Giant myoepithelioma of the upper lip

Myoepithelioma is a relatively rare form of salivary gland tumor composed entirely of myoepithelial cells. This tumor was formerly considered to be a subtype of pleomorphic adenoma; however, in the latest World Health Organization classification of 1991 it is listed as an independent entity. We report herein an extremely rare case of myoepithelioma of the upper lip. A 78-year-old Japanese female presented with a huge, painless mass on her upper lip. CT and MRI revealed a 50×40 mm² well-defined ovoid tumor. A benign minor salivary gland tumor was clinically suspected, and the patient underwent complete resection of the tumor under general anesthesia. The surgical defect was immediately reconstructed using an Abbe–Estlander flap. The tumor was histopathologically diagnosed as a benign myoepithelioma of the minor salivary gland. Immunohistochemically, the tumor cells were positive for vimentin, cytokeratins, α-smooth muscle actin and S-100 protein, confirming the morphological diagnosis of myoepithelioma. The patient's postoperative clinical course was uneventful, and satisfactory results were obtained both functionally and esthetically. The pathology, clinical manifestations and treatment of myoepithelioma are reviewed.     

Merkel-cell tumor of the upper lip

A case of Merkel cell tumor is reported. Generally localized in the dermis of the cervicofacial region, this case of a tumor involving the labial mucosa is unique. Clinical and histologic characteristics of this rare clinicopathologic entity are summarized.     

Reconstruction of the upper lip using the mucosal eversion technic

A one-stage reconstruction technique for upper lip defects is presented. This technique uses everted mucosal advancement flaps for the reconstruction of the vermilion border of the lip. It is an extension of Meyer's method employed in the reconstruction of the lower lip (1973) and differs from Camille Bernard's procedure in that horizontal incisions with bilateral triangular skin excisions are used instead of the more unaesthetic perpendicular incisions in the nasolabial fold, leaving a scar along the vermilion border. The method is suitable for reconstructing the upper lip after excision of up to 80% of its substance, and is superior to traditional methods in terms of both the functional and aesthetic results obtained.     

Basal cell adenomatosis of minor salivary glands of the upper lip

Summary The basal cell adenoma is one of the more commonly occurring types of salivary tumors in the upper lip. A case with multiple (five) tumors is presented and the literature reviewed. This lesion would be more correctly designated as an adenomatosis. In spite of its frequent multicentricity, recurrence is unusual following surgical removal.     

Basal cell adenomatosis of minor salivary glands of the upper lip

The basal cell adenoma is one of the more commonly occurring types of salivary tumors in the upper lip. A case with multiple (five) tumors is presented and the literature reviewed. This lesion would be more correctly designated as an adenomatosis. In spite of its frequent multicentricity, recurrence is unusual following surgical removal.     

Nerve sheath myxoma of the upper lip: a case report

Nerve sheath myxoma is a benign tumor that rarely occurs in the lip area. In this article, a 28-year-old woman admitted with a complaint of painless swelling in the upper lip is presented. The lesion was excised, and histopathological and immunohistochemical examinations were performed. There are only five reported cases in the available literature. Although very rare, nerve sheath myxoma should be considered in the differential diagnosis of lip mass and widely excised to avoid local recurrence. The patient is under clinical control with no signs of recurrence after 16 months.     

Transmedian innervation of the human upper lip: an embryological study

Anesthesia of the caudal margin of the nose and the upper lip is of considerable importance to otolaryngologists. It follows, therefore, that the sensory innervation is also important. In situations where adequate anesthesia is needed and limited quantity must be used, it is advantageous to know where that limited amount could be best placed to accomplish the greatest anesthesia. Due to transmedian innervation of the upper lip by the infraorbital nerves, it may be necessary to block both sides when procedures are to be carried out in the vicinity of the midline. The infraorbital nerves of each side cross the area of the frontonasal process and ultimately decussate in the midline. No other nerves were found to participate in sensory innervation of the upper lip.     

Schwannoma of the upper lip: case report and literature review

Schwannomas, arising from nerve-sheath Schwann cells, rarely occur in the lip area. A Medline search in English literature from 1966 to 2002 revealed only 6 documented cases of schwannomas of the lip. We report the unusual case of a 22-year-old female patient who developed a schwannoma of the upper lip. Histopathological examination and immunohistochemical staining studies were performed, with the relevant literature for this clinical rarity also reviewed. Complete enucleation of the schwannoma usually achieves cure. Although very rare, schwannoma should be taken into consideration in the differential diagnosis of any upper lip mass.     

Submandibular gland myoepithelioma

Benign myoepithelioma is a very rare form of salivary gland tumor, composed entirely of myoepithelial cells. It accounts for approximately 1% of all salivary gland tumors and is most frequently located in the parotid gland and in the minor salivary glands of the hard palate. We describe herein the ninth reported case of myoepithelioma of the submandibular gland. Benign myoepithelioma must be differentiated from several benign and malignant epithelial and mesenchymal tumors. Immunohistochemical staining can help differentiate between these conditions, but histopathology remains the gold standard for diagnosing this neoplastic process.     

Malignant myoepithelioma of the soft palate

Malignant myoepitheliomas (MM) (myoepithelial carcinomas) are rare tumors representing <1% of salivary gland tumors. They are characterized as being locally aggressive. Rarely do they present distant metastases; however, when they do metastasize the sites most affected are the lungs, liver, pleura, peritoneum and skin. They may originate de novo in a pleomorphic adenoma or a benign myoepithelioma. We report the case of a patient with a submucosal lesion of the soft palate measuring ∼4 cm × 3 cm. The patient underwent transoral resection with a microscope and CO₂ laser. Histopathological report was MM originating in a pleomorphic adenoma. Management of this neoplasm is controversial. Myoepithelial carcinoma is a rare neoplasm whose diagnosis includes immunohistochemical (IHC) studies. Surgery is the cornerstone of treatment. Management with laser surgery may preserve the function of the soft palate without deterioration of the quality of life in these patients.     

Salivary gland myoepithelioma

Myoepithelioma is a rare salivary gland tumor (less than 1%) which are usually located in parotid gland and minor salivary glands. Histology and immunohistochemical features of this tumors are reviewed. We report 2 cases arising in parotid and hard palate.