Myopericytoma of low grade malignancy in the oral cavity

Abstract

Myopericytoma (MPC) of the oral cavity is extremely rare. Herein reported is a case of MPC of low grade malignancy in the oral cavity. A 61-year-old man noticed a tumor of the cheek mucosa, and admitted to our hospital. Oral examination revealed a reddish elevated tumor of the cheek mucosa. Tumorectomy with wide margins was performed. The clinical diagnosis was pyogenic granuloma. Grossly, the tumor was reddish, and measured 1 x 1 x 1cm. Microscopically, oval to spindle tumor cells with hyperchromatic vesicular nuclei and many vasculatures were seen. The tumor cells were contiguous and mixed with endothelial cells in many blood vessels, thus resembling pericytes. Mitotic figures were scattered. The surgical margins were negative for tumor cells. Immunohistochemically, the tumor cells were positive for vimentin, α-smooth muscle actin and p53. The Ki67 labeling was 40%. The tumor cells were negative for cytokeratins (AE1/3 and CAM5.2), CD31, CD34, S100 protein, HMB45, CD10, vimentin, desmin, and factor VIII-related antigen. The endothelium of the vessels were positive for vimentin, CD31, CD34 and factor VIII-related antigen, but negative for α-smooth muscle actin, p53, cytokeratins (AE1/3 and CAM5.2), S100 protein, HMB45, CD10, vimentin, and desmin. The Ki67 labeling was 5%. Because the pericytoid tumor cells showed α-smooth muscle actin and negative for endothelial markers, MPC was diagnosed. In addition, because there was some atypia and mitotic figures were scatters and also because the tumor cells were positive for p53 and Ki67 labeling was high, a pathological diagnosis of MPC with low grade malignancy was made. No recurrence was observed, and the patient is now free from tumor 6 months after the operation.

Keywords

• Oral cavity, myopericytoma, low grade malignancy, histopathology, immunohistochemistry.