Mucoepidermoid carcinoma of salivary gland

Epidemiology

The most common malignant tumour of salivary glands, it constitutes 15.5% of all salivary gland tumours and 29% of all malignancies, occurring in both major and minor salivary glands².

Histopathology

Mucoepidermoid carcinomas are composed of varying proportions of epidermoid, glandular, mucous and intermediate cells.

Immunohistochemistry

cytokeratin 7	20/202
cytokeratin 8/18	28/282
cytokeratin 14	28/282
cytokeratin 17	8/82
cytokeratin 19	28/282
MUC1	20/204, 44/62 (membranous staining of intermediate, clear and epidermoid cells, and luminal surface of glandular cells)3
MUC2	13/63 (cytoplasmic staining of mucinous and non-specific cells)3
MUC4	48/61 (membranous staining of intermediate, clear and epidermoid cells, and luminal surface of glandular cells)3
MUC5AC	13/194, 43/63 (cytoplasmic staining of mucinous and non-specific cells)3

Differential diagnosis

High grade mucoepidermoid carcinoma:

• squamous cell carcinoma. Mucoepidermoid carcinomas contain mucins, as demonstrated by Alcian blue or antibodies to MUC5AC.

Prognosis

There is a broad spectrum of aggressiveness. Outcome is dependent on tumour grade, margin status, location of the tumour and nodal status². Negativity for MUC1 may be associated with a better prognosis³.

References

¹ Chu, P. G. and L. M. Weiss (2002). "Keratin expression in human tissues and neoplasms." Histopathology 40(5): 403-39. (Summary data from multiple papers)

² Perez-Ordonez B. Selected topics in salivary gland tumour pathology. Current Diagnostic Pathology2003;9:355-365.

³ Handra-Luca A, Lamas G, Bertrand JC, et al. MUC1, MUC2, MUC4, and MUC5AC expression in salivary gland mucoepidermoid carcinoma: diagnostic and prognostic implications. Am J Surg Pathol 2005; 29:881-9

⁴ Alos L, Lujan B, Castillo M. Expression of mucins (MUC1, MUC2, MUC5AC, MUC6) in mucoepidermoid carcinoma of salivary glands. Modern Pathology 2004;17:926 (abstract)

This page last revised 11.9.2005.

©SMUHT/PW Bishop