Mucoepidermoid carcinoma history and symptoms
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]
Overview
The hallmark symptom of mucoepidermoid carcinoma is painless swelling. A positive history of occupational exposure (rubber products manufacturing) may be suggestive of mucoepidermoid carcinoma tumor. Symptoms related with mucoepidermoid carcinoma will vary depending on the size and location of the tumor. Common symptoms of mucoepidermoid carcinoma may include facial numbness, adjacent muscle soreness, mandible claudication, otorrhea, dysphagia, and trismus.[1]
History
The clinical presentation of MEC of the minor salivary gland is protean and defies concise description. Many lesions present as a bluish or red purple, fluctuant, smooth surfaced mass that is often clinically mistaken as mucocele. The palate was the most common site for minor salivary gland involvement, which accounts for 41.1%. In our reported case floor of the mouth is involved. Usually the presenting complaint of MEC is an asymptomatic swelling in the floor of the mouth, a mass under the tongue causing some degree of discomfort. Other symptoms include pain, trouble with dental prosthesis retention and tongue numbness. In other cases the tumour may be incidentally discovered by a dentist [5]. In our case patient reported with pain and swelling below the tongue which was mimicking like a ranula.[2]
MEC most frequently arise in the parotid gland, and presents as a painless swelling, with or without facial nerve involvement. These tumours can however be found anywhere there are salivary glands. Overall distribution across various glands is as follows major salivary glands: ~50% parotid gland: ~40%, submandibular gland: ~7%, sublingual gland: ~3%. Minor salivary glands: ~50%, palate: most common, retromolar area, floor of the mouth, buccal mucosa, lip, tongue, other: anywhere in the proximal aerodigestive tract, the lacrimal glands and even in the bronchi. In the present case floor of the mouth is involved up to our knowledge only few cases have been reported involving this site
- Obtaining a complete and detailed history is an important aspect of diagnosing mucoepidermoid carcinoma. Specific areas of focus when obtaining the history include:
- Symptoms: duration, onset, and progression
- Previous exposure to risk factors such as: rubber products manufacturing and asbestos mining
- Ionizing radiation
Symptoms
Most patients with benign tumors of the major or minor salivary glands present with painless swelling of the parotid, submandibular, or the sublingual glands. Neurological signs, such as numbness or weakness caused by nerve involvement, typically indicate a malignancy.[2] Facial nerve weakness that is associated with a parotid or submandibular tumor is an ominous sign. Persistent facial pain is highly suggestive of malignancy; approximately 10% to 15% of malignant parotid neoplasms present with pain.[8,14] (Refer to the PDQ summary on Cancer Pain for more information.) The majority of parotid tumors, both benign and malignant, however, present as an asymptomatic mass in the gland.
- The majority of mucoepidermoid carcinomas are asymptomatic and are usually found incidentally.
- The hallmark of mucoepidermoid carcinomas is a painless growing swelling.
- Other symptoms of mucoepidermoid carcinoma may include:
- Adjacent muscle soreness
- Facial pain
- Dysphagia
- Trismus
- Tinnitus
- Pain during mastication
- Facial numbness
- Mandible claudication
References
- ↑ Eversole LR (1970). "Mucoepidermoid carcinoma: review of 815 reported cases". J Oral Surg. 28 (7): 490–4. PMID 5269211.
- ↑ Guzzo M, Andreola S, Sirizzotti G, Cantu G (August 2002). "Mucoepidermoid carcinoma of the salivary glands: clinicopathologic review of 108 patients treated at the National Cancer Institute of Milan". Ann. Surg. Oncol. 9 (7): 688–95. PMID 12167584.