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This rare group of salivary gland carcinomas are all distinguished by myoepithelial differentiation. These tumors are most common in the parotid gland and occur with about equal frequency between the sexes. The mean age is 55 yrs (range 24-77 yrs). The tumors range in size from 2.1-5.5 cm and most commonly present with pain. Occasional non-salivary gland variants have been reported.


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A case of cutaneous myoepithelial carcinoma.

Department of Pathology, Faculty of Medicine, Oita University, Yufu City, Japan.


J Cutan Pathol. 2007 Aug;34(8):648-53. Abstract quote

Background: Cutaneous myoepithelioma, both benign and malignant, is a rare neoplasm composed of neoplastic myoepithelial cells showing diverse histopathological features, and criteria for discriminating benign or malignant have not been fully clarified.

Patient: We present a case of cutaneous myoepithelial carcinoma in a 62-year-old woman presenting a solid mass in the right back.

Results: Resected tumor was located in the whole dermis and subcutis. Histopathologically, two different growth patterns were noted: a small-nested or trabecular pattern in the superficial part and a large nodular pattern with extensive central necrosis in the deep part. Tumor cells were all epithelioid, although plasmacytoid and glycogen-rich clear cells were also observed within the large nodules of the deep part. Immunohistochemically, the cells were positive for both epithelial and myogenic markers, suggesting myoepithelial origin. Lymphatic invasion and lymph node metastasis were evident despite inconspicuous atypia and low mitotic rate.

Conclusion: The final diagnosis was cutaneous myoepithelial carcinoma. At present, it seems to be difficult to predict the behavior of myoepithelioma of the skin and soft tissue, although atypia and high mitotic rate are reported to be associated with local recurrence and metastasis.


Infiltrative multinodular growth pattern composed of cellular areas with epithelioid, hyaline, spindle, clear, and mixed cell types

Majority (60%) are low grade cytology

No true glands are formed

There is a myxoid and/or hyalinized extracellular matrix.

Mitotic figures range from 3-51 per 10 hpf. Necrosis, perineural, and vascular invasion are frequent.

May have chondroid metaplasia, squamous and sebaceous metaplasia

Clear cell

Histopathol 1996;28:309-315
Oral Surg Oral Med Oral Pathol 1991;72:200-207

Tight nests, hyalinized cords, trabeculate, vacuolated signet ring cell-like and lipoblast-like morphologies

Usually mixed with other histological forms of myoepithelial carcinoma

Tend to have more aggressive behavior with 50% recurrence rate and 40% metastatic rate to lung and scalp


Immunostain Percentage
AE1:AE3 100%
S-100 protein 100%
Vimentin 100%
34BetaE12 92%
CAM5.2 89%
Calponin 75%
Cytokeratin 14 53%
Smooth muscle actin 50%
GFAP 31%
EMA 21%
CEA 0%


Malignant mixed tumors  
Polymorphous low grade adenocarcinoma of the salivary glands  
Adenoid cystic carcinoma Especially for the epithelioid type of myoepithelial carcinoma


PROGNOSIS Am J Surg Pathol 2000;24:761-774.

In spite of earlier studies dividing these tumors into low and high grade, there is no consistent association between the histology and behavior. In a follow up of 17 patients, the following results were obtained.
Outcome Percentage
47% (8/17)
Died of disease
29% (5/17) Mean 32 months
Alive with disease
12% (2/17)
Alive without disease
59% (10/17) Mean 42.2 months
TREATMENT Complete excision

Macpherson and Pincus. Clinical Diagnosis and Management by Laboratory Methods. Twentyfirst Edition. WB Saunders. 2006.
Rosai J. Ackerman's Surgical Pathology. Ninth Edition. Mosby 2004.
Sternberg S. Diagnostic Surgical Pathology. Fourth Edition. Lipincott Williams and Wilkins 2004.
Robbins Pathologic Basis of Disease. Seventh Edition. WB Saunders 2005.
DeMay RM. The Art and Science of Cytopathology. Volume 1 and 2. ASCP Press. 1996.
Weedon D. Weedon's Skin Pathology Second Edition. Churchill Livingstone. 2002
Fitzpatrick's Dermatology in General Medicine. 6th Edition. McGraw-Hill. 2003.
Weiss SW and Goldblum JR. Enzinger and Weiss's Soft Tissue Tumors. Fourth Edition. Mosby 2001.

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Last Updated August 21, 2007

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