Introduction: Epithelial–myoepithelial carcinoma (EMC) is a rare salivary gland neoplasm that most commonly occurs in the parotid gland. EMC is a hybrid tumor, which is a tumor composed of two different tumor entities.

Purpose: The purpose of this study is to add this rare case of EMC and its even less common palatal site of presentation to the body of literature describing this entity.

Case report: A 41-year-old Caucasian woman was referred to the University of Florida/Shands Hospital (Jacksonville, Fl) for evaluation of an expansile mass in the left maxilla of a few months duration. A computed tomography (CT) scan demonstrated a mass in the left maxilla that extended minimally in the left maxillary sinus. Microscopic examination from an incisional biopsy revealed a tumor mass with a prominent mucinous component giving resemblance to and, in fact, signed out as intermediate grade mucoepidermoid carcinoma. A left total maxillectomy was completed and the resultant defect was reconstructed with a radial forearm free flap. Microscopic examination of the surgical specimen revealed a lobulated tumor mass composed of a mixture of ductal/tubular epithelial structures surrounded by myoepithelial cells.

Conclusion: EMC is a rare salivary gland tumor. In this case, the pre-surgery biopsy revealed prominent mucinous component thus giving superficial resemblance to mucoepidermoid carcinoma, underscoring the importance of pathologic evaluation of complete resection specimen for final pathology diagnosis. Thus, it should be kept in mind that limited tumor representation on biopsy specimens may in some tumor types lead to improper histological characterization of tumor.

Conflict of interest: None declared.