Sign-in to Ask A Doctor - 24x7
OR
Sign in with Google
Can A Low Grade Mucoepidermoid Carcinoma Reoccur?
Question: Dear Sir/Madam
I had low grade mucoepidermoid carcinoma on my right parotid 4 years ago. My facial nerve was intact before the surgery and CT scan showed tumor size 2cm on superficial lobe. But during surgery it was found that three(3) branches of facial nerve were inside the tumor but nerve was not damaged. My surgeon removed the tumor by piecemeal excision with preservation of facial nerve and followed by radiation therapy of 32 fractions( 64 gy). Histopathology report shows low grade mucoepidermoid carcinoma with PERINEURAL INVASION.
During follow-up I was only locally checked by pressing fingers on affected area for local recurrence. I am fine and no evidence of disease.It has been 4 years since then.
What I want to know is
1) How long I have to follow-up and what is the cure rate in my case?
2) Can low grade mucoepidermoid carcinoma metastasize to lungs? I heard different opinion from different doctors and many say it normally does not metastasize and I have no symptoms( cough,shortness of breath, hoarseness etc.).
3) If it metastasizes then how many years it takes to be symptomatic ( must show symptoms).
Thank You.
I had low grade mucoepidermoid carcinoma on my right parotid 4 years ago. My facial nerve was intact before the surgery and CT scan showed tumor size 2cm on superficial lobe. But during surgery it was found that three(3) branches of facial nerve were inside the tumor but nerve was not damaged. My surgeon removed the tumor by piecemeal excision with preservation of facial nerve and followed by radiation therapy of 32 fractions( 64 gy). Histopathology report shows low grade mucoepidermoid carcinoma with PERINEURAL INVASION.
During follow-up I was only locally checked by pressing fingers on affected area for local recurrence. I am fine and no evidence of disease.It has been 4 years since then.
What I want to know is
1) How long I have to follow-up and what is the cure rate in my case?
2) Can low grade mucoepidermoid carcinoma metastasize to lungs? I heard different opinion from different doctors and many say it normally does not metastasize and I have no symptoms( cough,shortness of breath, hoarseness etc.).
3) If it metastasizes then how many years it takes to be symptomatic ( must show symptoms).
Thank You.
Brief Answer:
at least 10 years follow up required
Detailed Answer:
Hi
Thanks for your query.
Low grade mucoepidermoid carcinoma can also recur, especially as there was perineural invasion. Most of them are usually within 5 years but some between 5-10 years. We also do periodic CT or MRI scans in addition to clinical examination.
Overall the cure rate is good for you. 5 year and 10 year recurrence free rates may be 80% and 75% respectively.
It can also metastasize to the lungs but incidence is low.
Even if it metastasizes, initially there are no symptoms. Interval between incidental detection by scans and symptoms may be around 6 months.
Hope this helps.
Regards
at least 10 years follow up required
Detailed Answer:
Hi
Thanks for your query.
Low grade mucoepidermoid carcinoma can also recur, especially as there was perineural invasion. Most of them are usually within 5 years but some between 5-10 years. We also do periodic CT or MRI scans in addition to clinical examination.
Overall the cure rate is good for you. 5 year and 10 year recurrence free rates may be 80% and 75% respectively.
It can also metastasize to the lungs but incidence is low.
Even if it metastasizes, initially there are no symptoms. Interval between incidental detection by scans and symptoms may be around 6 months.
Hope this helps.
Regards
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank You for your reply
1)But as far as PERINEURAL INVASION is concern, many doctors said as my facial nerve was not damaged and some microscopic invasion has little contribution for recurrence as happens in case of facial paralysis.In my case stage-I and grade-I.
2) I have consulted many doctors since my surgery, most are of view that 2 years is crucial period where most of the tumors recur. After 2 years one should think himself safe and should follow-up upto 5 years as there is protocol. Some doctors said I have not heard any low grade especially LOW grade mucoepidermoid recurs after 4 years. I am confused and I want to know the truth.
3) For distance metastasis, they said LOW grade mucoepidermoid rarely metastasize as it happens in HIGHER STAGES. So frequent radiation to chest by chest x-ray dangerous. So I want to know the very initial symptoms of lungs tumor and within how many years it MUST show symptoms after incidence of tumor.
Sir, different versions from different doctors really a cause of worry for me. So guide me as you have enough experience.
Thank You Sir.
1)But as far as PERINEURAL INVASION is concern, many doctors said as my facial nerve was not damaged and some microscopic invasion has little contribution for recurrence as happens in case of facial paralysis.In my case stage-I and grade-I.
2) I have consulted many doctors since my surgery, most are of view that 2 years is crucial period where most of the tumors recur. After 2 years one should think himself safe and should follow-up upto 5 years as there is protocol. Some doctors said I have not heard any low grade especially LOW grade mucoepidermoid recurs after 4 years. I am confused and I want to know the truth.
3) For distance metastasis, they said LOW grade mucoepidermoid rarely metastasize as it happens in HIGHER STAGES. So frequent radiation to chest by chest x-ray dangerous. So I want to know the very initial symptoms of lungs tumor and within how many years it MUST show symptoms after incidence of tumor.
Sir, different versions from different doctors really a cause of worry for me. So guide me as you have enough experience.
Thank You Sir.
Brief Answer:
please refer below
Detailed Answer:
What I meant was that there is much more chance of cure than recurrence but recurrence is also seen in some patients, so we need to be careful. My specific answers below...
1.Microscopic perineural invasion is an important factor influencing outcome. Nobody can deny that. But as other risk factors are not present, its role is small in your case (but not to be ignored)
2. In case of low grade cancers it is all the more important to follow for many years as they take more time to regrow. High grade cancers tend to recur earlier
3. Lung metastasis from low grade mucoepidermoid cancer is well reported in literature. it may be rare but not impossible. Whether to do Xrays or CT scans regularly in your case may be be controversial however. But when symptoms do occur it is already quite advanced. Nobody can predict when exactly it MUST show symptoms
So basically I think that you need more follow-up even though the outcome is expected to be good.
please refer below
Detailed Answer:
What I meant was that there is much more chance of cure than recurrence but recurrence is also seen in some patients, so we need to be careful. My specific answers below...
1.Microscopic perineural invasion is an important factor influencing outcome. Nobody can deny that. But as other risk factors are not present, its role is small in your case (but not to be ignored)
2. In case of low grade cancers it is all the more important to follow for many years as they take more time to regrow. High grade cancers tend to recur earlier
3. Lung metastasis from low grade mucoepidermoid cancer is well reported in literature. it may be rare but not impossible. Whether to do Xrays or CT scans regularly in your case may be be controversial however. But when symptoms do occur it is already quite advanced. Nobody can predict when exactly it MUST show symptoms
So basically I think that you need more follow-up even though the outcome is expected to be good.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank You very much Sir. I have learnt a lot from you. I will regularly follow-up.
But my last question is, normally how many years a lungs cancer takes to be symptomatic in terms of time.
Thank you Sir.
But my last question is, normally how many years a lungs cancer takes to be symptomatic in terms of time.
Thank you Sir.
Brief Answer:
sure you will do well
Detailed Answer:
Do you mean lung cancer or some other cancer spreading to lung? Lung cancer takes many years to develop. Spread from other cancer takes shorter time from spread to symptoms. There is no fixed time as such so that part of your question cannot be answered.
sure you will do well
Detailed Answer:
Do you mean lung cancer or some other cancer spreading to lung? Lung cancer takes many years to develop. Spread from other cancer takes shorter time from spread to symptoms. There is no fixed time as such so that part of your question cannot be answered.
Above answer was peer-reviewed by :
Dr. Sonia Raina
I mean low grade mucoepidermoid carcinoma from parotid to lungs( distance metastasis).
Brief Answer:
average would be 2-3 years
Detailed Answer:
This is a rare tumor with even rarer lung metastasis and hence this is an approximate figure only.
average would be 2-3 years
Detailed Answer:
This is a rare tumor with even rarer lung metastasis and hence this is an approximate figure only.
Note: For further queries related to kidney problems Click here.
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
Get personalised answers from verified doctor in minutes across 80+ specialties
