2. Definition
mucoepidermoid carcinoma is most common malignant salivary gland tumor. This tumor makes up 10% of
major gland tumors (mostly parotid) and 20% of minor gland tumors (mostly palatal). This lesion may occur
at any age but the main age is 45 years. The male to female ratio is 3 : 2
3. Clinical features
mucoepidermoid carcinoma is the most common malignant salivary gland tumor in children.
The mucoepidermoid carcinoma is most common in parotid gland and usually appears as an
asymptomatic swelling.
painless mass 2 to 3 cm in diameter. With high-grade lesions, pain and rapid growth can be
prominent.
4. Clinical features
minor glands constitute second most common site that appear as
asymptomatic swellings ,are sometimes fluctuant and have a blue or red
color that can be mistaken clinically for a mucocele.
The clinical presentation is a submucosal mass that may be painful or
ulcerated. mass may appear to have a bluish tinge because of mucous
content within lesion.
5. Clinical features
An intraosseous form of mucoepidermoid carcinoma may present as
a multilocular radiolucency of posterior mandible with a raised
bluish lesion of retromolar pad.
mucoepidermoid carcinoma is composed of a mixture of mucus
producing cells and squamous (epidermoid) cells
6. locations
major salivary glands: ~50%
parotid gland: ~40%
submandibular gland: ~7%
sublingual gland: ~3%
minor salivary glands: ~50%
palate: most common
retromolar trigone
floor of the mouth
buccal mucosa
lip
tongue
8. Etiology and risk factors
most common is previous history of radiation therapy to head and neck region
Previous history of cancers
Occupational exposure to silica ,dust and nitrosamines
Mucoepidermoid carcinoma. Mass of the tongue.
9. Diagnosis
Fine needle aspiration biopsy , CT or MRI, Ultrasound
high-grade, intermediate-grade, or low-grade lesions.
The higher the grade, the more are predominance of epidermoid cells and cellular pleomorphism, lack of
mucous cells and cystic areas, and an overall more aggressive behavior
low grade lesion on ultrasound
Proportion of each cell type will grade the mucoepidermoid
carcinoma as:
10. Low-grade
Low-grade tumors show prominent cyst formation, minimal
cellular atypia, and a relatively high proportion of mucous
cells
High-grade tumors consist of solid islands of squamous and
intermediate cells which can demonstrate considerable
pleomorphism and mitotic activity
features fall between those of the low-grade and high-grade
neoplasms. Cyst formation occurs but is less prominent than
that observed in low-grade tumors
High-grade
Intermediate-grade
11. Treatment
Early stage tumors of the parotid :subtotal parotidectomy with preservation of the
facial nerve.
Advanced tumors : total removal of parotid gland with sacrifice of facial nerve.
Submandibular gland tumors : total removal of gland.
Mucoepidermoid carcinomas of the minor glands : assured surgical excision.
treatment of low grade lesions is wide surgical excision with a margin of
uninvolved normal tissue
12. Treatment
high grade lesions require more aggressive surgical removal with surgical
margins and possibly local radiation therapy. If there is underlying bone
destruction then involved bone must be excised.
Radical neck dissection is indicated for patients with clinical evidence of
metastatic disease and also may be considered for patients with larger or high-
grade tumors.
Intermediate-grade Mucoepidermoid carcinomas treatment has varied from
local excision to wide excision with lymphadenectomy and/or postoperative
radiotherapy
