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Coexistent parapharyngeal epithelial-myoepithelial carcinoma and bilateral Warthin’s tumors


Authors: Z. Mateášiková 1;  R. Salzman 1;  Ivo Stárek 1;  J. Michálek 2
Authors‘ workplace: Klinika otorinolaryngologie a chirurgie hlavy a krku LF UP a FN Olomouc 1;  Ústav klinické a molekulární patologie LF UP a FN Olomouc 2
Published in: Otorinolaryngol Foniatr, 71, 2022, No. 1, pp. 33-37.
Category: Case Reports
doi: https://doi.org/10.48095/ccorl202233

Overview

Epithelial-myoepithelial carcinoma (EMEC) is a very rare low-grade malignancy with an incidence of less than 1% of all salivary gland tumors. In the parapharyngeal space, it can arise either from the deep lobe of the parotid gland or from minor salivary glands of the oropharynx. We present a case of a 70-year-old female patient with progressive dysphagia and a bulging of paratonsillar space. A CT scan revealed a cystic formation in the parapharyngeal space and bilateral inhomogeneous tumors in parotid glands. Preoperative FNAB (fine needle aspiration bio­psy) was undiagnostic. Definitive histologic examination after surgical removal confirmed epithelial-myoepithelial carcinoma in the parapharyngeal space and Warthin’s tumors in both parotid glands. Immunohistochemical tests of the EMEC revealed BRAF, COSM476 a COSM775 and PIK3CA mutations, however, no HRAS mutation was detected. This case report shows a rare clinical and radiological presentation that could resemble benign dia­gnosis. Multiple salivary gland tumors are relatively rare conditions. Warthin’s tumor is the most common tumor with this type of behaviour. The coincidence of bilateral Warthin’s tumor of parotid glands with a parapharyngeal epithelial-myoepithelial carcinoma has not been documented in literature so far.

Keywords:

epithelial-myoepithelial carcinoma – parapharyngeal space cyst – salivary gland – Warthin’s tumor


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Audiology Paediatric ENT ENT (Otorhinolaryngology)

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