Myoepithelial carcinoma of soft tissues of the right axillary region with metastasis to the cecum: A clinical case

Abstract

Relevance: Myoepithelial carcinoma is a morphologically diverse tumor that arises either de novo or due to the malignant transformation of its benign counterpart, myoepithelium. These are relatively lesser-known lesions rarely found in the head and neck area. Myoepithelial carcinoma (MC) is a rare malignancy primarily found in the salivary gland. MK can be confused with many other tumors outside the salivary glands, as a wide range of cytomorphological and immunohistochemical features characterizes them. Soft tissue MCs are extremely rare, although a salivary gland MC is relatively common and well-known with similar morphology. The histogenesis of soft tissue MC is still unknown. The tumor may have myoepithelial differentiation but is not derived from myoepithelial cells. Due to the rarity of soft tissue MCs, the number of studies and data on this tumor’s clinical and pathological characteristics are limited. In addition, the limited number of diagnostic criteria and prognostic parameters makes diagnosing and treating soft tissue MC difficult.

The article describes a rare case of MC, formed from the soft tissues of the axillary region, with metastasis to the cecum.

The study aimed to describe the imaging and clinicopathological features of axillary myoepithelial carcinoma of soft tissues with metastasis to the cecum and to form an understanding of this disease.

Methods: A rare case of soft tissue CM of the axillary region with metastasis to the cecum is described. A 57-year-old woman complained of lymphadenopathy in the right axillary region in October 2020.

Results: According to ultrasound examination, the lymph node is up to 3.0x3.5 cm in the right axillary region. Based on histopathological and immunohistochemical (IHC) data, on 02/03/2022, the final diagnosis was made: MK of the soft tissues of the right axillary region. According to positron emission tomography/computed tomography (PET/CT), after 4 months, a local focus of active accumulation was detected in the projection of the cecum, with an adjacent enlarged regional lymph node of the paracolic group. On January 18, 2023, surgical treatment was performed in the following volume: “Right-sided hemicolectomy.” Histological examination confirmed MC. According to the multidisciplinary team’s (MDG) decision, the patient received 3 courses of targeted therapy.

Conclusion: This case report raises awareness and improves MC diagnostics and treatment.