Salivary gland myoepithelial neoplasms: a clinical and cytopathologic study of 15 cases and review of the literature.

Objective To describe the clinical and cytopathologic findings in 15 cases of salivary gland myoepithelial neoplasms and to assess the value of fine needle aspiration in the diagnosis of these tumors. Study Design Between 2000 and 2007, 15 consecutive patients were diagnosed with benign and malignant myoepithelioma of the head and neck region. A literature review ofPubMed using the search terms myoepithelioma, myoepithelial carcinoma and salivary gland was performed. Results There were 8 men and 7 women. The age at presentation was 12-79 years (mean, 44.5). Parotid gland consisted of 73 % of all primary sites. There were 10 benign and 5 malignant myoepitheliomas. In the benign group, only in 1 case did fine needle aspiration (FNA) revealed benign spindle cell variant, and in others, FNA diagnosis was mixed tumor. Similarly, in the malignant group, FNA diagnosis was malignant in only 1 case. The predominant cell morphology in the benign group was plasmacytoid cells, followed by a spindle and clear cell population. The cell morphology in the malignant lesions was epithelioid cell, clear cell and spindle cell. Scant fibrillary myxoid material was observed in both benign and malignant specimens. In the literature review and by analyzing the pooled data from 24 major reported series including 601 patients, the mean age at diagnosis was 51 years, and the mean male/female ratio was 1 /. 01. In addition, 39 % of all tumors were malignant, and parotid gland consisted of 45% of all primary sites. Conclusion According to the findings of the present study and review of the literature, the cytologic criteria for preoperative diagnosis of salivary gland myoepithelial neoplasms remain unsatisfactory and need to be clarified.