Mucoepidermoid carcinoma pathophysiology

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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 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. On microscopic histopathological analysis, mucoepidermoid carcinomas are characterized by mucous cells with abundant fluffy cytoplasm and large mucin vacuoles.

Pathogenesis

• Mucoepidermoid carcinomas arise from mucous cells, which are 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.

Genetics

• Development of mucoepidermoid carcinomas may be the result of multiple genetic mutations.
• Genes involved in the pathogenesis of include:

• MECT1 fusion gene
• MAML2 fusion gene

Associated Conditions

• Mucoepidermoid carcinomas have no associated conditions.

Gross Pathology

• On gross pathology, mucoepidermoid carcinoma is an cystic, solid or mixed appearance.
• Other gross pathology findings, include:

• The tumor size ranges from 1 to 8 cm
• Normally located on the parotid or submandibular gland

Microscopic Pathology

• On microscopic histopathological analysis, the characteristic feature of mucoepidermoid carcinomas, include:

• Mucus secreting cells (visible with musicarmine staining)
• Composed of three cell types: epidermoid, intermediate, and mucin producing
• Mucin vacuoles may be rare; in a superficial glance (mimics squamous cell carcinoma)
• Mucoepidermoid tumours are graded histologically into: low grade, intermediate grade, and high grade.
• Low grade is characterized by well-differentiated cells with little cellular atypia, high proportion of mucous cells, and prominent cyst formation
• Intermediate grade is characterized by intermediate features
• High grade is characterized by poorly differentiated with cellular pleomorphism, high proportion of squamous cells, and solid with few if any cysts

Gallery

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  Histopathologic image of mucoepidermoid carcinoma of the major salivary gland. H & E stain.

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  Histopathologic image of mucoepidermoid carcinoma of the major salivary gland. The same lesion as shown in a filename "Mucoepidermoid carcinoma (2) HE stain.jpg". H & E stain.]]

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  Histopathologic image of mucoepidermoid carcinoma. Postoperative recurrence of the submandibular tumor. Alcian blue-PAS stain.

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  Gross pathology mucoepidermoid carcinoma.

References

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