Metastasis of malignant myoepithelial carcinoma to the brain

Abstract

Myoepithelial tumours are a rare form of salivary gland neoplasm and intracranial metastases have rarely been described. The authors present the case of a 61-year-old patient with a history of primary myoepithelial carcinoma of the right foot. Metastases were found in the third ventricle, left temporal lobe and right frontal lobe. The third ventricular and left temporal lobe tumours were resected in a two-stage operation. Pathology of the third ventricular lesion was most consistent with metastasis. MRI of the spine 2 weeks after his operation revealed an intradural mass with several lesions in the lumbar thecal space suggesting further metastases. The patient succumbed to his disease 2 months after his two-stage operation and 5 years after his initial diagnosis. This appears to be the first case in the literature of multiple primary myoepithelial carcinoma metastases to the brain. Further information is needed to provide diagnostic and therapeutic recommendations.

Uncommon metastases to the brain: Frontal lobe myoepithelial carcinoma

“…ey are now increasingly being recognized in varied anatomical sites including head and neck (tongue, paranasal sinuses, pharynx, and larynx), breast, skin, vulva, respiratory, and gastrointestinal tract. [2,16] e occurrence of myoepithelial tumors within the central nervous system is also extremely rare, with only a few cases reported. [1,2,4,11] Most commonly these tumors present as benign myoepitheliomas, but malignant myoepithelial carcinomas have been known to metastasize to the lungs, bone, soft tissue, skin, liver, and brain.…”

“…[2,16] e occurrence of myoepithelial tumors within the central nervous system is also extremely rare, with only a few cases reported. [1,2,4,11] Most commonly these tumors present as benign myoepitheliomas, but malignant myoepithelial carcinomas have been known to metastasize to the lungs, bone, soft tissue, skin, liver, and brain. As reported by Ren et al, [15] the mean metastatic rate can reach 47% and mortality 29%.…”

Impending Doom: A Rare Case of Metastatic Myoepithelial Carcinoma

“…It is advised that myoepithelial neoplasms are best examined with a tumor panel that includes all antibodies to broad-spectrum keratins, high-molecular-weight keratins, and myofilaments [6]. About 95% of tumors express reactivity to keratin (CKAE 1/3), S100, EMA, PAN-K, CAM 5.2, pan-cytokeratin, calponin, SMA, muscle-specific actin (MSA), smooth muscle myosin, P63 protein, glial fibrillary acidic protein (GFAP), CD10, desmin, and p63 [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. In our case, the tumor was immunoreactive to SOX-10, CKAE 1/3, CAM 5.2, BCL-2, vimentin, and S100 confirming the diagnosis of myoepithelial carcinoma.…”

“…Given the rarity of this malignancy, the clinical course and treatment modalities remain undefined. Multiple treatment modalities have been described in case reports, ranging from complete surgical resection with clear margins to chemotherapy and/or neoadjuvant /adjuvant radiotherapy [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. There are limited reports of deep soft tissue myoepithelial carcinoma with concurrent metastasis and rapid mortality [10][11][12][13].…”

“…Multiple treatment modalities have been described in case reports, ranging from complete surgical resection with clear margins to chemotherapy and/or neoadjuvant /adjuvant radiotherapy [3][4][5][6][7][8][9][10][11][12][13][14][15][16]. There are limited reports of deep soft tissue myoepithelial carcinoma with concurrent metastasis and rapid mortality [10][11][12][13]. Therefore, we report a case of a 79-year-old male, with incidentally identified deep soft tissue mass in the sacral area and co-existent left axillary lymphadenopathy, which was biopsy confirmed to be a case of metastatic myoepithelial carcinoma.…”