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Clinical Problem Solving: Pathology
May 2006

Pathology Quiz Case 1: Diagnosis

Author Affiliations
 

FREDERIC B.ASKINMDWILLIAM H.WESTRAMD

Arch Otolaryngol Head Neck Surg. 2006;132(5):556. doi:10.1001/archotol.132.5.556

Epithelial-myoepithelial carcinoma, a rare malignant tumor of the salivary glands, was first described in 19721 and was established as a distinct diagnostic entity by the World Health Organization in 1991.2 Before its metastatic potential was realized in studies with sufficient long-term follow-up, EMC was reported under a variety of names, including glycogen-rich adenoma, clear cell adenoma, adenomyoepithelioma, tubular solid adenoma, and salivary duct carcinoma.3 Furthermore, it is difficult to assess the incidence of EMC because it was not included as a specific entity until recently. Current evaluations demonstrate that EMC represents approximately 1% of all salivary gland neoplasms, occurs predominantly in the parotid gland (70%-80%), has a predilection for females, and has a peak incidence in the seventh and eighth decades of life (mean age at onset, 60 years).25 However, the youngest patient in the case files of the Armed Forces Institute of Pathology is 15 years old, and EMC of the parotid gland has been reported in an 8-year-old boy.6 The proportion of EMCs that arise in the minor salivary glands is 10% to 15%.5,7

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