Case Report

Cutaneous Myoepithelioma: An Unusual Tumor in the Hand

Table 1

Main characteristics of the classic and syncytial variants of cutaneous myoepithelioma1.

Cutaneous myoepithelioma—classical variantCutaneous myoepithelioma—syncytial variant

Growth patternTrabecular, reticular, plexiform (rare)In sheets, solid, and syncytial
CytologyMixed: epithelioid, fusiform, clear, or plasmocytoid cellsOvoid, fusiform, or histiocytoid
StromaChondromyxoid, myxoid, or hyalineSparse; presence of adipose metaplasia seems to be more frequent than in the classical variant
Immunohistochemistry
Calponin(+) 86%–100%(+) >85%
SMA(+) in up to 60% of cases(+) 70%
Desmin(-) 80%–100%(-) 80%–100%
EMA(+) 42%(+) 100%
Cytokeratins (pankeratin, AE1/AE3, Cam5.2)Diffuse and intense positivity in most cases (93%–100%)Focal positivity in a few cases (12%)
S-100(+) 72%–100%(+) 86%–100%
GFAP(+) variable, 27%–54%(+) 42%
p63(+) variable, 7%–45%(+) 54%
Molecular alterationEWSR1 gene rearrangement. Identified fusion genes include PBX1, PBX3, POU5F1, ZNF444, DUX4, ATF1, NR4A3, CREB1.EWSR1 gene rearrangement. The fusion genes are different from the classical variant.

1Table references: 5 ,9 ,12 ,13 ,14.