Epithelial-Myoepithelial Carcinoma of Parotid Gland: A Cytological Challenge with Histological Correlation

Background: Epithelial-Myoepithelial Carcinoma (EMC) is a rare type of malignant tumor of salivary gland accounting for less than 1.5% of all salivary neoplasms. Differential diagnosis of this tumor is complicated, especially by cytological examinations. Case: We present the case of an 86-year-old female who presented clinically with a bulky lesion behind her right ear. Fine needle aspiration cytology with immunocytochemistry has been performed and the patient was diagnosed with a biphasic neoplasm, epithelial-myoepithelial, highly suggestive of EMC. She underwent a wide surgical excision and diagnostic was confirmed by histological examinations, which showed a tumor composed of ducts with double cell lining surrounded by a basement membrane in a sclerotic stroma. Immunohistochemistry was carried on to highlight the biphasic cell pattern. The patient is free of disease after 20 months of surgical procedure. Conclusion: Although there isn’t any antibody that confirms the diagnosis of EMC, due to the difficulty to make a correct diagnostic of this lesion by cytology, we have highly recommended the use of immunocytochemistry assay as an important tool to confirm the double-cell pattern, which in together with a clinical course may help in the diagnostic of EMC. Cytology and histology correlation are rarely reported.