PMC10113058_01
Radiologic images of a MAML2-rearranged central mucoepidermoid carcinoma. (a) Panoramic radiograph showing an ill-defined unilocular radiolucency distal to tooth #31. (b) Axial view of a CT-scan shows a unilocular radiolucency distal to tooth #31 with erosion of the lingual cortical plate and thinning of the buccal cortical plate. (c) Sagittal view of a CT-scan shows a unilocular radiolucency.
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Panoramic radiographic imaging revealed an asymptomatic ill-defined radiolucent lesion distal to tooth #31, without association with the apices, and no evidence of root resorption (Figure 1(a)). A CT-scan of the skull and jaws showed the mandibular radiolucency measuring 23 mm in widest diameter, erosion of the lingual cortical plate, thinning of the buccal cortical plate, and absence of bucco-lingual bony expansion (Figures 1(b) and 1(c)).
Histopathologic photomicrographs of a MAML2-rearranged central mucoepidermoid carcinoma. (a) Epithelial lined cyst wall with infiltrating nests of admixed epidermoid and mucous cells (H&E x40). (b) Infiltrating nests of epidermoid and admixed mucous cells (H&E x100). (c) Infiltrating nest of admixed epidermoid and mucous cells (H&E x400). (d) Split signals indicating positive MAML2 rearrangement by fluorescence in-situ hybridization [Mayo Clinic Laboratories, Laboratory Developed Test 11q21(3'MAML2,5'MAML2) break-apart probe].
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An incisional biopsy of the lesion was performed, and histopathologic examination revealed an epithelial-lined cyst wall with infiltrating nest of an admixture of epidermoid and mucous cells with a predominant mucinous component (Figures 2(a), 2(b), and 2(c)). The MAML2 rearrangement was confirmed by fluorescence in-situ hybridization (Figure 2(d)), with 54% of examined cells translocated.
Gross evaluation of cut sections of a MAML2-rearranged central mucoepidermoid carcinoma of the mandible revealed a cystic cavity filled with gelatinous material.
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Gross evaluation of cut sections of the mandible revealed a cystic cavity filled with gelatinous material (Figure 3).