aged↗

Mucoepidermoid lung tumors.

Mucoepidermoid lung tumors are uncommon, representing 0.2% of all lung tumors and 1% to 5% of bronchial adenomas. Eighteen patients with mucoepidermoid tumors are reported. There were 10 male and 8 female patients with a mean age of 36.8 years (range, 9 to 62 years). On the basis of mitotic activity, cellular necrosis, and nuclear pleomorphism, we subclassified these tumors as low grade (15 patients) or high grade (3 patients). The achievement of complete resection and low-grade versus high-grade staging correlated with prognosis. All 12 patients who had a low-grade tumor that was completely excised are alive with no evidence of disease at a mean follow-up of 4.7 years (range, 1 to 27 years). All high-grade tumors proved fatal within 16 months. Two of the 3 high-grade tumors were unresectable because of extensive local disease. Patients with low-grade tumors and microscopically positive margins require close follow-up and can undergo a successful repeat resection. Nine of the 16 resections were sleeve resections, high-lighting the importance of conservative lung-sparing procedures in these central airway tumors. Both patients with an unresectable high-grade tumor had radiation therapy postoperatively and died 11 months later. The role of radiation therapy with high-grade tumors or incomplete resection has yet to be determined.

Adult↗