Insights from literature of esophageal mucoepidermoid carcinoma in a female: A rare case report

Table 1 Clinicopathological findings of mucoepidermoid carcinoma of the esophagus

Ref.	n	Sex		Age in years	Localization			Symptoms	Treatment	Size in cm	IHC	Molecular findings
		Male	Female		Upper	Middle	Lower
Ozawa et al[18]	2	2	-	61	0	1	1	Dysphagia and metastasis	-	6	-	-
Fegelman et al[3]	18	18	2	65.7	2	11	5	Dysphagia	-	6.1	-	-
Lieberman et al[5]	14	9	5	60	1	5	8	Dysphagia	-	-	-	-
Batoon et al[19]	1	1	-	80	0	0	1	Dysphagia	-	6	-	-
Hagiwara et al[4]	8	8	-	58	1	4	3	Dysphagia	Esophagectomy 2 preop-RT & CT	-	PCNA, CEA	-
Tamura et al[6]	1	1	-	67	0	1	0	-	EMR	-	CEA	-
Turkyilmaz et al[20]	1	-	1	82	0	1	0	Dysphagia	Esophagectomy	2	-	-
Chen et al[21]	36	27	9	58	0	30	6	Dysphagia, weight loss, retrosternal pain	Esophagectomy	5	-
Kiyozaki et al[22]	1	-	1	67	0	1	0	-	Esophagectomy	1.5	-	-
Wang et al[7]	58	36	22	59	10	39	9	-	-	5	-	-
Chen et al[2]	1	1	-	52	1	0	0	Dysphagia	Esophagectomy	1	AE1/AE3, CK5/6, CK7, CK18, p40, p63	MAML2 rearrangement
Jeun et al[23]	1	-	1	63	0	1	0	-	EMR	6	-	-
Wang et al[1]	48	42	6	63	3	34	11	-	-	5	p63, CEA, CK, PSA, CK5/6, CK7	-
Osama et al[8]	1	-	1	58	0	0	1	-	Esophagectomy	-	-	FISH, Absence of MAML2 rearrangement
Total	101	117	17	62.5	18	72	38	-	-	-	-	-
Present case	1	-	1	58	0	0	1	Dysphagia	Esophagectomy	1.5	p63, p40, CEA, CK19, MUC1, MUC4, CK8	-

-: Not reported. AE1/AE3: Anticytokeratin monoclonal antibodies; CEA: Carcinoembryonic antigen; CK: Cytokeratin: CT: Chemotherapy; EMR: Endoscopic mucosal resection; FISH: Fluorescent in situ hybridization; IHC: Immunohistochemistry; MAML2: Mastermind-like transcriptional coactivator 2; MEC: Mucoepidermoid carcinoma; MUC: Mucin; PCNA: Proliferating cell nuclear antigen; PSA: Prostate-specific antigen; RT: Radiation therapy.

Table 2 Differential diagnosis table for mucoepidermoid carcinoma of the esophagus

Characteristic	Mucoepidermoid carcinoma	Squamous cell carcinoma	Adenosquamous carcinoma
Composition	Mixed composition of epidermoid, intermediate, and mucous cells[2]	Primarily composed of squamous cells[3]	Distinct squamous and adenocarcinoma components[8]
Cellular arrangement	Squamous and mucinous cells intermixed[1]	Predominantly shows keratinization and intercellular bridges[4]	Separate squamous and glandular components[5]
Nuclear features	Mild atypia with rare mitotic figures[2]	High nuclear pleomorphism and increased mitotic activity[7]	Variable nuclear features depending on cell type[3]
Mucin production	Mucin-producing glandular structures present[5]	Minimal to no mucin production[4]	Some mucin production possible, but less than MEC[1]
IHC markers	Positive for p63, p40, CEA, CK19, MUC1, MUC4, CK8[1]	Positive for p63, p40, may show keratinization[8]	Positive for CK7 and CEA; p63 may be positive[4]
Surface dysplasia	Typically absent; no surface dysplasia observed[3]	Surface dysplasia is commonly present[5]	Dysplasia may be present in adenocarcinoma components[8]
Diagnosis confirmation	Often requires surgical resection for definitive diagnosis; FISH analysis may be beneficial for MAML2 rearrangement[2]	Diagnosed via biopsy; histological features confirm diagnosis[4]	Diagnosis made by identifying distinct components[7]

CEA: Carcinoembryonic antigen; CK: Cytokeratin: FISH: Fluorescent in situ hybridization; MAML2: Mastermind-like transcriptional coactivator 2; MEC: Mucoepidermoid carcinoma; MUC: Mucin.