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10 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
Mucoepidermoid carcinoma is the most common salivary gland cancer and, for most people, one of the most curable: low-grade tumours are removed surgically and rarely return, while high-grade tumours need radiotherapy after surgery and are treated like other aggressive head and neck cancers if they spread.
Mucoepidermoid carcinoma is made of mucous, intermediate and squamous-like (epidermoid) cells in varying proportions, and most tumours carry a CRTC1-MAML2 or CRTC3-MAML2 fusion that drives CREB-regulated genes and marks a better outlook. It arises in the parotid, the minor salivary glands of the palate and lips, and the bronchi, and it is the commonest salivary cancer in children and after radiotherapy or chemotherapy for a childhood cancer. Grade, assigned by histological systems such as the AFIP and Brandwein scores, is the strongest predictor of behaviour: low-grade tumours are indolent, high-grade tumours spread to nodes and distant sites.
Treatment is surgical. Low-grade tumours are cured by complete excision with a margin (superficial or total parotidectomy preserving the facial nerve, or excision of the palatal lesion), and do not need radiotherapy when margins are clear. High-grade and intermediate-grade tumours, and any with positive margins, perineural invasion or nodal spread, are treated with neck dissection and postoperative radiotherapy, with cisplatin chemoradiation considered for extranodal extension or positive margins by analogy with squamous cell carcinoma.
| Setting | Approach | Guideline |
|---|---|---|
| Low-grade, localised | Complete excision with a margin (parotidectomy preserving the facial nerve, or excision of the minor gland lesion); postoperative radiotherapy only for positive margins that cannot be re-excised. | NCCN Category 2A |
| Intermediate- and high-grade or node-positive | Resection with neck dissection and postoperative radiotherapy; cisplatin chemoradiation considered for extranodal extension or positive margins. | NCCN Category 2A |
| Recurrent or metastatic | Platinum-based chemotherapy (carboplatin-paclitaxel or cisplatin-based); pembrolizumab for PD-L1-positive or mutation-rich tumours; observation for indolent low-grade metastases. | NCCN Category 2A |
| Trials | Pan-salivary and pan-tumour trials of new agents that accept mucoepidermoid carcinoma. | not mapped |