Decoding myoepithelioma: Highlighting diagnostic dilemmas through a series of rare cases

Myoepitheliomas are exceedingly rare neoplasms of the salivary glands. Minor salivary gland neoplasms most frequently occur in the palate (hard palate), followed by the lips, oral mucosa, and tongue/floor of the mouth. Additionally, less prevalent locations encompass the retromolar area, pharynx, nasal cavity, paranasal sinuses, and larynx. The lack of distinctive cytologic features and bland morphology in both benign and malignant myoepitheliomas necessitates the use of histopathology and immunohistochemistry for accurate diagnosis. Hence, here, we report a series of three cases, including two benign and one malignant myoepithelioma, stressing the significance of the above-mentioned techniques for efficient diagnosis and management. This rare case series comprises many salivary gland myoepithelial neoplasms. Examples include the cystic plasmacytoid and clear cell myoepithelioma and low-grade myoepithelial carcinoma with parenchymal invasion. Immunohistochemical myoepithelial markers include vimentin, smooth muscle antigen, S 100, and p63. All of our patients had a positive p63. Myoepithelioma is diagnosed by biopsy because many tumours have similar clinical and radiological characteristics. They rarely reoccur, improving prognosis. Malignant myoepitheliomas may require wide local excision with clean margins. Regular follow-up is recommended. Myoepitheliomas are rare salivary gland tumours. Myoepithelioma should be suspected in slow-growing, well-defined salivary gland masses with variable post-contrast enhancement on CT images. Histopathology and immunohistochemistry are the best myoepithelioma diagnostic methods. Malignant myoepithelioma must be ruled out by thorough invasion testing.