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Nonsebaceous Lymphadenoma-like Mucoepidermoid Carcinoma: A Rare Case Report
Julin Liu1,2, Yan Ma3, Jiling Zeng3
1Histo Pathology Diagnostic Center, Shanghai, China.
International Journal of Surgical Pathology
|December 12, 2025
Summary
This study details a rare nonsebaceous lymphadenoma-like mucoepidermoid carcinoma (NSLA-like MEC) in a parotid gland. Molecular testing for CRTC1::MAML2 fusion is crucial for diagnosing this challenging tumor.
Area of Science:
- Pathology
- Oncology
- Head and Neck Surgery
Background:
- Nonsebaceous lymphadenoma-like mucoepidermoid carcinoma (NSLA-like MEC) is an extremely rare variant of mucoepidermoid carcinoma.
- Distinguishing NSLA-like MEC from nonsebaceous lymphadenoma (NSLA) presents diagnostic difficulties.
Purpose of the Study:
- To present a case of NSLA-like MEC in a parotid gland.
- To highlight the diagnostic challenges and the importance of molecular testing in classifying these tumors.
Main Methods:
- Histopathological examination of a parotid tumor.
- Immunohistochemical staining for P63, S100, SMA, and keratin 7.
- Mucicarmine staining for mucin detection.
- Fluorescence in situ hybridization (FISH) for CRTC1::MAML2 fusion analysis.
Main Results:
- The tumor exhibited neoplastic epithelial cells within a lymphoid stroma with germinal centers.
- Immunohistochemistry showed specific staining patterns for outer basaloid and inner cuboidal cells.
- FISH analysis confirmed CRTC1::MAML2 fusion in 78% of tumor cells, confirming MEC diagnosis.
- Morphological features included complex glandular structures and subtle cytologic atypia.
Conclusions:
- NSLA-like MEC requires careful morphological assessment and molecular confirmation.
- CRTC1::MAML2 fusion analysis is essential for accurate diagnosis of MEC, especially in lymphoid-rich lesions.
- Early and accurate diagnosis is critical for appropriate patient management.
