Mucoepidermoid carcinoma classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Badria Munir M.B.B.S.[2] Maria Fernanda Villarreal, M.D. [3]


Overview

Mucoepidermoid carcinoma may be classified according to location into 2 subtypes: salivary gland-confined carcinomas and other organ mucoepidermoid carcinomas. Based on histological features, it is divided into low, intermediate and high grade tumors.

Classification

Mucoepidermoid carcinoma may be classified according to location into 2 subtypes:[1]

Classification: Mucoepidermoid Carcinomas
Salivary gland-confined carcinomas
  • Major salivary glands (50%)
  • Parotid gland (40%)
  • Submandibular gland (7%)
  • Sublingual gland (3%)
  • Minor salivary glands (50%)
  • Palate (most common)
  • Retromolar area
  • Floor of the mouth
  • Buccal mucosa
  • Lip
  • Tongue
Other organ mucoepidermoid carcinomas
  • Thyroid
  • Lung

Grading based on Histopathology:

  • Mucoepidermoid carcinoma are graded into three sub types based on histopathological features:
    • Low
    • Intermediate
    • High grade
  • The three most popular grading systems are:
    • The AFIP grading system [2]
    • Modified Healey system[3]
    • The Brandwein system[4]
  • All categories are based on similar set of parameters which include both cytomorphologic and architectural, particularly perineural and angiolymphatic invasion.
Category Histopathologic findings
Low grade
  • Macrocysts, microcysts,
  • Transition with excretory ducts,
  • Differentiated mucin producing epidermoid cells, often in a 1:1 ratio, minimal to moderate intermediate cell population
  • Daughter cyst proliferation from large cysts    
  • Minimal to absent pleomorphism, rare mitoses    
  • Broad-front, often circumscribed invasion    
  • Pools of extravasated mucin with stromal reaction
Intermediated grade
High grade

References

  1. Mucoepidermoid carcinoma. Radiopedia. Dr Frank Gailliard. http://radiopaedia.org/articles/mucoepidermoid-carcinoma-of-salivary-glands Accessed on February 17, 2016
  2. Goode RK, Auclair PL, Ellis GL (April 1998). "Mucoepidermoid carcinoma of the major salivary glands: clinical and histopathologic analysis of 234 cases with evaluation of grading criteria". Cancer. 82 (7): 1217–24. PMID 9529011.
  3. Batsakis JG, Luna MA (October 1990). "Histopathologic grading of salivary gland neoplasms: I. Mucoepidermoid carcinomas". Ann. Otol. Rhinol. Laryngol. 99 (10 Pt 1): 835–8. doi:10.1177/000348949009901015. PMID 2221741.
  4. Brandwein MS, Ferlito A, Bradley PJ, Hille JJ, Rinaldo A (October 2002). "Diagnosis and classification of salivary neoplasms: pathologic challenges and relevance to clinical outcomes". Acta Otolaryngol. 122 (7): 758–64. PMID 12484654.

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