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Puay Hoon Tan - One of the best experts on this subject based on the ideXlab platform.

  • cancer stem cell and epithelial mesenchymal transition markers predict worse outcome in Metaplastic Carcinoma of the breast
    Breast Cancer Research and Treatment, 2015
    Co-Authors: Ming Liang Oon, Puay Hoon Tan, Aye Aye Thike, Sie Yong Tan
    Abstract:

    Metaplastic breast Carcinomas are known to overexpress markers of epithelial-mesenchymal transition and cancer stem cells. We evaluated their immunohistochemical expression, correlating with clinicopathological parameters and survival outcomes. The study cohort comprised 63 cases diagnosed at the Department of Pathology, Singapore General Hospital. Tumor size, grade, lymph node stage, and Metaplastic components were reviewed. Immunohistochemistry was performed on sections cut from tissue microarray blocks. Antibodies to ER, PR, HER2, CK14, EGFR, 34βE12, cancer stem cell markers (CD44, CD24, ALDH1A1), epithelial–mesenchymal transition markers (Twist and E-cadherin), were applied. Survival outcomes were correlated with immunohistochemical findings. T2 tumors accounted for 74.7 % of cases, with grade 3 tumors predominating (71.4 %). Triple negativity occurred in 87.3 %, and basal-like subtype in 69.8 % of tumors. CD44+, CD44+CD24−, ALDH1A1+, loss of membranous E-cadherin (Ecadloss) and positive Twist expression was found in 82.5, 73.0, 77.8, 54.0, and 57.1 % of tumors, respectively. Combinational phenotypes of CD44+EcadlossTwist+, CD44+CD24−EcadlossTwist+, and ALDH1A1+EcadlossTwist+ were observed in 28.6, 25.4, and 2.6 % of tumors. Histologic grade was significantly correlated with E-cadherin loss (p = 0.042), Twist positivity (P = 0.001), CD44+EcadlossTwist+ (P = 0.010), CD44+CD24−EcadlossTwist+ (P = 0.018), and ALDH1A1+EcadlossTwist+(P = 0.010). Lymph node stage was significantly associated with CD44+EcadlossTwist+(P = 0.044) and CD44+CD24-EcadlossTwist+ (P = 0.044). Basal-like phenotype was significantly correlated with CD44 expressing (P = 0.004) and CD44+CD24− tumors (P = 0.049). Tumors harboring CD44+EcadlossTwist+ and CD44+CD24−EcadlossTwist+ phenotypes disclosed early recurrence (P = 0.027, P = 0.006) and poorer overall survival (P = 0.037, P = 0.006), respectively. Expression of cancer stem cell and epithelial–mesenchymal transition markers in Metaplastic breast cancers correlates with adverse pathological parameters and outcome.

  • prognostic factors in Metaplastic Carcinoma of the breast a multi institutional study
    British Journal of Cancer, 2015
    Co-Authors: Emad A Rakha, Gary M K Tse, Puay Hoon Tan, Zsuzsanna Varga, Abeer M Shaaban, Fina Climent, C H M Van Deurzen, D Purnell, David Dodwell, Timothy S K Chan
    Abstract:

    Metaplastic breast Carcinoma (MBC) is a rare type of breast cancer that has basal-like characteristics and is perceived to have poorer prognosis when compared with conventional no specific type/ductal Carcinomas (ductal/NST). However, current data on MBC are largely derived from small case series or population-based reports. This study aimed to assess the clinicopathological features and outcome of MBC identified through an international multicentre collaboration. A large international multicentre series of MBC (no=405) with histological confirmation and follow-up information has been included in this study. The prognostic value of different variables and outcome has been assessed and compared with grade, nodal status and ER/HER2 receptor-matched ductal/NST breast Carcinoma. The outcome of MBC diagnosed in Asian countries was more favourable than those in Western countries. The outcome of MBC is not different from matched ductal/NST Carcinoma but the performance of the established prognostic variables in MBC is different. Lymph node stage, lymphovascular invasion and histologic subtype are associated with outcome but tumour size and grade are not. Chemotherapy was associated with longer survival, although this effect was limited to early-stage disease. In this study no association between radiotherapy and outcome was identified. Multivariate analysis of MBC shows that histologic subtype is an independent prognostic feature. This study suggests that MBC is a heterogeneous disease. Although the outcome of MBC is not different to matched conventional ductal/NST breast Carcinoma, its behaviour is dependent on the particular subtype with spindle cell Carcinoma in particular has an aggressive biological behaviour. Management of patients with MBC should be based on validated prognostic variables.

  • spindle cell lesions of the breast the pathologic differential diagnosis
    Breast Cancer Research and Treatment, 2008
    Co-Authors: Gary M K Tse, Puay Hoon Tan, Philip C W Lui, Thomas C Putti
    Abstract:

    Spindle cell lesions of the breast represent an interesting diagnostic problem, as the differential diagnoses are wide. Diagnosing this is particularly problematic but important when encountered in a needle core biopsy, as treatments of different entities are different. In the histologic assessment of spindle cell lesions, the simplified approach is to evaluate the spindle cells and the accompanying epithelial cells. In the biphasic lesions with predominance of spindle cells with benign epithelial component, fibroepithelial lesions including fibroadenomas and phyllodes tumors are the most common, followed by pseudoangiomatous stromal hyperplasia, hamartoma and adenomyoepithelioma. For biphasic lesions with predominance of spindle cells with malignant epithelial component, the biphasic Metaplastic Carcinoma is likely. For monophasic lesions with pure pleomorphic spindle cell only, the monophasic Metaplastic Carcinoma is more common than the rare primary sarcomas like malignant fibrous histiocytoma, angiosarcoma, and other high grade sarcomas. In monophasic lesions with pure bland spindle cells only, the possible lesions include fibromatosis, fibromatosis like Metaplastic Carcinoma and other unusual conditions like dermatofibrosarcoma protuberance. By careful searching for the accompanying epithelial element, and with the aid of appropriate clinical input and judicious use of immunohistochemistry, many of these lesions can be confidently diagnosed in the needle core biopsy, thus facilitating appropriate treatments.

  • Metaplastic Carcinoma of the breast a clinicopathological review
    Journal of Clinical Pathology, 2006
    Co-Authors: Gary M K Tse, Puay Hoon Tan, Thomas C Putti, Philip C W Lui, Benjaporn Chaiwun, Bonita Kb Law
    Abstract:

    Background: Mammary Metaplastic Carcinoma encompasses epithelial-only Carcinoma (high-grade adenosquamous Carcinoma or pure squamous cell Carcinoma), biphasic epithelial and sarcomatoid Carcinoma and monophasic spindle cell Carcinoma. Aim: To evaluate the clinicopathological features of a large series of 34 Metaplastic Carcinomas. Methods: 10 epithelial-only, 14 biphasic and 10 monophasic Metaplastic Carcinomas were assessed for nuclear grade, hormone receptor status, HER2/neu (cerbB2) oncogene expression, Ki-67 and p53, lymph node status and recurrence on follow-up. Results: Intermediate to high nuclear grade were assessed in most (33/34) tumours. Oestrogen and progesterone receptors were negative in 8 of 10 epithelial-only, all 14 biphasic, and 9 of 10 monophasic tumours, cerbB2 was negative in 7 of 10 epithelial-only, all 14 biphasic and 8 of 10 monophasic tumours. Ki-67 was found to be positive in 6 of 10 epithelial-only, 6 of 14 biphasic, and 7 of 10 monophasic tumours, whereas p53 was positive in 6 of 10 epithelial-only, 7 of 14 biphasic, and 8 of 10 monophasic tumours. Lymph node metastases were seen in 7 of 7 epithelial-only, 7 of 11 biphasic, and 3 of 7 monophasic tumours. Recurrences were seen in 4 of 7 epithelial-only, 8 of 9 biphasic, and 4 of 9 monophasic tumours. Conclusions: All three subtypes of Metaplastic Carcinoma are known to behave aggressively, and should be differentiated from the low-grade fibromatosis-like Metaplastic Carcinoma, which does not metastasise. Oncological treatment options may be limited by the frequently negative status of hormonal receptor and cerbB2.

  • fine needle aspiration cytology of Metaplastic Carcinoma of the breast
    Journal of Clinical Pathology, 2006
    Co-Authors: Philip C W Lui, Gary M K Tse, Puay Hoon Tan, Thomas C Putti, Benjaporn Chaiwun, Gita Jayaram, Norman H L Chan, Patrick P L Lau, K L Mak, Aye T Khin
    Abstract:

    Background: Metaplastic Carcinoma of the breast encompasses a heterogeneous group of tumours with variable components of sarcomatoid, squamous or poorly differentiated Carcinomas. Aim: To review a series of 19 cytological preparations of Metaplastic Carcinomas to assess diagnostic cytological features. Methods: 17 cases of fine-needle aspirates of histologically proven Metaplastic Carcinomas (4 monophasic spindle cell Carcinomas, 4 squamous cell Carcinomas and 11 biphasic tumours) were reviewed, with an emphasis on the presence of poorly differentiated Carcinoma, squamous cell Carcinoma, atypical spindle cells, benign stromal fragments and necrosis. Results: All cases were diagnosed as malignant, with 68% of cases showing moderate to high cellularity, and 47% showing necrosis. If the tumours were analysed according to the constituting components histologically, 7, 15 and 8 cases, respectively, possess poorly differentiated Carcinoma cells, sarcomatoid malignant cells and squamous Carcinoma cells, whereas these components were cytologically identified in 11, 10 and 7 cases, respectively. Dual tumour populations were identified in only 5 of the 11 biphasic Carcinomas in the cytological preparations; and the stromal material was cytologically identified in the only case with chondroid stroma. Conclusions: Identification of Metaplastic Carcinoma in cytology remains problematic. There seems to be morphological overlap between various components. The identification of dual components, unequivocal squamous Carcinoma cells and chondroid stroma is helpful for diagnosis, but it is uncommon. The presence of poorly differentiated Carcinoma cells with a suggestion of focal spindle morphology is another clue to the suggestion of Metaplastic Carcinoma.

Gary M K Tse - One of the best experts on this subject based on the ideXlab platform.

  • prognostic factors in Metaplastic Carcinoma of the breast a multi institutional study
    British Journal of Cancer, 2015
    Co-Authors: Emad A Rakha, Gary M K Tse, Puay Hoon Tan, Zsuzsanna Varga, Abeer M Shaaban, Fina Climent, C H M Van Deurzen, D Purnell, David Dodwell, Timothy S K Chan
    Abstract:

    Metaplastic breast Carcinoma (MBC) is a rare type of breast cancer that has basal-like characteristics and is perceived to have poorer prognosis when compared with conventional no specific type/ductal Carcinomas (ductal/NST). However, current data on MBC are largely derived from small case series or population-based reports. This study aimed to assess the clinicopathological features and outcome of MBC identified through an international multicentre collaboration. A large international multicentre series of MBC (no=405) with histological confirmation and follow-up information has been included in this study. The prognostic value of different variables and outcome has been assessed and compared with grade, nodal status and ER/HER2 receptor-matched ductal/NST breast Carcinoma. The outcome of MBC diagnosed in Asian countries was more favourable than those in Western countries. The outcome of MBC is not different from matched ductal/NST Carcinoma but the performance of the established prognostic variables in MBC is different. Lymph node stage, lymphovascular invasion and histologic subtype are associated with outcome but tumour size and grade are not. Chemotherapy was associated with longer survival, although this effect was limited to early-stage disease. In this study no association between radiotherapy and outcome was identified. Multivariate analysis of MBC shows that histologic subtype is an independent prognostic feature. This study suggests that MBC is a heterogeneous disease. Although the outcome of MBC is not different to matched conventional ductal/NST breast Carcinoma, its behaviour is dependent on the particular subtype with spindle cell Carcinoma in particular has an aggressive biological behaviour. Management of patients with MBC should be based on validated prognostic variables.

  • spindle cell lesions of the breast the pathologic differential diagnosis
    Breast Cancer Research and Treatment, 2008
    Co-Authors: Gary M K Tse, Puay Hoon Tan, Philip C W Lui, Thomas C Putti
    Abstract:

    Spindle cell lesions of the breast represent an interesting diagnostic problem, as the differential diagnoses are wide. Diagnosing this is particularly problematic but important when encountered in a needle core biopsy, as treatments of different entities are different. In the histologic assessment of spindle cell lesions, the simplified approach is to evaluate the spindle cells and the accompanying epithelial cells. In the biphasic lesions with predominance of spindle cells with benign epithelial component, fibroepithelial lesions including fibroadenomas and phyllodes tumors are the most common, followed by pseudoangiomatous stromal hyperplasia, hamartoma and adenomyoepithelioma. For biphasic lesions with predominance of spindle cells with malignant epithelial component, the biphasic Metaplastic Carcinoma is likely. For monophasic lesions with pure pleomorphic spindle cell only, the monophasic Metaplastic Carcinoma is more common than the rare primary sarcomas like malignant fibrous histiocytoma, angiosarcoma, and other high grade sarcomas. In monophasic lesions with pure bland spindle cells only, the possible lesions include fibromatosis, fibromatosis like Metaplastic Carcinoma and other unusual conditions like dermatofibrosarcoma protuberance. By careful searching for the accompanying epithelial element, and with the aid of appropriate clinical input and judicious use of immunohistochemistry, many of these lesions can be confidently diagnosed in the needle core biopsy, thus facilitating appropriate treatments.

  • Metaplastic Carcinoma of the breast a clinicopathological review
    Journal of Clinical Pathology, 2006
    Co-Authors: Gary M K Tse, Puay Hoon Tan, Thomas C Putti, Philip C W Lui, Benjaporn Chaiwun, Bonita Kb Law
    Abstract:

    Background: Mammary Metaplastic Carcinoma encompasses epithelial-only Carcinoma (high-grade adenosquamous Carcinoma or pure squamous cell Carcinoma), biphasic epithelial and sarcomatoid Carcinoma and monophasic spindle cell Carcinoma. Aim: To evaluate the clinicopathological features of a large series of 34 Metaplastic Carcinomas. Methods: 10 epithelial-only, 14 biphasic and 10 monophasic Metaplastic Carcinomas were assessed for nuclear grade, hormone receptor status, HER2/neu (cerbB2) oncogene expression, Ki-67 and p53, lymph node status and recurrence on follow-up. Results: Intermediate to high nuclear grade were assessed in most (33/34) tumours. Oestrogen and progesterone receptors were negative in 8 of 10 epithelial-only, all 14 biphasic, and 9 of 10 monophasic tumours, cerbB2 was negative in 7 of 10 epithelial-only, all 14 biphasic and 8 of 10 monophasic tumours. Ki-67 was found to be positive in 6 of 10 epithelial-only, 6 of 14 biphasic, and 7 of 10 monophasic tumours, whereas p53 was positive in 6 of 10 epithelial-only, 7 of 14 biphasic, and 8 of 10 monophasic tumours. Lymph node metastases were seen in 7 of 7 epithelial-only, 7 of 11 biphasic, and 3 of 7 monophasic tumours. Recurrences were seen in 4 of 7 epithelial-only, 8 of 9 biphasic, and 4 of 9 monophasic tumours. Conclusions: All three subtypes of Metaplastic Carcinoma are known to behave aggressively, and should be differentiated from the low-grade fibromatosis-like Metaplastic Carcinoma, which does not metastasise. Oncological treatment options may be limited by the frequently negative status of hormonal receptor and cerbB2.

  • fine needle aspiration cytology of Metaplastic Carcinoma of the breast
    Journal of Clinical Pathology, 2006
    Co-Authors: Philip C W Lui, Gary M K Tse, Puay Hoon Tan, Thomas C Putti, Benjaporn Chaiwun, Gita Jayaram, Norman H L Chan, Patrick P L Lau, K L Mak, Aye T Khin
    Abstract:

    Background: Metaplastic Carcinoma of the breast encompasses a heterogeneous group of tumours with variable components of sarcomatoid, squamous or poorly differentiated Carcinomas. Aim: To review a series of 19 cytological preparations of Metaplastic Carcinomas to assess diagnostic cytological features. Methods: 17 cases of fine-needle aspirates of histologically proven Metaplastic Carcinomas (4 monophasic spindle cell Carcinomas, 4 squamous cell Carcinomas and 11 biphasic tumours) were reviewed, with an emphasis on the presence of poorly differentiated Carcinoma, squamous cell Carcinoma, atypical spindle cells, benign stromal fragments and necrosis. Results: All cases were diagnosed as malignant, with 68% of cases showing moderate to high cellularity, and 47% showing necrosis. If the tumours were analysed according to the constituting components histologically, 7, 15 and 8 cases, respectively, possess poorly differentiated Carcinoma cells, sarcomatoid malignant cells and squamous Carcinoma cells, whereas these components were cytologically identified in 11, 10 and 7 cases, respectively. Dual tumour populations were identified in only 5 of the 11 biphasic Carcinomas in the cytological preparations; and the stromal material was cytologically identified in the only case with chondroid stroma. Conclusions: Identification of Metaplastic Carcinoma in cytology remains problematic. There seems to be morphological overlap between various components. The identification of dual components, unequivocal squamous Carcinoma cells and chondroid stroma is helpful for diagnosis, but it is uncommon. The presence of poorly differentiated Carcinoma cells with a suggestion of focal spindle morphology is another clue to the suggestion of Metaplastic Carcinoma.

Mario Trignano - One of the best experts on this subject based on the ideXlab platform.

  • low grade fibromatosis like spindle cell Metaplastic Carcinoma of the breast a case report and literature review
    Clinical Breast Cancer, 2012
    Co-Authors: Rita Nonnis, Panagiotis Paliogiannis, Daiana Giangrande, Vincenzo Marras, Mario Trignano
    Abstract:

    Low grade fibromatosis-like spindle cell Metaplastic Carcinoma (FLSpCC) of the breast is a very rare variant of breast neoplasia presenting characteristic clinical and biological features: atypical clinical and radiologic presentation amd high risk of local recurrence but low risk of lymph node and distant metastases. Differentiation from other malignant tumors can be obtained only by histologic and immunohistochemical evaluation. These particulars may render the diagnosis and surgical management of such tumors challenging. Given the small amount of data published, every clinical case reported may be important to improve our knowledge on the argument. Therefore we describe in detail the clinical, diagnostic, histopathologic, and therapeutic information observed in our patient and compare them with those acquired by a review of the literature. Of particular interest is the comprehension of the role of the surgical resection margins for the reduction or elimination of local recurrences, which represent the most fearful aspect in the management of such tumors. Another interesting aspect is the assessment of the appropriate follow-up strategy for the early detection of local recurrences or distant metastases. The latter is rare but it must always be considered in patients with FLSpCC.

Naveen Faridi - One of the best experts on this subject based on the ideXlab platform.

  • clinicopathologic features of invasive Metaplastic and micropapillary breast Carcinoma comparison with invasive ductal Carcinoma of breast
    BMC Research Notes, 2018
    Co-Authors: Atif Ali Hashmi, Saher Aijaz, Raeesa Mahboob, Saadia Mehmood Khan, Muhammad Irfan, Narisa Iftikhar, Mariam Nisar, Maham Siddiqui, Muhammad Muzzammil Edhi, Naveen Faridi
    Abstract:

    The aim of this study was to determine the frequency of Metaplastic breast Carcinoma and invasive micropapillary Carcinoma in our population and also to compare the clinico-pathologic features of Metaplastic breast Carcinoma and invasive micropapillary Carcinoma with invasive ductal Carcinoma, not otherwise specified (IDC, NOS). 86.9% of the cases were identified as ductal Carcinoma, NOS, while 2.2% were Metaplastic and 0.76% cases were micropapillary Carcinoma. Metaplastic Carcinomas were found to be of higher grade as compared to IDC, NOS as 81% of Metaplastic Carcinoma were grade III compared to 35% IDC, NOS. 79% of Metaplastic Carcinoma were ER negative and 86% were PR negative, respectively as compared to ductal Carcinoma NOS, which were 40% ER negative and 54% were PR. Similarly, 86.7% micropapillary cancers were ER positive and 73.3% were PR positive. Moreover, 66.7% micropapillary Carcinoma showed nodal metastasis and 77.8% showed lymphovascular invasion, which was significantly higher than that of IDC, NOS micropapillary and Metaplastic Carcinomas accounts for less than 2 and 1% of the breast cancer burden in our population and highly correlates with poor prognosis parameters therefore, require more intensive management in our population.

  • Clinicopathologic features of invasive Metaplastic and micropapillary breast Carcinoma: comparison with invasive ductal Carcinoma of breast
    'Springer Science and Business Media LLC', 2018
    Co-Authors: Atif Ali Hashmi, Saher Aijaz, Raeesa Mahboob, Saadia Mehmood Khan, Muhammad Irfan, Narisa Iftikhar, Mariam Nisar, Maham Siddiqui, Muhammad Muzzammil Edhi, Naveen Faridi
    Abstract:

    Abstract Objectives The aim of this study was to determine the frequency of Metaplastic breast Carcinoma and invasive micropapillary Carcinoma in our population and also to compare the clinico-pathologic features of Metaplastic breast Carcinoma and invasive micropapillary Carcinoma with invasive ductal Carcinoma, not otherwise specified (IDC, NOS). Results 86.9% of the cases were identified as ductal Carcinoma, NOS, while 2.2% were Metaplastic and 0.76% cases were micropapillary Carcinoma. Metaplastic Carcinomas were found to be of higher grade as compared to IDC, NOS as 81% of Metaplastic Carcinoma were grade III compared to 35% IDC, NOS. 79% of Metaplastic Carcinoma were ER negative and 86% were PR negative, respectively as compared to ductal Carcinoma NOS, which were 40% ER negative and 54% were PR. Similarly, 86.7% micropapillary cancers were ER positive and 73.3% were PR positive. Moreover, 66.7% micropapillary Carcinoma showed nodal metastasis and 77.8% showed lymphovascular invasion, which was significantly higher than that of IDC, NOS micropapillary and Metaplastic Carcinomas accounts for less than 2 and 1% of the breast cancer burden in our population and highly correlates with poor prognosis parameters therefore, require more intensive management in our population

Ja Seung Koo - One of the best experts on this subject based on the ideXlab platform.

  • Metaplastic Carcinoma show different expression pattern of yap compared to triple negative breast cancer
    Tumor Biology, 2015
    Co-Authors: Hye Min Kim, Sang Kyum Kim, Woo Hee Jung, Ja Seung Koo
    Abstract:

    The purpose of this study is to examine the expression of Yes-associated protein (YAP) in Metaplastic Carcinoma and compare to those of triple-negative breast Carcinoma (TNBC) for investigation of its implication. Tissue microarrays containing 34 cases of Metaplastic Carcinoma and 175 cases of TNBC were constructed and immunohistochemical staining was used to evaluate expression of the following proteins: YAP and phosphorylated YAP (pYAP). According to immunohistochemical staining results of cytokeratin 5/6, EGFR, claudin 3, claudin 4, claudin 7, E-cadherin, STAT-1, androgen receptor, and GGT-1, Metaplastic Carcinoma and TNBC were sub-classified into six subtypes: basal-like type, molecular apocrine type, claudin-low type, immune-related type, mixed type, and null type. Comparing the expression of YAP and pYAP in Metaplastic Carcinoma and TNBC, the expression of nuclear YAP (p = 0.025), cytoplasmic pYAP (p = 0.010), and nuclear pYAP (p = 0.014) in tumor cell was higher in Metaplastic Carcinoma than TNBC. In Metaplastic Carcinoma, the nuclear YAP expression in tumor cell was associated with loss of E-cadherin (p = 0.020) and claudin type (p = 0.020), and the stromal YAP expression was associated with claudin 7 positivity (p = 0.003). In conclusion, the YAP expression in Metaplastic Carcinoma is higher than that in TNBC, representing the association of stemness and epithelial-mesenchymal transition features in Metaplastic Carcinoma.

  • low grade adenosquamous Carcinoma of the breast with diverse expression patterns of myoepithelial cell markers on immunohistochemistry a case study
    Korean Journal of Pathology, 2014
    Co-Authors: Yoon Jin Cha, Gi Jeong Kim, Byeong Woo Park, Ja Seung Koo
    Abstract:

    This paper reports a case of low-grade adenosquamous Carcinoma (LGASC) arising in a 69-year-old woman, who presented with a 1-cm palpable mass on her right breast. Core needle biopsy diagnosed the mass as a fibroadenoma. After six months, the mass increased in size, and the patient received subsequent mammotome excision. On microscopic examination, bland-looking small glands were infiltrating into the fibrotic stroma with lymphocytic infiltrates at the periphery. Hematoxylin and eosin staining revealed relatively easily detectable myoepithelial cells along the outside in each of the glandular structures with variable degrees of squamous metaplasia. Based on histologic features, the patient was diagnosed with LGASC. LGASC is a rare variant of Metaplastic Carcinoma, which is characterized by a favorable prognosis. Due to the bland cytology and presence of myoepithelial cells, LGASC can be misdiagnosed as benign lesion. Additionally, inconsistent expression of myoepithelial markers could aid the diagnosis of LGASC.