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Open Access Highly Accessed Case report

Myoepithelioma within the carpal tunnel: a case report and review of the literature

Jonathan CM Clark1, Stuart J Galloway2, Stephen M Schlicht3, Ross PV McKellar3 and Peter FM Choong14*

Author Affiliations

1 Department of Orthopaedics and Department of Surgery, University of Melbourne, St Vincent's Hospital, Melbourne, Australia

2 Department of Anatomical Pathology, St Vincent's Hospital, Melbourne, Australia

3 Department of Radiology, St Vincent's Hospital, Melbourne, Australia

4 Bone and Soft Tissue Sarcoma Service, Peter MacCallum Cancer Centre, Melbourne, Australia

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International Seminars in Surgical Oncology 2009, 6:15  doi:10.1186/1477-7800-6-15

Published: 9 September 2009

Abstract

Myoepitheliomas of the extremity are rare and usually benign, while a minority display malignant features. This case demonstrates the diagnosis and management of myoepithelioma within the carpal tunnel. Clinical and radiological tumour features were evaluated. Hematoxylin and eosin stained tumour sections were examined, and immunohistochemistry was performed. Histology revealed a nodular mass of epithelioid cells in clusters within a myxoid/chondroid stroma. No mitoses were noted. Cytokeratins, neuron-specific enolase, synaptophysin, glial fibrillary acidic protein, and S100 were positive on immunohistochemistry. A literature review revealed very few prior reports of myoepithelioma in the wrist, and limited data concerning any relationship between recurrence and quality of surgical margins. In this case, wide local excision would have significantly compromised dominant hand function, and therefore a marginal excision was deemed appropriate in the context of bland histological features. Surgical margins noted in future case reports will aid clinical decision making.