Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2011:2011:610383.
doi: 10.1155/2011/610383. Epub 2011 Jul 12.

Skull metastasis as initial manifestation of pulmonary epithelial-myoepithelial carcinoma: a case report of an unusual case

Masamitsu Nishihara  1 , Naoya Takeda, Shoutarou Tatsumi, Keiji Kidoguchi, Shigeto Hayashi, Takashi Sasayama, Eiji Kohmura, Kimio Hashimoto
Affiliations
Case Reports

Skull metastasis as initial manifestation of pulmonary epithelial-myoepithelial carcinoma: a case report of an unusual case

Masamitsu Nishihara et al. Case Rep Oncol Med. 2011.

Abstract

Epithelial-myoepithelial carcinoma (EMC) of the lung is rare and is considered to be low-grade malignancy. Intracranial metastasis of pulmonary EMC has not previously been reported according to our search of the literature. We report a case of skull metastasis as the initial manifestation of pulmonary EMC. An 81-year-old man complained of left leg motor weakness. Neurological examination showed left hemiparesis. Computed tomography and magnetic resonance imaging revealed an osteolytic tumor in the right frontal bone with invasion to the dura and subdural space, attached to the superior sagittal sinus. Subtotal removal of the tumor was performed, and the left hemiparesis showed improvement. Histopathological study revealed the tumor to consist of epithelial and myoepithelial cells. Pulmonary EMC was diagnosed. The MIB-1 index in primary lesion was approximately 10%. The skull and dura are possible sites for metastasis from pulmonary EMC. The MIB-1 index is a predictive marker of malignant potential.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Computed tomographic scan of the brain shows an osteolytic tumor in the right frontal region (a). Coronal (b) and sagittal (c) T1-weighted magnetic resonance images with gadolinium-diethylenetriaminepenta-acetic acid revealing a heterogeneously enhanced tumor in the right frontal region with perifocal edema. The tumor was attached to the wall of the superior sagittal sinus and dura. Computed tomographic scan of the chest reveals an endobronchial growth in the hilum of the right upper lobe (d).
Figure 2
Figure 2
Intraoperative photographs of the tumor. (a) Complete exposure of the tumor covered by the periosteum. (b) Resected tumor with bone.
Figure 3
Figure 3
(a) Tubular structures with an inner layer of cuboidal epithelial cells and an outer layer of myoepithelial cells with clear cytoplasm. Mitoses were not conspicuous (hematoxylin-eosin, original magnification ×200). (b) Immunoreactivity in epithelial cells for cytokeratin (original magnification ×200). (c) Immunoreactivity in myoepithelial cells for p63 (original magnification ×200). (d) Immunoreactivity for the MIB-1 was about 10% (original magnification ×200).
See this image and copyright information in PMC

References

    1. Muslimani AA, Kundranda M, Jain S, Daw HA. Recurrent bronchial epithelial-myoepithelial carcinoma after local therapy. Clinical Lung Cancer. 2007;8(6):386–388. - PubMed
    1. Doganay L, Bilgi S, Ozdil A, Yoruk Y, Altaner S, Kutlu K. Epithelial-myoepithelial carcinoma of the lung: a case report and review of the literature. Archives of Pathology & Laboratory Medicine. 2003;127(4):e177–180. - PubMed
    1. Ruska A, Kerekes Z, Hovorková E, Bartoň P. Epithelial-myoepithelial carcinoma of the bronchus. Pathology Research and Practice. 1998;194(6):431–435. - PubMed
    1. Wilson RW, Moran CA. Epithelial-myoepithelial carcinoma of the lung: immunohistochemical and ultrastructural observations and review of the literature. Human Pathology. 1997;28(5):631–635. - PubMed
    1. Kang DY, Yoon YS, Kim HK, et al. Primary salivary gland-type lung cancer: surgical outcomes. Lung Cancer. 2010;72:250–254. - PubMed

Publication types

LinkOut - more resources