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CLINICAL IMAGE
Year : 2020  |  Volume : 152  |  Issue : 7  |  Page : 179-180

Warthin-like low-grade mucoepidermoid carcinoma of the minor salivary gland: A diagnostic & therapeutic dilemma of this commingle appearance


1 Department of Oral & Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Deralakatte, Mangaluru 575 018, Karnataka, India
2 Department of Oral & Maxillofacial Pathology & Oral Microbiology, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Deralakatte, Mangaluru 575 018, Karnataka, India

Date of Submission20-Nov-2019
Date of Web Publication25-May-2021

Correspondence Address:
Pushparaja Shetty
Department of Oral & Maxillofacial Pathology & Oral Microbiology, AB Shetty Memorial Institute of Dental Sciences, Nitte (Deemed to be University), Deralakatte, Mangaluru 575 018, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijmr.IJMR_2274_19

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How to cite this article:
Hegde P, Shetty P. Warthin-like low-grade mucoepidermoid carcinoma of the minor salivary gland: A diagnostic & therapeutic dilemma of this commingle appearance. Indian J Med Res 2020;152, Suppl S1:179-80

How to cite this URL:
Hegde P, Shetty P. Warthin-like low-grade mucoepidermoid carcinoma of the minor salivary gland: A diagnostic & therapeutic dilemma of this commingle appearance. Indian J Med Res [serial online] 2020 [cited 2021 Jul 30];152, Suppl S1:179-80. Available from: https://www.ijmr.org.in/text.asp?2020/152/7/179/316808

The child's assent and parent's consent obtained to publish clinical information and images.


A 17 yr old male child presented to the department of Oral and Maxillofacial Surgery, AB Shetty Memorial Institute of Dental Sciences, Mangaluru, India, in August 2019, with a history of painful palatal mass of five years' duration [Figure 1]A. Wide excision of the mass was done under local anaesthesia [Figure 1]B. Histopathological examination showed a neoplasm with multiloculated cystic architecture, remarkably similar to that of Warthin tumour [Figure 2]A. The cysts were lined by stratified or bilayered epithelium, with supporting stroma packed with small lymphocytes [Figure 2]B. One small 1 mm focus had a different morphology, comprising smaller cystic or glandular structures filled with mucin [Figure 2]C and [Figure 2]D lined by attenuated epithelial cells, mucocytes with adjacent epidermoid cells and intermediate cells. This was suggestive of mucoepidermoid carcinoma. Histopathological analysis of tumour section led to diagnosis of Warthin-like mucoepidermoid carcinoma. The overall condition of the patient was good on a follow up after one month.
Figure 1: (A) Soft tissue palatal mass. (B) Postoperative photograph after closure.

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Figure 2: (A) Cystic glandular structures filled with mucin with adjacent epidermoid cells (arrow) and intermediate (double arrow) cells (H and E, ×10). (B) Warthin tumour-like architecture with multiple cystic formations containing lymphocytes (H and E, ×100). (C) Periodic Acid Schiff (PAS) staining showing mucin filled spaces (PAS, ×100). (D) PAS staining showing cystic spaces filled with mucin (PAS, ×100).

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Warthin-like mucoepidermoid carcinoma is not been widely recognized and can be misdiagnosed as Warthin tumour. The need for diagnostic awareness of this variant of mucoepidermoid carcinoma is challenging because Warthin tumour and mucoepidermoid carcinoma are not normally considered differential diagnoses of one another.

Conflicts of Interest: None.


    Figures

  [Figure 1], [Figure 2]



 

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