PMC4639669_01
Preoperative MRI, coronal T2-W: 5 x 4 x 3 cm mass originating from the left submandibular gland. Two different multilobed neoformations with colliquate areas (black square and black trapezius) delimited by a thick pathological peripheral tissue are clearly visible.
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Contrast-enhanced magnetic resonance imaging (MRI) of the head and neck (Figure 1) showed a 5 x 4 x 3 cm multilobed neoformation originating from the left submandibular gland.
Mucoepidermoid carcinoma: glandular-like structure composed of a mixture of squamous and clear cells containing mucin (hematoxylin and eosin, 40x).
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Such elements appeared arranged in solid cell nests with central necrosis and cribriform areas (Figure 2).
Some neoplastic epithelial cells with clear cytoplasm retain PAS positivity after diastase digestion (40x).
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Cytokeratin and PAS positivity (Figure 3) were evident.
Osteosarcoma cells: mesenchymal elements of medium or large size with hyperchromatic, pleomorphic, and multinucleated nuclei arranged around an osteoid matrix (hematoxylin and eosin, 10x).
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Such cellular elements appeared to be arranged around an eosinophilic material attributable to an osteoid matrix (Figure 4).