MYOCARDIAL THORAX CARCINOMA - CASE REPORT

Myoepithelial carcinoma (CME) is a rare type of tumor that mainly affects the salivary glands. It has morphological, immunohistochemical, clinical and pathological aspects similar to other tumors, such as myoepithelioma, its benign variant, which makes its diagnosis difficult. The etiology is unknown. The tumor manifests mainly in the salivary glands, predominantly in the parotid, corresponding to 0.2% of all tumors of these glands. There is no predominance of gender or ethnicity or great variability in relation to age. The clinical behavior of this disease tends to be aggressive. Diagnostic confirmation of this disease requires combinations of histopathological features and corroborating immunohistochemical profile. The treatment strategy still remains without consensus. Safe margin surgical exeresis with optimized adjuvant chemotherapy offer better survival outcomes. Radiotherapy can be used to prevent local recurrences. The CME becomes even more complicated in relation to management and diagnosis because it can present varied presentation sites, such as the case reported. Male patient, 76 years old, former smoker, referred to the cancer hospital in April 2019 for splenomegaly. He referred right chest pain for 2 months, asthenia and weight loss of 10 kg in 2 years. Brought with him Full abdomen tomography showing bone lesion suggestive of secondary implantation in the right costal arches, abdominal lymph node enlargement, signs of chronic liver disease and splenomegaly. No findings suggestive of primary neoplastic site. On physical examination, a 4.5 × 7 cm lower right costal mass was palpated. New chest and total abdominal CT scans revealed mediastinal lymph node enlargement and right hilar; vegetating lesion in the rectosigmoid transition, suggestive of primary neoplasia; bone injury in the eighth costal arch suggestive of secondary injury. Suspected metastatic colon cancer, costal nodule resection suggested for analysis. Performed biopsy we obtained anatomopathological result of mesenchymal neoplasia, suspected chondrosarcoma; Immunohistochemistry compatible with myoepithelial carcinoma. Patient continues to investigate new primary colon, awaiting colonoscopy and enlargement of immunohistochemical panel seeking possible diagnoses of Castleman's disease, lymphoproliferative or GIST. The authors have no conflict of interest.

 

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Artikel online veröffentlicht:
23. Oktober 2019