Parotid Epithelial–Myoepithelial Carcinoma, Lymph Node Metastasis After 9 Years: A Case Report

TL;DR

A rare case of a salivary gland tumor metastasizing to a lymph node 9 years after initial diagnosis highlights the need for long-term monitoring.

Contribution

This is the first reported case of loco-regional lymph node metastasis from parotid EMC after a 9-year interval.

Findings

EMC of the parotid gland can metastasize to lymph nodes even after a long latency period.

The case suggests that long-term follow-up is essential for EMC, even when initially diagnosed at an early stage.

Abstract

Background and Clinical Significance: Epithelial–myoepithelial carcinoma (EMC) is a rare, low-grade malignant tumor of the salivary glands. It is characterized by a low malignancy potential, as indicated by its low rate of lymph node involvement and distant metastasis, and has a local recurrence rate of approximately 50%. Due to the rarity of EMC and the limited data available in the literature, there are no established treatment or follow-up guidelines. Case Presentation: We report the case of an 83-year-old man who presented with swelling in the left submandibular region, occurring 9 years following an initial diagnosis of EMC in the ipsilateral parotid gland. After radiological examinations and an ultrasound-guided fine-needle aspiration biopsy, the patient underwent surgical excision of the lesion with a histological diagnosis of recurrence/metastasis of low-grade epithelial–myoepithelial carcinoma. Conclusions: This is the first documented case of loco-regional lymph node metastasis 9 years after an initial diagnosis of EMC of the parotid gland. Based on our experience, EMC of the parotid gland, even when diagnosed at an early stage, seems to require a long follow-up period.

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