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Q. Had removal of myoepithelial carcinoma before three years. Can I have a recurrence of it?

Answered by
Dr. Chitrangada
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Nov 26, 2018

Hi doctor,

I had an extraction of two tumors of epithelial-myoepithelial carcinoma with a prominent dedifferentiated (high-grade transformation) myoepithelial component extracted from my nasal cavity before three years. MRI scans were performed to look for recurrences. In my previous MRI, I had a perfusion curve showing ascending plateau.

I have significant weight loss for the past seven months. I have occasional nosebleeds with pain. I also have fever, sensitivity, and bleeding in the mouth palate occasionally. Currently, I am taking Iscador P series II injections three times a week, painkillers, and supplements. Please advice.

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Hi,

Welcome to icliniq.com.

Please give your queries and concerns on pointwise. So that, I can answer them for you. I will point out the abnormalities present in the scan soon.

Thank you doctor,

I would like to know whether there is anything abnormal or any signs of new potential lesions or tumors. This type of cancer is rare and unpredictable, hence recurrence can occur anywhere. Also, I am concerned about the perfusion curve showing descending plateau. On my previous MRI, perfusion curve showed ascending plateau. Is it a sign of malignancy? Could you please tell me what is called washout and what is ADC mean in this scan?

#

Hi,

Welcome back to icliniq.com.

I have gone through the attachment (attachment removed to protect patient identity). The present MRI (magnetic resonance imaging) shows polypoidal mucosal thickening involving the bilateral maxillary sinuses suggesting sinusitis. Left inferior turbinate hypertrophy is noted. Postoperative changes are seen in the anterior nasopharynx (probably post right uncinectomy). There is no mass lesion noted along with the operative bed to suggest recurrent or residual disease. There is no cervical lymphadenopathy and intra-cranial abnormality seen. The orbital structures appear normal bilaterally.

The imaging signs do not show a recurrence. Areas of restricted diffuse indicate solid tumors on MRI, and these lesions show a corresponding signal drop on ADC (apparent diffusion coefficient) maps or images. There is no such area seen along the operative bed in the MRI scan. Acutely ascending dynamic contrast curves indicate malignancy on MRI. However, the plateau or shouldering of the curves favors benign pathology.


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