Malignant myoepithelioma of the oral palate: Ultrastructural and immunohistochemical studies and survey of the literature

Malignant myoepithelioma arising in the palatal gland is extremely rare. The present study demonstrated ultrastructural and immunohistochemical features of malignant myoepithelioma transformed from long-standing benign myoepithelioma occurring in the palatal gland. Microscopically, the tumor mass was composed of plasmacytoid cells and epitheloid cells. The malignant feature was seen only at the area adjacent to the bone. Immunohistochemically, most of the cells were S-100 positive, whereas vimentin and keratin were only partially positive. Glial fibrillary acid protein (GFAP) was positive at the peripheral cells of the solid nests and epitheloid cells with myxoid stroma. Ultrastructurally, filament-rich cells, tonofilament-rich cells, and filament-poor cells were observed. At the area adjacent to the bone, the cells implying malignancy were filament-poor cells in which the luminal structures could be detected. From these findings, a scarcity of filaments in myoepitheliomatous components may imply a malignancy.