Mucoepidermoid carcinoma

Background Mucoepidermoid carcinoma is the most common malignant salivary gland tumor. The histopathologic grade of this tumor is the most important predictor of prognosis, which has a huge impact on the treatment protocols. Tumor behavior is worse with an aggressive outcome in high-grade than in low-grade mucoepidermoid carcinoma, leading to a need for more intensive treatment. Patients and methods A retrospective clinical study and review of histopathologic grading were carried out, using the two most well-known grading systems, of 60 patients with mucoepidermoid carcinoma diagnosed at the Pathology Department, National Cancer Institute, Cairo University, from 2005 to 2010. Results The recurrence rate was strongly correlated with high tumor grade according to Armed Forces Institute of Pathology and Brandwein grading systems ( P =0.003 and 0.03, respectively). Male sex was significantly correlated with a high tumor grade ( P =0.01). Lymph node status was significantly correlated with the overall survival ( P =0.026). Using the Brandwein grading system, it was found that as the histologic grade increased from low and intermediate to high, disease-free survival ( P =0.029) was significantly decreased. Conclusion The outcome of the cases with intermediate-grade mucoepidermoid carcinoma is less clear and may be categorized as low or high grade according to the grading system used. The Brandwein grading system may have a better predictive value than the Armed Forces Institute of Pathology systems as it identifies the low-grade cases very well.