Pathology – Research and Practice 207 (2011) 127–130 Contents lists available at ScienceDirect Pathology – Research and Practice journal homepage: www.elsevier.de/prp Teaching cases Primary myoepithelial carcinoma of the larynx: Case report and review of the literature Guohua Yu a,∗ , Guimei Qu a , Lingling Kong b , Xubo Pan a , Wei Wang a , Junwei Lv c a Department of Pathology, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, No. 20, Yuhuangding East Road, Yantai, 264000, China b Binzhou Medical University, Yantai, China c Department of Imaging Center, Affiliated Yantai Yuhuangding Hospital, Medical College of Qingdao University, Yantai, China article info Article history: Received 1 August 2010 Received in revised form 28 September 2010 Accepted 25 October 2010 Keywords: Myoepithelial carcinoma Immunohistochemistry Larynx abstract Myoepithelial carcinoma of the head and neck is a rare malignant tumor and usually arises from the salivary glands. The larynx is an uncommon condition of involvement in myoepithelial carcinoma. Here we describe the forth reported case of myoepithelial carcinoma in the larynx. It affected a 78-year- old male who presented initially with hoarseness and bloody sputum. The patient had suffered from continuing hoarseness and bloody sputum for three months before he consulted an otorhinolaryngologist one month ago. Computed tomography scan showed a polypoid tumor involving the right vocal cords. Biopsy was performed, and the disease was pathologically diagnosed as myoepithelial carcinoma of the larynx by hematoxylin–eosin and immunohistochemical staining. The total follow-up period was eleven months. The repeated laryngoscopy or CT scan revealed no recurring or residual lesion during the post-surgical course. © 2010 Elsevier GmbH. All rights reserved. Introduction Myoepithelial carcinoma (MEC), also referred to as malignant myoepithelioma, is a rare malignant tumor of the salivary glands and is characterized by clonal proliferation of myoepithelial cells. Myoepithelioma, which commonly occurs in the major salivary gland, accounts for less than 1% of salivary gland tumors, and MEC represents only 10% of myoepithelioma [1]. To the best of our knowledge, only three cases of MEC in the larynx have been reported in the English-language literature [2,3]. Therefore, we present another case and discuss its clinical, histopathological, and immunohistochemical features, as well as the prognosis. Clinical history A 78-year-old male presented with a three-month history of continuing hoarseness and bloody sputum. The patient presented at our Department of Otorhinolaryngology one month ago. No abnormal physical sign was found during medical examination, and neck palpation was negative for lymph nodes. Fiber laryngoscopy revealed a grayish and raised mass (1.5 cm × 1.3 cm × 1 cm) on the right side of the vocal cords. The surface of the mass was hyper- emic and anabrotic (Fig. 1). A computed tomography (CT) scan ∗ Corresponding author. Tel.: +86 1385 4501 211; fax: +86 535 6691 999x81461. E-mail address: ygh0535@hotmail.com (G. Yu). showed that a polypoid tumor involved the right vocal cords, and the outer edge of the tumor was smooth. The CT attenuation value was 35.9 HU. There were no swollen lymph nodes around the neck, and no bone invasions were observed (Fig. 2). His complete blood counts, erythrocyte sedimentation rate, C-reactive protein, blood biochemistry, electrolytes, blood urea nitrogen and serum crea- tinine, urine analysis, and endocrine profile were normal. Chest X-ray, technetium bone scan, and abdominal ultrasonography did not reveal any other abnormality. Pathological finding Biopsy using a fiber laryngoscope was performed, with the patient under general anesthesia. The tumor was fragile and hem- orrhagic. Histologically, the tumor was anabrotic and covered with squamous epithelium (Fig. 3a); the tumor consisted of round or oval cells with a typical plasmocytoid appearance and atypical nuclear mitotic activity. The cells were arranged as loose aggregates lying in a myxoid background, and exhibited no ductal differentiation. Infil- trative tumor cells were seen at the edge of the tumor. Pathological mitosis and multifocal necrosis could be observed easily (Fig. 3b). Using immunohistochemical techniques, cells were positive with antibody to S100 protein, smooth muscle actin (Fig. 4a), glial fibril- lary acidic protein, P63, vimentin, and broad-spectrum cytokeratin (Fig. 4b), and were negative with antibody to CD10, HMB45, desmin, and CD138. The Ki67 labeling index was approximately 30%. All the primary antibodies are listed in Table 1. On the basis of clinical 0344-0338/$ – see front matter © 2010 Elsevier GmbH. All rights reserved. doi:10.1016/j.prp.2010.10.006