Mucoepidermoid carcinoma overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
Mucoepidermoid carcinoma (also known as "Salivary gland mucoepidermoid carcinoma") is a malignant salivary gland tumor that consists of epidermoid and mucin producing cells. Mucoepidermoid carcinomas arise from mucous cells, which is normally involved in the secretion of mucous and the protection of surrounding tissue. Mucoepidermoid carcinoma is the most common malignant salivary gland tumor, and usually occurs in the parotid and submandibular salivary glands. Mucoepidermoid carcinomas may be classified according to location into 2 subtypes: salivary gland confined carcinomas and other organ mucoepidermoid tumors. The majority of these tumors present as parotid gland mucoepidermoid carcincoma lesions (65%). Development of Mucoepidermoid carcinoma is the result of an abnormal production of mucin by mucus-secreting cells. Genes involved in the pathogenesis of mucoepidermoid carcinoma include MECT1 and MAML2 fusion genes. Mucoepidermoid carcinoma are usually found in adults between the second and fourth decade of life. Males are slightly more affected with mucoepidermoid carcinoma than females. The incidence of mucoepidermoid carcinoma is approximately 2.5 to 3.0 cases per 100,000 individuals a year. If left untreated, progression occurs slow and is then followed by centinel organ metastasis. The treatment choice for mucoepidermoid carcinoma is surgical removal.
Historical Perspective
Mucoepidermoid carcinoma was first described by Foote and Frazell, two American pathologists, in 1954.[1]
Classification
Mucoepidermoid carcinoma may be classified according to location into 2 subtypes: salivary gland-confined carcinomas, and other organ mucoepidermoid carcinomas.
Pathophysiology
Mucoepidermoid carcinomas arise from mucous cells, which is normally involved in the secretion of mucous and the protection of surrounding tissue. The pathogenesis of mucoepidermoid carcinoma consists of abnormal production of mucin from mucous cells, associated with the aberrant overgrowth of squamous and epidermoid cells. Genes involved in the pathogenesis of mucoepidermoid carcinoma include MECT1 and MAML2 fusion genes. On gross pathology, mucoepidermoid carcinomas have a cystic, solid or mixed appearance, the tumor size ranges from 1 to 8 cm, and they are normally located on the parotid or submandibular gland .[2] On microscopic histopathological analysis, mucoepidermoid carcinomas are characterized by mucous cells with abundant fluffy cytoplasm and large mucin vacuoles.[2]
Causes
There are no established direct causes for mucoepidermoid carcinoma. The development of mucoepidermoid carcinoma has been associated with the result of multiple genetic mutations.
Differentiating Mucoepidermoid Carcinoma from other Diseases
Mucoepidermoid carcinoma must be differentiated from other diseases that cause painless swelling, facial deformity,and facial numbness or weakness, such as Warthin tumour, adenoid cystic carcinoma, benign mixed tumor, and metastasis.
Epidemiology and Demographics
Mucoepidermoid carcinoma is the most common malignant salivary gland tumor among general population. The incidence of mucoepidermoid carcinoma is approximately 2.5 to 3.0 cases per 100,000 individuals a year. The incidence of mucoepidermoid carcinoma decreases with age; the median age at diagnosis is between 20 to 40 years. Males are slightly more affected with mucoepidermoid carcinoma than females. Mucoepidermoid carcinoma usually affects individuals of the Caucasian race.
Risk Factors
Common risk factors in the development of salivary gland tumors, include: ionizing radiation, occupations associated with an increased risk, such as rubber products manufacturing, asbestos mining, plumbing, and some types of woodworking.[3]
Screening
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for mucoepidermoid carcinoma. .[3]
Natural History, Complications and Prognosis
If left untreated, patients with mucoepidermoid carcinoma may progress to develop .Common complications mucoepidermoid carcinoma include fracture
Prognosis is generally regarded as good after surgical excision. The recurrence rate of mucoepidermoid carcinoma is 2%.
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
There are no diagnostic laboratory findings associated with osteochondroma.
X Ray
CT
MRI
Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
References
- ↑ Foote FWJ, Frazell EL. Tumors of the major salivary glands. Atlas of Tumor Pathology, first series, Fascicle 11. Washington, DC: Armed Forces Institute of Pathology, 1954
- ↑ 2.0 2.1 Mucoepidermoid carcinoma. Libre Pathology. http://librepathology.org/wiki/index.php/Mucoepidermoid carcinoma Accessed on February 17, 2015
- ↑ 3.0 3.1 Mucoepidermoid carcinoma. Salivary Gland Cancer Treatment–for health professionals (PDQ®).http://www.cancer.gov/types/head-and-neck/hp/salivary-gland-treatment-pdq#link/_403_toc Accessed on February 17, 2016