Epithelial-Myoepithelial Carcinoma of the Submandibular Gland: Case Report

J Nippon Med Sch. 2021;88(3):238-241. doi: 10.1272/jnms.JNMS.2021_88-309.


Epithelial-myoepithelial carcinoma (EMC) is a rare malignant salivary gland tumor that occurs mostly in the parotid gland. We report a case of EMC of the submandibular gland in a young man. The patient was aware of a slow-growing mass in the right submandibular gland for 1 year. Clinical examination and ultrasound confirmed a right submandibular mass, 2.5 × 3 cm2 in size. Ultrasound-guided fine-needle aspiration indicated a diagnosis of pleomorphic adenoma, which was also suggested by magnetic resonance imaging. The submandibular gland tumor was excised. Immunohistochemical analysis showed carcinoma ex pleomorphic adenoma with a major epithelial-myoepithelial component. The patient was not treated with radiotherapy after surgery. No recurrence was observed during 24 months of follow-up. Because the morphology of EMC is similar to that of a benign tumor, it is frequently initially misdiagnosed. Surgery is always the most effective diagnostic and therapeutic measure for salivary gland tumors, especially those that grow slowly. Resection with negative margins is the treatment of choice for EMC; use of adjuvant radiotherapy is controversial.

Keywords: case report; epithelial-myoepithelial carcinoma; pathological diagnosis; salivary cancer; submandibular gland neoplasm.

Publication types

  • Case Reports

MeSH terms

  • Adenoma, Pleomorphic / diagnostic imaging
  • Adenoma, Pleomorphic / pathology
  • Adenoma, Pleomorphic / surgery*
  • Adult
  • Carcinoma / diagnostic imaging
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Myoepithelioma / diagnostic imaging
  • Myoepithelioma / pathology
  • Myoepithelioma / surgery*
  • Neoplasms, Multiple Primary / diagnostic imaging
  • Neoplasms, Multiple Primary / pathology
  • Neoplasms, Multiple Primary / therapy*
  • Submandibular Gland / diagnostic imaging
  • Submandibular Gland / pathology
  • Submandibular Gland / surgery*
  • Submandibular Gland Neoplasms / diagnostic imaging
  • Submandibular Gland Neoplasms / pathology
  • Submandibular Gland Neoplasms / surgery*
  • Treatment Outcome