Mucoepidermoid carcinoma pathophysiology

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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]


Mucoepidermoid carcinomas arise from mucous cells, which are normally involved in the secretion of mucous and the protection of the surrounding tissue. The pathogenesis of mucoepidermoid carcinoma consists of abnormal production of mucin from mucous cells, associated with the aberrant overgrowth of squamous and epidermoid cells. Genes involved in the pathogenesis of mucoepidermoid carcinoma include the MECT1 and MAML2 fusion genes. On gross pathology, mucoepidermoid carcinomas have a cystic, solid or mixed appearance, are normally located on the parotid or submandibular gland, and range in size from 1 to 8 cm.



  • Development of mucoepidermoid carcinoma may be the result of multiple genetic mutations.
  • Mucoepidermoid carcinoma is specifically associated with t(11;19)(q21;p13) translocation.[4][5]

Associated Conditions

Human cytomegalovirus (hCMV) infection is commonly seen associated with development of mucoepidermoid carcinoma.

  • As HCMV is commonly resides in salivary gland ductal epithelium, It is hypothesized that HCMV could be integral part of pathogenesis of mucopidermoid carcinoma.
  • Following results were noted when they tested implication of HCMV in development

Gross Pathology

  • On gross pathology, mucoepidermoid carcinoma has a cystic, solid, or mixed appearance.
  • Mucoepidermoid carcinoma usually occurs in the parotid or submandibular gland.
  • Low grade mucoepidermoid carcinoma are small and partially encapsulated.
  • It appears as fluctuant light blue or purplish submucosal lumps. [12]
  • Other findings on gross pathology include:
  • Tumor size ranging from 1 to 8 cm
  • Gray or white in color, with mucin filled cysts

Microscopic Pathology

The characteristic findings of mucoepidermoid carcinoma on microscopic histopathological analysis are listed below.[13][9][14][1][15][16]

  • Mucus secreting cells
  • Composed of three cell types:
    • Epidermoid
    • Intermediate
    • Columnar
    • Clear cells
  • They all demonstrates prominent cystic growth. [9]
  • Mucin vacuoles may be rare; however they are integral part of histological features of mucoepidermoid carcinoma.
  • Hallmark of these tumors are:
    • Prominent cystic structures lined by mature mucous, intermediate, or epidermoid cells
    • Solid areas are not evident
    • Prominent fibrous stroma
    • It grows in a well-circumscribed manner
  • Mucoepidermoid tumors are graded histologically into:
    • Low grade
    • Intermediate grade
    • High grade.
  • Low grade is characterized by well-differentiated cells with little cellular atypia, high proportion of mucous cells, and prominent cyst formation.
  • Intermediate grade is characterized by intermediate features
  • High grade is characterized by poorly differentiated with cellular pleomorphism, high proportion of squamous cells, and solid with few if any cysts



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  8. Cheuk W, Chan JK (July 2007). "Advances in salivary gland pathology". Histopathology. 51 (1): 1–20. doi:10.1111/j.1365-2559.2007.02719.x. PMID 17539914.
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  12. Flaitz CM (2000). "Mucoepidermoid carcinoma of the palate in a child". Pediatr Dent. 22 (4): 292–3. PMID 10969433.
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  14. Maloth AK, Nandan SR, Kulkarni PG, Dorankula SP, Muddana K (December 2015). "Mucoepidermoid Carcinoma of Floor of the Mouth - A Rarity". J Clin Diagn Res. 9 (12): ZD03–4. doi:10.7860/JCDR/2015/15595.6912. PMID 26813873.
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