Related Experiment Video
Updated: May 12, 2025
Isolation of Salivary Epithelial Cells from Human Salivary Glands for In Vitro Growth as Salispheres or Monolayers
Published on: July 15, 2019
Clinicopathological Analysis of Salivary Glands Warthin-like Mucoepidermoid Carcinoma: A Systematic Review
Ricardo Anderson de Oliveira Vasconcelos1, Isaac Santos Araújo1, Luiz Miguel Ferreira1
1Oral Diagnosis Department, Piracicaba Dental School, University of Campinas (UNICAMP), Avenida Limeira 901, Areião, Piracicaba, São Paulo, 13414-900, Brazil.
Purpose:
This systematic review summarizes the current literature on Warthin-like mucoepidermoid carcinoma (WL-MEC), highlighting its clinicopathological, immunohistochemical and molecular characteristics.
Methods:
This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered by PROSPERO (protocol CRD42024523598). Case reports and case series published in English on WL-MEC of major and minor salivary glands were included. The search was conducted in MEDLINE/PubMed, Scopus, Web of Science, and Embase databases in November 2024, along with a search in grey literature. Twenty-one articles met the eligibility criteria. The extracted information included clinicopathological data, immunohistochemical and molecular tests, treatment, recurrence, metastasis, follow-up, and status. The data analysis was performed descriptively, and presented as absolute and relative frequencies, and means or median for numerical variables.
Results:
78 WL-MEC cases were analyzed, with a female predominance observed and a wide age range, peaking in the sixth decade of life. Most cases involved the parotid gland and presented as indolent nodular masses, often asymptomatic. Histologically, the majority were low-grade tumors, with multicystic growth patterns and a lymphocytic infiltrate. Immunohistochemical analysis revealed consistent expression of p63, p40, CK5/6, and exhibited low Ki67 proliferation index (< 5%). MAML2 rearrangement was identified in all molecularly analyzed cases (n = 72/ 100%). Surgical treatment was the most common approach, which typically resulted in low recurrence rates, no distant metastasis, and favorable overall outcomes.
Conclusion:
WL-MEC cases typically present as indolent, asymptomatic nodules in the parotid gland, often with a female predominance and a wide age range, peaking in the sixth decade of life. Surgery is the primary treatment and is associated with a favorable prognosis, characterized by low rates of recurrence and metastasis. These tumors commonly exhibit low-grade histopathological features, a multicystic pattern, and lymphocytic inflammatory infiltrate. The detection of MAML2 rearrangement, typically via FISH, is an essential diagnostic tool, emphasizing the molecular similarities between WL-MEC and conventional MEC.
