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Epithelial-myoepithelial carcinoma (EMC) of the parotid gland is a comparatively rare tumor that accounts for less than 1% of all salivary gland tumors. A patient with EMC of the parotid gland that was initially diagnosed as pleomorphic adenoma and that recurred locally during the watchful waiting period but was controlled by surgery under local anesthesia is reported. An 80-year-old man had noticed a swelling in the left infra aural region. A left parotid gland tumor was suspected, and he was referred to our department. Magnetic resonance imaging (MRI) and fine-needle aspiration cytology findings were suggestive of pleomorphic adenoma of the superficial lobe of the parotid gland, and this was therefore resected under general anesthesia. Postoperative histopathological examination, immunostaining, and genetic tests resulted in a diagnosis of EMC. Postoperative pathological review showed that part of the resection margin was positive. The possibility of recurrence was explained to the patient, and additional treatment was recommended, but since the patient did not desire this, a policy of watchful waiting was adopted. Signs of cutaneous metastasis in the left infra aural region were detected at 13 months postoperatively, and this metastasis was excised under local anesthesia. The resection margin was negative, and the patient's course remains uneventful. EMC is classified as a low-grade malignant tumor, but it requires stringent monitoring because of its frequent local recurrence. Since local control can usually be achieved by surgical treatment alone, and postoperative adjuvant therapy may not necessarily warranted. [ABSTRACT FROM AUTHOR]

Epithelial-myoepithelial carcinoma (EMC) is a rare malignant neoplasm arising most frequently in the salivary glands and exceptionally in the nasal cavity. EMC accounts for ~1–2% of salivary gland tumors. Even if the nodal and distant metastasis rates are low, tumor staging remains indicated. Here, the authors present the 2-deoxy-2-[18F]fluoro-D-glucose PET-CT (18F-FDG-PET/CT) study of a very rare case of biopsy-proven EMC of the left nasal cavity. This 18F-FDG-PET/CT was performed to stage this tumor and guide the therapeutic strategy due to an atypical high-grade presentation in immunohistochemistry. To our knowledge, this is the first case reporting such high 18F-FDG avidity of EMC of the nasal cavity in PET/CT.

Epithelial-myoepithelial carcinoma (EMC) is an extremely rare low-grade malignant salivary gland tumor that most commonly occurs in the parotid gland, but can also arise in minor salivary glands. We report here a case of EMC localized in oral floor in a 66-year-old female who presented with left side of oral floor swelling of four years duration. CT scan revealed a nonhomogeneously enhancing mass in the left side of the oral floor extending to the midline of the oral cavity. After establishing a clinical diagnosis of a benign tumor arising in the left side of oral floor, a biopsy of the lesion was performed under local anesthesia. The histological diagnosis was suspected pleomorphic adenoma, however, it could not deny the possibility of malignancy, because of that there were any evidence of nuclear atypia or mitotic figures. Then, the patient underwent a wide local excision, where was realized immunohistochemical analysis, staining the duct-like structures, where the inner layer of epithelial cells positively for AE1/AE3 and CK 14, whereas outer layer of myoepithelial cells stained positively for calponin and vimentin antibodies. Based on these findings, the final histological diagnosis was EMC. The patient was discharged from the hospital, and she is being followed up about 5 years without evidence for neither recurrences nor metastases. [ABSTRACT FROM AUTHOR]