Abstract
Malignant myoepithelioma of the salivary gland is discussed in terms of its clinical behaviour, morphological features and the frequent pre-existence of a pleomorphic adenoma. The study comprised six female and four male patients aged 14–63 years (mean age 38.9 years). Two tumours presented as intraoral lesions and eight were located in the parotid gland. Tumour cells displayed a morphological spectrum ranging from round epithelioid cells to spindle-shaped and stellate cells. Most cells displayed reactivity for high molecular weight keratins and in four tumours there was strong immunoreactivity for smooth muscle actin. Malignant myoepithelioma seems to arise in two different clinical settings: either de novo or in a recurrent pleomorphic adenoma. De novo malignant myoepitheliomas arise in normal salivary gland, tend to be more aggressive and have a short clinical history. Recurrences may not develop or may occur as a single event within a short time interval, and métastases develop in the lungs. Malignant myoepitheliomas arising in recurrent pleomorphic adenomas have a long clinical history, are characterized by multiple recurrences and have to be distinguished from aggressive carcinomas arising in these adenomas. In contrast, the tumours described in the present series arising in pleomorphic adenomas showed local aggressiveness and metastases did not occur until decades after the first treatment. The general opinion that all malignant tumours that arise from pleomorphic adenomas are highly aggressive is not confirmed by the present study.
Similar content being viewed by others
References
Barnes L, Appel BN, Perez H, El-Attar AM (1985) Myoepitheliomas of the head and neck: case report and review. J Surg Oncol 28:21–28
Batsakis JG (1985) Myoepithelioma. Ann Otol Rhinol Laryngol 94:523–524
Chaudhry AP, Satchidanand S, Peer R, Cutler LS (1982) Myoepithelial cell adenoma of the parotid gland: a light and ultrastructural study. Cancer 49:288–293
Crissman JD, Wirman JA, Harris A (1977) Malignant myoepithelioma of the parotid gland. Cancer 40:3042–3049
Dardick I (1985) Malignant myoepithelioma of parotid salivary gland. Ultrastruct Pathol 9:163–168
Dardick I, Cavell S, Boivi M, et al (1989a) Salivary gland myoepithelioma variants. Histological, ultrastructural, and immunocytological features. Virchows Arch [A] 416:25–42
Dardick I, Thomas MJ, Nostrand AWP van (1989 b) Myoepithelioma — new concepts of histology and classification. A light and electron microscopic study. Ultrastruct Pathol 13:187–224
Di Palma S, Pilotti S, Rilke F (1991) Malignant myoepithelioma of the parotid gland arising in a pleomorphic adenoma. Histopathology 19:273–275
El-Naggar A, Batsakis JG, Luna MA, Goepfert H, Tortoledo ME (1989) DNA content and proliferative activity of myoepithelioma. J Laryngol Otol 103:1192–1197
Franquemont DW, Mills SE (1993) Plasmacytoid monomorphic adenoma of the salivary glands. Absence of myogenous differentiation and comparison to spindle cell myoepithelioma. Am J Surg Pathol 17:146–153
Herrera GA (1990) Light microscopic, ultrastructural and immunocytochemical spectrum of malignant lacrimal and salivary gland tumors, including malignant mixed tumors. Pathobiology 58:312–322
Ibrahim R, Bird DJ, Sieler MW (1990) Malignant myoepithelioma of the larynx with massive metastatic spread to the liver: an ultrastructural and immunocytochemical study. Ultrastruct Pathol 15:69–76
Khan LB, Schoub LS (1973) Myoepithelioma of the palate. Histochemical and ultrastructural observations. Arch Pathol 95:209–212
Leifer C, Miller AS, Putong PB, Harwick RD (1974) Myoepithelioma of the parotid gland. Arch Pathol 98:312–319
Lins JEW, Gnepp DR (1986) Myoepithelioma of the palate in a child. Int J Pediatr Otorhinolarnygol 11:5–13
LiVolsi VA, Perzin KH (1977) Malignant mixed tumors arising in salivary glands. I. Carcinomas arising in benign mixed tumors: a clinicopathologic study. Cancer 39:2209–2230
Luna MA, Mackay B, Gamez-Araujo J (1973) Myoepithelioma of the palate. Report of a case with histochemical and electron microscopic observations. Cancer 32:1429–1435
Moberger JG, Eneroth C-M (1968) Malignant mixed tumor of the salivary glands: special reference to the histological structure in metastases. Cancer 21:1198–1211
Nagao K, Matsuzaki O, Saiga H, et al (1981) Histopathologic studies on carcinoma in pleomorphic adenoma of the parotid gland. Cancer 48:113–121
Nesland JM, Olafsson J, Sobrinho-Simoes M (1981) Plasmacytoid myoepithelioma of the palate. A case report with ultra-structural findings and review of the literature. J Oral Pathol 10:14–21
Sciubba JJ, Brannon RB (1982) Myoepithelioma of salivary glands: report of 23 cases. Cancer 49:562–572
Sciubba JJ, Goldstein BH (1976) Myoepithelioma. Review of the literature and report of a case with ultrastructural confirmation. Oral Surg 42:328–338
Seifert G (1991) World Health Organization international histological classification of tumours. Histological typing of salivary gland tumours, 2nd edn. Springer, Berlin Heidelberg New York
Singh R, Cawson RA (1988) Malignant myoepithelial carcinoma (myoepithelioma) arising in a pleomorphic adenoma of the parotid gland. An immunohistochemical study and review of the literature. Oral Surg Oral Med Oral Pathol 66:65–70
Spiro RH, Huvos AG, Strong EW (1977) Malignant mixed tumor of salivary origin. A clinicopathologic study of 146 cases. Cancer 39:388–396
Stromeyer FW, Haggitt RC, Nelson JF, Hardman JM (1975) Myoepithelioma of minor salivary gland origin. Light and electron microscopical study. Arch Pathol 99:242–245
Takeda Y (1992) Malignant myoepithelioma of minor salivary gland origin. Acta Pathol Jpn 42:518–522
Tanimura A, Nakamura Y, Nagayama K, Tanaka S, Hashisuka H (1985) Myoepithelioma of the parotid gland. Report of two cases with immunohistochemical technique for S-100 protein and electron microscopic observation. Acta Pathol Jpn 35:409–417
Thompson SH, Bender S, Richards A (1985) Plasmacytoid myoepithelioma of a minor salivary gland. J Oral Maxillofac Surg 43:285–288
Tortoledo ME, Luna MA, Batsakis JG (1984) Carcinomas ex pleomorphic adenoma and malignant mixed tumors. Arch Otolaryngol 110:172–176
Toto PD, Hsu D-J (1986) Product definition in a case of myoepithelioma. Oral Surg Oral Med Oral Pathol 62:169–174
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Di Palma, S., Guzzo, M. Malignant myoepithelioma of salivary glands: Clinicopathological features of ten cases. Vichows Archiv A Pathol Anat 423, 389–396 (1993). https://doi.org/10.1007/BF01607152
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01607152