Myoepithelial Tumors of Salivary Gland: A Clinicopathologic and Immunohistochemical Study of 15 Patients with MIB-1 Corr
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ORIGINAL PAPER
Myoepithelial Tumors of Salivary Gland: A Clinicopathologic and Immunohistochemical Study of 15 Patients with MIB‑1 Correlation Ramesh Babu Telugu1 · Pranay Gaikwad2 · Amey Baitule1 · Rajiv Charles Michael3 · Thenmozhi Mani4 · Meera Thomas1 Received: 10 August 2020 / Accepted: 10 September 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Myoepithelial neoplasms are rare tumors of the salivary glands with predominant myoepithelial differentiation and a broad histologic spectrum. Their histological features, immunohistochemical profile and biological behavior are not well characterized and pose a diagnostic challenge. A total of 15 myoepithelial tumors, diagnosed during 2012 and 2019 were subcategorized and correlated with MIB-1 labeling index (LI) and various histological parameters. Immunohistochemical stains for MIB-1 and other antibodies were performed. Statistical analysis was done by chi-square test, Fisher’s exact test and Kaplan Meier curve. Nine patients were male and six were female with the median age of 44 years (range 21–83 years). Of the 15 patients, 6 cases were classified as myoepithelioma (ME) and 9 cases as myoepithelial carcinoma (MECA). Parotid gland was the most common site (46.7%) followed by the palate. MEs showed well circumscribed tumor borders whereas MECAs exhibited focal capsular to extensive invasion into adjacent tissues. Epithelioid cell morphology was most common followed by mixed cell morphology. MIB-1 LI was significantly associated with invasive tumor borders, necrosis and high mitosis. Increased frequency of recurrence was noted with high MIB-1 LI, though it was not statistically significant. MIB-1 LI was high in nearly all MECAs with focal capsular to extensive invasion while low in MEs. Myoepithelial tumor with multinodular growth pattern and focal capsular invasion may have an indolent behavior if mitotic activity and MIB-1 LI is low. Early diagnosis and treatment of MECAs significantly improves the patient’s survival and prognosis. Keywords Immunohistochemistry · Myoepithelioma · Myoepithelial carcinoma · MIB-1 · Parotid · Salivary gland tumor
Introduction Myoepithelial neoplasms are rare tumors of the salivary glands composed almost exclusively of cells with myoepithelial differentiation, which have contractile properties occurring in the middle to older age group. Myoepithelial tumors include benign myoepitheliomas (ME) and malignant myoepithelial carcinomas (MECA), which represent * Meera Thomas [email protected] 1
Department of General Pathology, Christian Medical College, Vellore, Tamil Nadu 632004, India
2
Department of Surgery Unit 1 – General Head & Neck Surgery, Christian Medical College, Vellore, India
3
Department of Head & Neck Surgery Unit‑1, Christian Medical College, Vellore, India
4
Department of Biostatistics, Christian Medical College, Vellore, India
1% and 7 mitoses per 10 high power fields (HPF) or MIB-1 LI > 10% suggests malignancy irrespective of histological appearance. MECA is a
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