Primary mucoepidermoid carcinoma of scalp: a case report

Mucoepidermoid carcinoma of the skin is an exceedingly rare neoplasm, with only a limited number of cases documented in the literature. Typically, mucoepidermoid carcinoma arises in the salivary glands, where it accounts for 30% of all malignant salivary gland tumors and generally presents as a low-grade malignancy with a low probability of metastasis.

We report a case of a 49-year-old female patient of African origin who presented to our tertiary center with a longstanding scalp lesion that had been present for approximately 10 years. Initially, the lesion was roughly the size of a tennis ball and remained stable until about 3 months prior to presentation, when it was excised at a peripheral primary health center. Unfortunately, no histological analysis or follow-up was conducted after the excision, and the lesion recurred, progressively increasing in size. The patient reported no cardinal B-symptoms or central nervous system symptoms at any point. Histopathological analysis of the recurrent mass confirmed a diagnosis of mucoepidermoid carcinoma, and a complete surgical excision was subsequently performed. Following surgery, the patient was referred to the national oncology center for radiotherapy as part of her comprehensive oncological management. She is currently 8 months post-excision, receiving radiotherapy, and exhibits no clinical signs of recurrence.

Mucoepidermoid carcinoma originating in cutaneous sites is particularly unusual and may stem from the embryonic development of ectopic salivary glands within the skin. In this case report, we describe a unique presentation of primary mucoepidermoid carcinoma on the scalp, which demonstrated aggressive characteristics with suspected metastasis to the vertebral body. This case highlights the importance of considering mucoepidermoid carcinoma in the differential diagnosis of scalp masses and underscores the need for further investigation into its pathogenesis and metastatic potential.