Mucoepidermoid carcinoma natural history

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

If left untreated, patients with mucoepidermoid carcinoma may progress to develop sentinel metastasis to adjacent lymph nodes. Common complications of mucoepidermoid carcinoma include facial deformity, dysphagia, and local lymph node metastasis. Prognosis will generally depend on the clinical stage, tumor size, and histological grade. The overall recurrence rate will depend on the stage. Low grade tumors have a 90-98% survival rate and a low rate of local recurrence.

Natural History

The majority of patients with mucoepidermoid carcinoma are initially asymptomatic.
Symptoms usually develop in the second or fifth decade of life, and initially patients complain of swallowing problems that are increased upon mastication.
If left untreated, patients with mucoepidermoid carcinoma may progress to develop sentinel lymph node metastasis.
Mode of metastasis may be^[1]

- Lymphatic (cervical lymph node)
- Hematogenous
Most common site for the metastasis is:
- Lungs
- Liver
- Brain
- Skin
- Ovary
- Peritoneum

Complications

Common complications of mucoepidermoid carcinoma include:^[2]

Cosmetic concerns leading to severe emotional stress
Ulceration
Bleeding from the tumor
Compression of adjacent tissues which causes:
- Dysphagia
- Odynophagia
- Recurrence of the tumor after surgery
- Bones may undergo demineralization
- Submandibular tumors commonly spread to the lymphatic system
- Intraoral mucoepidermoid carcinoma tumors tend to metastasize to the submandibular glands, post-auricular and neck lymph nodes
- Palate tumors may metastasize to the skull base and respiratory tract
Surgical complications:
- Facial nerve palsy
- Gustatory sweating (Frey’s syndrome)
- Post-surgical wound infection
- Side effects from chemotherapy and radiation therapy

Prognosis

Prognosis will generally depend on the clinical stage, tumor size, and histological grade.^[2]
The overall recurrence rate depends on the stage of the tumor.^[2]^[3]

Low grade tumors have a 90-98% survival rate and a low rate of local recurrence.
High grade tumors have a 30-54% survival rate, and a high local recurrence rate.^[3]
The 5-year survival rate of patients with mucoepidermoid carcinoma is:^[4]

Stage I 75%
Stage II 59%
Stage III 57%
Stage IV 28%

Overall incidence of lymph node involvement ranges from 18–28%.
When distant metastases develop in patients with minor salivary gland tumours the average survival is 2.3 years
Tumours of the major salivary glands is 2.6 years.^[5]^[6]^[7]

^[8]^[9]

References

↑ Asuquo, ME; Nwagbara, VI; Umana, AN; Bassey, G; Ugbem, T (2013). “Giant Mucoepidermoid Carcinoma of the Parotid Gland: A Case Report and Review of Literature”. Journal of Clinical & Experimental Oncology. 02 (01). doi:10.4172/2324-9110.1000103. ISSN 2324-9110.
↑ ^2.0 ^2.1 ^2.2 Plambeck K, Friedrich RE, Schmelzle R (1996). “Mucoepidermoid carcinoma of salivary gland origin: classification, clinical-pathological correlation, treatment results and long-term follow-up in 55 patients”. J Craniomaxillofac Surg. 24 (3): 133–9. PMID 8842902.
↑ ^3.0 ^3.1 Armstrong JG, Harrison LB, Spiro RH, Fass DE, Strong EW, Fuks ZY (1990). “Malignant tumors of major salivary gland origin. A matched-pair analysis of the role of combined surgery and postoperative radiotherapy”. Arch. Otolaryngol. Head Neck Surg. 116 (3): 290–3. PMID 2306346.
↑ Wealey, W. V., Perzin, K. H. and Smith, L. (1970), Mucoepidermoid carcinoma of salivary gland origin. Classification, clinical-pathologic correlation, and results of treatment. Cancer, 26: 368–388. doi: 10.1002/1097-0142(197008)26:2<368::AID-CNCR2820260219>3.0.CO;2-K
↑ Spiro RH, Huvos AG, Berk R, Strong EW (October 1978). “Mucoepidermoid carcinoma of salivary gland origin. A clinicopathologic study of 367 cases”. Am. J. Surg. 136 (4): 461–8. PMID 707726.
↑ Rapidis AD, Givalos N, Gakiopoulou H, Stavrianos SD, Faratzis G, Lagogiannis GA, Katsilieris I, Patsouris E (February 2007). “Mucoepidermoid carcinoma of the salivary glands. Review of the literature and clinicopathological analysis of 18 patients”. Oral Oncol. 43 (2): 130–6. doi:10.1016/j.oraloncology.2006.03.001. PMID 16857410.
↑ Clode, Ana Luisa; Fonseca, Isabel; Santos, J. Rosa; Soares, Jorge (1991). “Mucoepidermoid carcinoma of the salivary glands: A reappraisal of the influence of tumor differentiation on prognosis”. Journal of Surgical Oncology. 46 (2): 100–106. doi:10.1002/jso.2930460207. ISSN 0022-4790.
↑ Spitz, M. R.; Batsakis, J. G. (1984). “Major Salivary Gland Carcinoma: Descriptive Epidemiology and Survival of 498 Patients”. Archives of Otolaryngology – Head and Neck Surgery. 110 (1): 45–49. doi:10.1001/archotol.1984.00800270049013. ISSN 0886-4470.
↑ Rapidis, Alexander D.; Givalos, Nikolaos; Gakiopoulou, Hariklia; Stavrianos, Spyros D.; Faratzis, Gregory; Lagogiannis, George A.; Katsilieris, Ioannis; Patsouris, Efstratios (2007). “Mucoepidermoid carcinoma of the salivary glands”. Oral Oncology. 43 (2): 130–136. doi:10.1016/j.oraloncology.2006.03.001. ISSN 1368-8375.

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[AsuquoNwagbara2013-1] Asuquo, ME; Nwagbara, VI; Umana, AN; Bassey, G; Ugbem, T (2013). “Giant Mucoepidermoid Carcinoma of the Parotid Gland: A Case Report and Review of Literature”. Journal of Clinical & Experimental Oncology. 02 (01). doi:10.4172/2324-9110.1000103. ISSN 2324-9110.

[pmid8842902-2] 2.0 ^2.1 ^2.2 Plambeck K, Friedrich RE, Schmelzle R (1996). “Mucoepidermoid carcinoma of salivary gland origin: classification, clinical-pathological correlation, treatment results and long-term follow-up in 55 patients”. J Craniomaxillofac Surg. 24 (3): 133–9. PMID 8842902.

[pmid2306346-3] 3.0 ^3.1 Armstrong JG, Harrison LB, Spiro RH, Fass DE, Strong EW, Fuks ZY (1990). “Malignant tumors of major salivary gland origin. A matched-pair analysis of the role of combined surgery and postoperative radiotherapy”. Arch. Otolaryngol. Head Neck Surg. 116 (3): 290–3. PMID 2306346.

[tumor-4] Wealey, W. V., Perzin, K. H. and Smith, L. (1970), Mucoepidermoid carcinoma of salivary gland origin. Classification, clinical-pathologic correlation, and results of treatment. Cancer, 26: 368–388. doi: 10.1002/1097-0142(197008)26:2<368::AID-CNCR2820260219>3.0.CO;2-K

[pmid707726-5] Spiro RH, Huvos AG, Berk R, Strong EW (October 1978). “Mucoepidermoid carcinoma of salivary gland origin. A clinicopathologic study of 367 cases”. Am. J. Surg. 136 (4): 461–8. PMID 707726.

[pmid16857410-6] Rapidis AD, Givalos N, Gakiopoulou H, Stavrianos SD, Faratzis G, Lagogiannis GA, Katsilieris I, Patsouris E (February 2007). “Mucoepidermoid carcinoma of the salivary glands. Review of the literature and clinicopathological analysis of 18 patients”. Oral Oncol. 43 (2): 130–6. doi:10.1016/j.oraloncology.2006.03.001. PMID 16857410.

[ClodeFonseca1991-7] Clode, Ana Luisa; Fonseca, Isabel; Santos, J. Rosa; Soares, Jorge (1991). “Mucoepidermoid carcinoma of the salivary glands: A reappraisal of the influence of tumor differentiation on prognosis”. Journal of Surgical Oncology. 46 (2): 100–106. doi:10.1002/jso.2930460207. ISSN 0022-4790.

[SpitzBatsakis1984-8] Spitz, M. R.; Batsakis, J. G. (1984). “Major Salivary Gland Carcinoma: Descriptive Epidemiology and Survival of 498 Patients”. Archives of Otolaryngology – Head and Neck Surgery. 110 (1): 45–49. doi:10.1001/archotol.1984.00800270049013. ISSN 0886-4470.

[RapidisGivalos2007-9] Rapidis, Alexander D.; Givalos, Nikolaos; Gakiopoulou, Hariklia; Stavrianos, Spyros D.; Faratzis, Gregory; Lagogiannis, George A.; Katsilieris, Ioannis; Patsouris, Efstratios (2007). “Mucoepidermoid carcinoma of the salivary glands”. Oral Oncology. 43 (2): 130–136. doi:10.1016/j.oraloncology.2006.03.001. ISSN 1368-8375.

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