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Medical condition From Wikipedia, the free encyclopedia
Mucoepidermoid carcinoma (MEC)[1] is the most common type of minor salivary gland malignancy in adults. Mucoepidermoid carcinoma can also be found in other organs, such as bronchi, lacrimal sac,[2] and thyroid gland.
Mucoepidermoid carcinoma | |
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Micrograph of a mucoepidermoid carcinoma. FNA specimen. Pap stain. | |
Specialty | Oncology, Maxillofacial surgery, ENT surgery |
Mucicarmine staining is one stain used by pathologist for detection.[3]
Presents as painless, slow-growing mass that is firm or hard. Most appear clinically as mixed tumors. Usually occurs at 30–50 years of age. More predilection towards female sex.[citation needed]
This tumor is not encapsulated and is characterized by squamous cells, mucus-secreting cells, and intermediate cells.[4]
Mucoepidermoid carcinomas of the salivary and bronchial glands are characterized by a recurrent t(11;19)(q21;p13) chromosomal translocation resulting in a MECT1-MAML2 fusion gene.[5] The CREB-binding domain of the CREB coactivator MECT1 (also known as CRTC1, TORC1 or WAMTP1) is fused to the transactivation domain of the Notch coactivator MAML2.[6]
A possible association with Radiation Exposure has been reported.[7] It has also been proposed that mucoepidermoid tumors arise from subepithelial mucus glands of the upper respiratory or digestive tracts.[8]
Generally, there is a good prognosis for low-grade tumors, and a poor prognosis for high-grade tumors, however recent research have found reoccurring low grade tumors also have a poor prognosis.[9]
Surgery is the recommended treatment for localised resectable disease.[10] When the tumour is incompletely resected (positive margins) post-operative radiotherapy gives local control comparable to a complete resection (clear margins).[11]
Sometimes when surgery is not possible due to extent of disease or if a patient is too frail for surgery, or declines surgery, palliative radiotherapy may be helpful. There has been a report of a case where low dose radiotherapy achieve disease response and control for more than 4 years.[12]
In patients with metastatic disease, chemotherapy response tends to be low (27% partial response rate) and short lived.[13]
Occurs in adults, with peak incidence from 20–40 years of age. A causal link with cytomegalovirus (CMV) has been strongly implicated in a 2011 research.[14]
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