Benign Look, Malignant Outcome: Unexpected Nodal Spread in Upper Lip Mec

KOTRA SOUMYA KUMARI; M. RAJINI KANTH; PAVANI VIDHYADHARI; K.S VIDYA; G. SPANDANA; K. SOWMYA

Benign Look, Malignant Outcome: Unexpected Nodal Spread in Upper Lip Mec

Author(s)	Dr. KOTRA SOUMYA KUMARI, Dr. M. RAJINI KANTH, Dr. PAVANI VIDHYADHARI, Dr. K.S VIDYA, Dr. G. SPANDANA, Dr. K. SOWMYA
Country	India
Abstract	Background: Tumors of the salivary glands are uncommon neoplasms, representing approximately 3-6 % of all head and neck tumors, with minor salivary gland tumors (MiSGTs) accounting for about 10–15% of all salivary gland neoplasms. Among minor salivary gland malignancies, mucoepidermoid carcinoma (MEC) is an important subtype that commonly arises in sites such as the palate and retromolar region; its occurrence in the upper lip is extremely rare. MEC shows variable biological behavior, tumor grading, staging, and correlation with prognosis and risk of recurrence or metastasis. Case Presentation: A 22 year old male presented with a firm, non-tender swelling in the right upper lip without functional impairment since 1 month. Clinical examination revealed a benign lesion, and excisional biopsy was performed. Histopathological analysis revealed an encapsulated lesion composed of sheets and islands of predominantly intermediate- cells, along with mucous cells and focal capsular invasion, leading to a diagnosis of intermediate- grade MEC. Within 45 days of the procedure, a submental swelling developed. Histology of the excised lymph node demonstrated microcystic spaces with mucin material, mucinophages, signet ring–type mucinous cells, and sheets of intermediate cells, confirming nodal metastasis. Given the intermediate grade and nodal involvement, the patient underwent combined chemoradiotherapy, receiving a total of 50 Gy and two cycles of cisplatin and 5 fluorouracil. Conclusion: This case highlights the rare presentation of MEC in the upper lip with early regional lymph node metastasis, emphasizing the need for careful histopathological evaluation and grading to guide treatment. Although uncommon in this anatomic location, MEC can demonstrate aggressive behavior, even in intermediate -grade forms, necessitating multimodal treatment and long-term follow-up to detect recurrence or further spread.
Keywords	Mucoepidermoid carcinoma, Minor salivary gland tumor, Intermediate grade, Histopathology, Chemoradiotherapy
Published In	Volume 8, Issue 1, January-February 2026
Published On	2026-02-17

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Benign Look, Malignant Outcome: Unexpected Nodal Spread in Upper Lip Mec

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