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1For pathologists
Two tables built from the abstracts of the published series: how often each immunostain is positive, and which tumors the disease is confused with1. They were extracted by a model and have not been checked by a pathologist. Each row links to its sources.
2Immunostains in myoepithelial carcinoma
Markers with a positivity rate in two or more series of the carcinoma. Each series is shown on its own, because they differ in site, antibody and cut-off and their abstracts do not all give counts that could be added up.
| Marker | Series | Range | Each series: share positive, tumors, site |
|---|---|---|---|
| S-100 | 6 | 50 to 100% | 100% of 25, salivary gland (Savera 2000); 88% of 25, salivary gland (Skálová 2015); 82% of 51, salivary gland (Kane 2010); 72% of 29, soft tissue (Gleason 2007); 54% of 29, salivary gland (Wang 2015); 50% of 10, soft tissue (Flucke 2012) |
| P63 | 6 | 25 to 100% | 100% of 4, salivary gland (Abd 2015); 96% of 25, salivary gland (Skálová 2015); 92% of 29, salivary gland (Wang 2015); 38% of 16, other (Jiang 2012); 28% of 51, salivary gland (Kane 2010); 25% of 10, soft tissue (Flucke 2012) |
| Smooth muscle actin | 4 | 35 to 75% | 75% of 10, soft tissue (Flucke 2012); 50% of 25, salivary gland (Savera 2000); 36% of 29, salivary gland (Wang 2015); 35% of 51, salivary gland (Kane 2010) |
| EMA | 4 | 21 to 66% | 66% of 29, soft tissue (Gleason 2007); 57% of 10, soft tissue (Flucke 2012); 27% of 51, salivary gland (Kane 2010); 21% of 25, salivary gland (Savera 2000) |
| Pan-keratin | 4 | 67 to 92% | 92% of 29, salivary gland (Wang 2015); 80% of 10, soft tissue (Flucke 2012); 74% of 51, salivary gland (Kane 2010); 67% of 21, soft tissue (Gleason 2007) |
| INI1 loss | 3 | 9 to 50% | 50% of 2, soft tissue (Cyrta 2022); 26% of 19, other (Rekhi 2015); 9% of 22, soft tissue (Hornick 2009) |
| Calponin | 3 | 67 to 98% | 98% of 51, salivary gland (Kane 2010); 75% of 25, salivary gland (Savera 2000); 67% of 10, soft tissue (Flucke 2012) |
| GFAP | 3 | 31 to 54% | 54% of 28, soft tissue (Gleason 2007); 50% of 2, salivary gland (Gorski 2022); 31% of 25, salivary gland (Savera 2000) |
| CEA | 3 | 0 to 0% | 0% of 25, salivary gland (Savera 2000); 0% of 51, salivary gland (Kane 2010); 0% of 29, salivary gland (Wang 2015) |
| CAM5.2 | 2 | 89 to 94% | 94% of 18, soft tissue (Gleason 2007); 89% of 25, salivary gland (Savera 2000) |
| Keratin AE1/AE3 | 2 | 75 to 100% | 100% of 25, salivary gland (Savera 2000); 75% of 20, soft tissue (Gleason 2007) |
| CK14 | 2 | 53 to 96% | 96% of 25, salivary gland (Skálová 2015); 53% of 25, salivary gland (Savera 2000) |
| Vimentin | 2 | 100 to 100% | 100% of 25, salivary gland (Savera 2000); 100% of 51, salivary gland (Kane 2010) |
| Ki-67 | 2 | 31 to 62% | 62% of 29, salivary gland (Wang 2015); 31% of 16, other (Jiang 2012) |
| DOG1 | 2 | 0 to 0% | 0% of 2, salivary gland (Khurram 2019); 0% of 4, salivary gland (Abd 2015) |
3Tumors it is confused with
Tumors named alongside myoepithelial carcinoma in two or more abstracts, with how those abstracts say they are told apart.
| Tumor | Papers | Mostly in | How papers tell them apart |
|---|---|---|---|
| Pleomorphic adenoma | 8 | salivary gland, other head and neck | Uniformly cellular myoepithelial proliferation with expansile nodular lobulated pattern and alternating hypocellular and hypercellular zones indicates carcinoma. (Xu 2019) Multinodular pushing borders, zonal arrangement with hypocellular necrotic myxoid center and peripheral myoepithelial rim, plus infiltration and metastasis, mark carcinoma. (Cormier 2022) |
| Hyalinizing clear cell carcinoma | 7 | salivary gland, other head and neck | EWSR1-ATF1 fusion, found in most hyalinizing clear cell carcinomas, separates them from histological mimics; control clear-cell tumors lacked it. (Antonescu 2011) EWSR1-ATF1 molecular signature is absent in other clear cell mimics. (Weinreb 2013) |
| Myoepithelioma | 7 | salivary gland, other | Uniformly cellular myoepithelial proliferation with expansile nodular lobulated pattern and alternating hypocellular and hypercellular zones indicates carcinoma. (Xu 2019) Malignant myoepithelioma shows infiltrating and destructive growth, unlike benign myoepithelial neoplasms. (Dean 1999) |
| Malignant rhabdoid tumor | 6 | other head and neck | |
| Epithelioid sarcoma | 4 | soft tissue | INI1 lost in 93% of epithelioid sarcomas versus 9% of soft tissue myoepithelial carcinomas; INI1 loss supports epithelioid sarcoma. (Hornick 2009) |
| Epithelial-myoepithelial carcinoma | 4 | salivary gland | HRAS mutations found in 82.7% of epithelial-myoepithelial carcinomas but not in myoepithelial carcinoma. (Urano 2019) RAS Q61R immunostaining was positive in 65% of epithelial-myoepithelial carcinomas but only 3% of tumors with similar components, including myoepithelial carcinoma. (Nakaguro 2021) |
| Extraskeletal myxoid chondrosarcoma | 3 | bone | RT-PCR did not show the chimeric transcripts characteristic of extraskeletal myxoid chondrosarcoma. (Alberghini 2007) EWSR1 rearranged by FISH but no EWSR1/NR4A3 or other EWSR1 fusion partners detected. (Machado 2015) |
| Carcinoma ex pleomorphic adenoma | 3 | salivary gland | PLAG1 or HMGA2 abnormalities present in carcinoma ex pleomorphic adenoma; 90% of de novo carcinomas lacked them. (Katabi 2015) PLAG1 immunohistochemistry cannot separate carcinoma ex pleomorphic adenoma from de novo myoepithelial carcinoma; it did separate it from salivary duct carcinoma. (Katabi 2018) |
| Metaplastic breast carcinoma | 3 | breast | Spindle cells of pure myoepithelial carcinoma have more abundant cytoplasm and lack the small epithelial aggregates seen in fibromatosis-like spindle cell carcinoma. (Kristian 2006) |
| Epithelioid malignant peripheral nerve sheath tumor | 2 | soft tissue | INI1 lost in 50% of epithelioid MPNST versus 9% of myoepithelial carcinomas, so INI1 loss alone does not separate them reliably. (Hornick 2009) |
| Adamantinoma-like ewing sarcoma | 2 | other head and neck, salivary gland | Strong diffuse CD99 should prompt molecular testing; all cases showed EWSR1 and FLI1 rearrangements by FISH. (Bishop 2015) Monotonous cytology despite infiltrative growth, p40 and synaptophysin positivity are clues; EWSR1-FLI1 translocation confirms the diagnosis. (Rooper 2019) |
| Smarcb1-deficient sinonasal carcinoma | 2 | other head and neck | All tumors showed loss of SMARCB1 (INI-1) by immunohistochemistry. (Shah 2020) Surgical specimen showed loss of SMARCB1 (INI-1) by immunohistochemistry; FNA cytology features are nonspecific and overlap with myoepithelial neoplasms. (Allison 2016) |
| Adenomyoepithelioma | 2 | breast | Spindle-cell adenomyoepithelioma was a small circumscribed nodule with spindle-cell lobules and clear-cell glands at the periphery, and looked benign. (Torlakovic 1993) Malignant adenomyoepithelioma showed dual differentiation: myoepithelial cells with secretory epithelial cells intermingled, shown by immunohistochemistry and electron microscopy. (Sugano 2001) |
| Lipid-rich breast carcinoma | 2 | breast | Clear cell myoepithelial tumor showed myoepithelial differentiation: electron microscopy microfilaments and basal membrane remnants, plus actin, keratin and S-100 positivity. (Cartagena 1988) Clear cell myoepithelial carcinoma shows myoepithelial markers (CK14, SMA, S100, calponin, myosin heavy chain, p63); lipid-rich carcinoma stains for neutral lipid. (Jorge 2003) |
| Chordoma | 2 | other head and neck, soft tissue | Brachyury expression and morphology favored poorly differentiated chordoma. (Renard 2014) |
| Mucoepidermoid carcinoma | 2 | salivary gland | Clear cell mucoepidermoid carcinoma lacked myoepithelial markers (S-100, SMA, calponin) and carried CRTC1-MAML2 fusion. (Tajima 2017) MAML2 gene fusion is characteristic of mucoepidermoid carcinoma. (Skalova 2022) |
| Sclerosing rhabdomyosarcoma | 2 | salivary gland | Tumor cells were negative for keratins, S100 and p63 but positive for desmin and myogenin. (Warner 2015) Strong diffuse nuclear MyoD1 and myogenin positivity. (Lamovec 2009) |
| Matrix-producing breast carcinoma | 2 | lung, breast | High-grade epithelial component merges with chondroid matrix without an intervening spindle-cell sarcomatoid zone; stated to differ from conventional myoepithelial carcinoma. (Kinkor 2004) |
| Adenoid cystic carcinoma | 2 | breast, salivary gland | Cells positive for CK14 and SMA, negative for ER and PR, supported malignant myoepithelioma. (Suguna 2011) c-KIT is expressed in both (about 85% versus 61%), so it cannot separate adenoid cystic carcinoma from other salivary tumors. (Vijayakumar 2024) |
4Criteria and grading
In the salivary glands the diagnosis requires a tumor that is unequivocally malignant and exclusively myoepithelial2. In soft tissue, at least moderate cytologic atypia makes a myoepithelial tumor malignant3. Grading is described as controversial4. Necrosis and vascular invasion correlated with disease-free survival in one salivary series4, and tumor size over 5 cm and more than 10 mitoses per 10 high-power fields with worse survival in the pooled literature5.
For patients, the guide to reading a report explains these terms.
5References
- Catalog compiled for this page: PubMed, Europe PMC, OpenAlex and Semantic Scholar records merged and de-duplicated, retrieved 11 November 2026. Method described on this page. method ↩
- Savera AT, Sloman A, Huvos AG et al. Myoepithelial carcinoma of the salivary glands: a clinicopathologic study of 25 patients. The American journal of surgical pathology, 2000. PubMed ↩
- Jo VY, Fletcher CD. Myoepithelial neoplasms of soft tissue: an updated review of the clinicopathologic, immunophenotypic, and genetic features. Head and neck pathology, 2015. PubMed ↩
- Kong M, Drill EN, Morris L et al. Prognostic factors in myoepithelial carcinoma of salivary glands: a clinicopathologic study of 48 cases. The American journal of surgical pathology, 2015. PubMed ↩
- Giridhar P, Gupta P, Mallick S et al. Impact of adjuvant therapy on survival in patients with myoepithelial carcinoma: A systematic review and individual patient data analysis of 691 patients. Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology, 2019. PubMed ↩