Dental and Medical Problems

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Dental and Medical Problems

2016, vol. 53, nr 2, April-June, p. 282–290

doi: 10.17219/dmp/61145

Publication type: clinical case

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

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Myoepithelioma of the Parotid Gland – Diagnosis and Surgical Treatment Difficulties: a Case Study

Myoepitelioma przyusznicy – rozpoznanie i trudności w leczeniu chirurgicznym: opis przypadku

Ludmila Halczy-Kowalik1,D,F, Andrzej Wiktor2,A,C, Lukasz Warmbier2,B,E

1 Pomeranian Medical University of Szczecin, Szczecin, Poland

2 Clinic of Maxillofacial Surgery, Pomeranian Medical University, Szczecin, Poland

Abstract

In the article, a rare case of parotid gland neoplasm pre-surgically diagnosed as fibrous histiocytoma which midsurgically displayed the features of malignancy was reported. On the basis of histopathological and immunohistochemical examination, the neoplasm was diagnosed as myoepithelioma. Discrepancies between the pre-surgical examination results and the biological features of the neoplasm, and also the expectations in relation to the immunohistochemical examination were emphasized. On the basis of recent literature, possibilities were reported of pre-surgical assessment of a tissue fragment complemented with immunohistochemical examination, as well as a smear assessment acquired during FNAB complemented with immunocytochemical examination. Histopathological examination of the fragments stained with H-E, as a basic examination, and the complementing role of immunocytochemical and immunohistochemical examinations, were emphasized. Understanding that myoepithelioma is a neoplasm with a clinical course not always possible to foresee on the basis of its morphology led us to seek the reports of myoepitheliomas whose aggressive growth did not correlate with the diagnosis of a benign tumor in the literature. The reports found on the tumors were mentioned in the article, and they correlate with the findings in our patient. There was a remarkable lack of the influence of certain pre-surgical diagnostics on surgery planning and its course. Since 2011 in our hospital, immunocytochemical and immunohistochemical examinations have been performed with all neoplasms formed of myoepithelial cells.

Key words

salivary gland tumors, myoepithelioma, fibrous histiocytoma, diagnosis difficulties, surgical treatment difficulties

Słowa kluczowe

guzy ślinianek, myoepitelioma, fibrohistiocytoma, trudności diagnostyczne, trudności w leczeniu chirurgicznym

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