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salivary mucoepidermoid carcinoma

Monday 8 March 2004

salivary gland mucoepidermoid carcinoma


Definition: The mucoepidermoid carcinoma is the most common malignant neoplasm observed in the major and minor salivary glands.

Mucoepidermoid carcinoma is the most common adult salivary malignancy. It histologically is non-encapsulated and shows three cell types - squamous, mucous and intermediate, and may show prominent oncocytic change. It is associated with t(11;19) fusing MECT1 and MAML2 (MAML2-MECT1 fusion gene).


- Small mucoepidermoid carcinoma / parotid gland

- mucoepidermoid carcinoma


- In children: 10964053


- cytokeratin+
- mucin proteins expression (15958852)

  • 71% for MUC1
  • 21% for MUC2
  • 79% for MUC4
  • 68% for MUC5AC


- oncocytic mucoepidermoid carcinoma (18971778)

Differential diagnosis

- necrotizing sialometaplasia (NSM)
- salivary metastatic squamous carninoma (for high-grade MEC)
- salivary adenosquamous carcinoma
- salivary cystadenoma
- salivary cystadenocarcinoma
- salivary sebaceous carcinoma
- salivary clear cell tumors

- salivary oncocytic tumors

  • salivary oncocytoma
  • salivary concocytic carcinoma

- salivary metastatic renal cell carcinoma


- t(11;19)(q21;p13) translocation

Molecular biology

- MECT1-MAML2 fusion gene by t(11;19)(q21;p13)

  • fusion of the N-terminal CREB-binding domain of the cAMP coactivator TORC1 (a.k.a. MECT1 and WAMTP1) to the Notch coactivator MAML2.

The MECT1/MAML2 translocation is identified in a large proportion of mucoepidermoid carcinomas (MEC) of the salivary gland and is an emerging favorable prognosticator.

However, there are conflicting data on this translocation’s specificity, restriction to low/intermediate MEC, and strength as a prognosticator.

Grading: 11420454, 9529011

- Grading parameters (9529011)

  • intracystic component @<@20%
  • neural invasion
  • necrosis
  • mitosis > 4 per 10 HPF
  • anaplasia

See also

- salivary tumors (salivary gland tumors)


- A reappraisal of the MECT1/MAML2 translocation in salivary mucoepidermoid carcinomas. Seethala RR, Dacic S, Cieply K, Kelly LM, Nikiforova MN. Am J Surg Pathol. 2010 Aug;34(8):1106-21. PMID: 20588178

- Handra-Luca A, Lamas G, Bertrand JC, Fouret P. MUC1, MUC2, MUC4, and MUC5AC expression in salivary gland mucoepidermoid carcinoma: diagnostic and prognostic implications. Am J Surg Pathol. 2005 Jul;29(7):881-9. PMID: 15958852

- Guzzo M, Andreola S, Sirizzotti G, Cantu G. Mucoepidermoid carcinoma of the salivary glands: clinicopathologic review of 108 patients treated at the National Cancer Institute of Milan. Ann Surg Oncol. 2002 Aug;9(7):688-95. PMID: 12167584

- Brandwein MS, Ivanov K, Wallace DI, Hille JJ, Wang B, Fahmy A, Bodian C, Urken ML, Gnepp DR, Huvos A, Lumerman H, Mills SE. Mucoepidermoid carcinoma: a clinicopathologic study of 80 patients with special reference to histological grading. Am J Surg Pathol. 2001 Jul;25(7):835-45. PMID: 11420454

- Goode RK, Auclair PL, Ellis GL. Mucoepidermoid carcinoma of the major salivary glands: clinical and histopathologic analysis of 234 cases with evaluation of grading criteria. Cancer. 1998 Apr 1;82(7):1217-24. PMID: 9529011