Pediatric Upper Lip Myopericytoma: A Case Report and Comprehensive Review

Pediatric Upper Lip Myopericytoma: A Case Report and Comprehensive Review | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Pediatric Upper Lip Myopericytoma: A Case Report and Comprehensive Review Bin Wei, Gui Liu, Kun Li, Hongzhi Quan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-3824306/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 19 Apr, 2024 Read the published version in BMC Oral Health → Version 1 posted 8 You are reading this latest preprint version Abstract Myopericytoma, a seldom encountered spindle cell tumor of mesenchymal origin, is usually benign. It is marked by the concentric proliferation of tumor cells surrounding blood vessels within subcutaneous tissues. Its primary occurrence is observed among middle-aged adults and is typically located in the distal extremities, although cases have been documented in the proximal extremities and the head-neck region. Nevertheless, its manifestation within the oral cavity is exceedingly uncommon. So far, literature reviews have uncovered just two cases in children under the age of 10, alongside a mere five reported occurrences of myopericytoma in the lip region. In this report, we present a case involving myopericytoma located in the upper lip of a 7-year-old girl. Additionally, we furnish a comprehensive review and analysis of all documented cases, contributing to an improved comprehension of this condition. Myopericytoma Pediatric oral diseases Pathology Immunohistochemical staining Hematoxylin and Eosin staining. Figures Figure 1 Figure 2 Background Myopericytoma (MPC) is a histopathologically benign subcutaneous tumor distinguished by the concentric organization of oval to spindle-shaped myoid cells surrounding delicate vascular channels, exhibiting a distinctive concentric perivascular cell proliferation.(1) Myopericytoma can manifest at any age but is most prevalent in middle-aged individuals. It typically originates in subcutaneous tissues, frequently impacting the distal extremities, but it can also arise in the proximal extremities, neck, thoracic spine, and various other regions. Nevertheless, documented cases of MPC within the oral cavity are exceedingly scarce. (2)Clinically, it manifests as painless subcutaneous nodules characterized by slow growth, and the disease course may span several years. While it frequently appears as a solitary nodule, multiple lesions are not uncommon. Multiple lesions often develop asynchronously, typically affecting a specific anatomical region, such as the foot or head-neck region. (3)To date, a comprehensive literature review has unveiled a total of 41 documented cases of myopericytoma manifesting in the oral cavity (Table 1). In this report, we present a case involving myopericytoma located in the upper lip of a 7-year-old girl. 【Table 1】The Case Reports of Myopericytoma Occurring in the Oral Cavity Case Presentation On August 10, 2023, a 7-year-old girl was brought to Xiang Ya Stomatological Hospital in Hunan Province, China. Her mother reported the discovery of a painless swelling on the inner aspect of the upper lip two weeks before the visit. The patient had a history of overall good health, with no known drug allergies or other systemic medical conditions. During a specialized examination, an upper lip lesion was identified on the left side. The lesion exhibited a color resembling that of the surrounding mucosa, had a firm texture, unclear borders, and dimensions measuring approximately 0.5 x 1.0 x 1.0 cm. The treatment involves surgical excision. Subsequently, the excised lesion was dispatched to the pathology department for thorough examination. Following consultation with the pathology department at Xiang Ya Hospital, the comprehensive pathological assessment, which encompassed hematoxylin and eosin (HE) staining and immunohistochemistry, conclusively established the diagnosis of a benign myopericytoma originating from the mesenchyme in the upper lip. Histological Features Histological Features: Grossly, the lesion displayed indistinct boundaries with surrounding tissues and was enclosed by a complete capsule, measuring approximately 0.5 x 1.0 x 1.0 cm. Microscopic examination of hematoxylin and eosin-stained sections revealed the following characteristics: First， the presence of relatively uniform oval or spindle-shaped myoid cells arranged in concentric or whirlpool patterns. Additionally, there were some blood vessels with occasional red blood cells in the lumens, and certain tumor cells displayed vacuolar changes with centrally located nuclei. Furthermore, the myoid cells exhibited acidophilic cytoplasm, uniform nuclear chromatin, and lacked notable nuclear pleomorphism. In specific regions, mucinous degeneration was detected within the matrix between concentric circles or whirlpool structures. Moreover, the fibrous capsule exhibited distinct demarcation from the surrounding normal tissues. Cross-sections within the central part of the tumor revealed the presence of nerve fibers【Fig 1A～1F】. To corroborate the diagnosis, immunohistochemical staining was conducted, yielding the following outcomes: SMA (+++), CD99 (+), Ki-67 (20%), P53 (wild type), Desmin (-), and CD34 (-)【Fig 2A～2F】. Consequently, the ultimate diagnosis aligns with a benign myopericytoma originating from the mesenchyme in the upper lip. Discussion The term myopericytoma (MPC) was first introduced by Granter et al. in 1998. (4)This category encompasses tumors in adults displaying features akin to infantile myofibromatosis, as well as glomangiopericytoma (GPC), glomus tumors, and angioleiomyoma (ALM). In the same year, Kutzner, from the Friedrichshafen Institute of Dermatopathology, introduced the concept of perivascular myoma, essentially referring to the same tumor.(5) In both instances, the tumor cells exhibit characteristics associated with perivascular myoid cells or myopericytic differentiation. MPC most commonly originates in the subcutaneous tissues of the skin, with a predilection for the distal extremities.(2) The lower limbs are the primary sites of occurrence, followed by the upper limbs, head, neck, and trunk.(6, 7, 8, 9, 10, 11)In literature reports related to oral myopericytomas, there have been 6 cases occurring in the tongue, 10 cases in the salivary glands,(3, 4, 6, 12, 13, 14, 15, 16, 17) and 5 cases in the lips.(7, 18, 19, 20, 21) There have been reports of a few cases occurring in AIDS patients with concurrent EBV infection.(6) Unlike those occurring in soft tissues, such as the limbs, EBV-positive myopericytomas tend to be located in specific regions, such as around the bronchi, tongue, and periprostatic area, and they may exhibit multifocality.(22) While most MPC cases are benign, there have been a few reported instances of malignancy or recurrence. Oral presentations are exceedingly rare.(6, 10, 23, 24) Typically, they manifest as solitary, well-defined, slow-growing, painless nodules.(5, 25, 26) However, multiple lesions can also occur.(2) Benign tumors typically measure less than 2 cm in diameter, although tumors that have recurred may reach dimensions of 5.6*5.5*3 cm.(4) To date, 41 cases of oral MPC have been reported, with ages of onset ranging from 21 months to 80 years and a median age of 43 years. The incidence rate ratio between males and females is 17:24. Furthermore, MPCs can occur multifocally across various anatomical regions.(27) Multiple-nodular tumors or deep-seated lesions generally demonstrate a greater degree of invasiveness in comparison to superficial nodules.(4) Malignant transformation within the oral cavity has been reported twice in the literature. Malignant transformation within the oral cavity has been reported twice in the literature. In detailed, Tadashi Terada reported a case of malignant tumor occurring in the buccal mucosa of a 61-year-old male. Through immunohistochemical and HE staining tests, a pathological diagnosis of low-grade malignant myopericytoma was made due to the presence of some atypical and scattered mitotic figures, positive p53 expression in tumor cells, and a relatively high Ki67 labeling index.(28) A malignant myopericytoma was reported to occur in the left neck region of an 80-year-old female, as documented by M. E. McMenamin. Intraoperatively, a tumor of approximately 20 mm was identified, invading into the sternocleidomastoid muscle. Nine months after excision, a tumor with morphological similarities measuring 70 mm was discovered in the liver, suggesting a metastatic lesion.(29) Ultrastructurally, tumor cells display characteristics consistent with pericytic differentiation.(30) In molecular genetics research, Anna Dahle´n identified a t(7;12)(p21-22;q13-15) translocation in 5 cases of perivascular tumors. This translocation leads to the fusion of the ACTB gene on 7p22 with the GLI gene on 12q13.(31) However, there have been no reports of extensive case series analyzing these lesions or providing a more comprehensive characterization of their biological potential. Some researchers, including Jeffrey K. Mito and Peter M. Sadow, have proposed that BRAF mutations may constitute a novel genetic anomaly in the pathogenesis of myopericytomas, along with related biomarkers. Nevertheless, this viewpoint remains a topic of debate.(32, 33) A definitive diagnosis necessitates an excisional biopsy followed by histological examination. The primary characteristic of MPC is the concentric arrangement of pericytic myoid cells around thin-walled vascular channels.(1) In this case, the hematoxylin and eosin (HE) staining results reveal identical pathological features: relatively uniform oval or spindle-shaped myoid cells arranged in concentric circles or whirlpool patterns. Even in specific areas, mucinous degeneration is detected within the matrix between concentric circles or whirlpool structures. Additionally, some blood vessels contain occasional red blood cells, and certain tumor cells exhibit vacuolar changes with centrally located nuclei. Clinical differential diagnoses encompass fibrous proliferation, pyogenic granuloma, giant cell lesions, ossifying fibroma, and benign odontogenic (or hamartomatous) lesions. While clinical features may appear similar, microscopic features are distinctive. Fibrous proliferation is characterized by mature connective tissue stroma. Pyogenic granuloma is identified by numerous dilated capillaries within a loose inflammatory stroma. Giant cell lesions manifest as a mixture of giant cells resembling osteoclasts, often with associated hemorrhage and hemosiderin-laden macrophages in the periphery. Ossifying fibroma displays calcifications within a highly cellular fibroblastic stroma. Additionally, odontogenic lesions can be ruled out in lip lesions since they lack odontogenic epithelium.(26) Histological differential diagnoses include conditions such as myofibroma, glomus tumor, angioleiomyoma, and solitary fibrous tumor.(4) Myofibromas characteristically display well-defined areas with low cellularity and zoning. Glomus tumors are composed of cuboidal cells with clear cell borders and round central nuclei, lacking spindled cell morphology.(5) Angioleiomyomas show significant proliferation of thick-walled vessels.(26) Nevertheless, immunohistochemical differentiation is still necessary. In terms of immunohistochemistry, MPCs consistently demonstrate strong immunoreactivity for SMA, smooth muscle actin heavy chain, muscle-specific actin, and muscle-specific actin.(5, 7, 34) Most cases are negative for Desmin, although some occasional cases with focal Desmin reactivity have been reported. This suggests that possible precursor cell sources may include pericytic or myofibroblastic cells.(5) Strong SMA expression and negative CD34 staining effectively differentiate MPCs from other perivascular myoid tumors, such as solitary fibrous tumors and myofibromas.(1, 3, 21) The distinctive feature distinguishing MPC from angioleiomyoma is the concentric arrangement of cells and the absence of Desmin staining, a characteristic more frequently observed in MPC. As anticipated, we performed immunohistochemical testing on the specimen, including SMA, Desmin, and CD34. The test results are consistent with the reported characteristics of MPC in the literature: SMA (+++), Desmin (-), CD34 (-). It is noteworthy that a study by Atsuji Matsuyama et al. demonstrated that up to 20% of angioleiomyoma cases exhibit focal perivascular concentric growth. This suggests that this feature alone cannot serve as a reliable means of differentiation between these two tumors.(35) Additionally, while angioleiomyomas generally exhibit positive staining, they do not display positivity within concentric cell structures. This necessitates further immunohistochemistry and consideration of molecular differences for improved discrimination between MPC and angioleiomyoma. Differentiating MPC from epithelioid smooth muscle cell tumors, such as Pecomas, can be accomplished by observing their negativity for HMB45.(28) Thus, pathological examination remains the gold standard for distinguishing MPC. Vickie Y. Jo and colleagues conducted immunohistochemical staining for nuclear β-catenin in 50 soft tissue tumors located in the nasal sinuses or oral cavity. They recorded the staining intensity and extent in a semi-quantitative manner. Solitary fibrous tumors (SFTs) all exhibited nuclear β-catenin expression, and 90% of synovial sarcomas showed varying degrees of staining intensity from weak to strong. In contrast, none of the myopericytoma cases exhibited this expression.(36) Therefore, the immunohistochemical expression of nuclear β-catenin can be considered significant for distinguishing it from other diseases. In this case, the immunohistochemical staining results for nuclear β-catenin were also negative, thereby excluding the possibility of solitary fibrous tumor. Immunohistochemical antibodies may lack absolute specificity, but they provide a degree of relative specificity. Multiple antibody combinations are frequently employed to enhance diagnostic accuracy. In the future, distinguishing these types of lesions may be facilitated through cytogenetics and/or molecular genetic studies. The immunohistochemical findings from the 41 cases are summarized in Table 1. The standard treatment for benign MPC is surgical excision, typically resulting in a favorable prognosis.(25) Extensive local excision is recommended to prevent recurrence, followed by meticulous follow-up. Among the 41 reported cases, only two patients experienced recurrences.(4, 7) These recurrences typically stem from unclear margins, tumor extension into other areas, or exceedingly rare malignant transformations. A single case report detailed an MPC situated in the parotid area, which recurred as a larger and multicentric lesion after two incomplete excisions.(4) While benign MPCs occurring in the lips are relatively straightforward to surgically remove, their removal often necessitates considering the patient's age, lesion location, and potential postoperative adverse reactions. Compared to the case reported by Dalit Porat Ben Amy, which involved a 6-year-old boy with an MPC in the upper jaw involving teeth, our patient—a 7-year-old girl with a lesion in the upper lip that did not involve teeth—underwent a relatively straightforward excision.(25) Given the child's young age, we chose a conservative direct excision, and she exhibited an excellent recovery during a three-month follow-up visit, showing no signs of recurrence. Abbreviations MPC myopericytoma GPC glomangiopericytoma ALM angioleiomyoma NA not available Declarations Acknowledgments The authors would like to express their sincere thanks to Dr. Yi Xiang from the Department of Pathology at Changsha Stomatological Hospital for her support in histopathology and immunohistochemistry. Author contributions B.W contributed to the conception and design of study. B.W, HZ.Q, G.L and K.L contributed to the data acquisition of study. B.W, HZ.Q, G.L and K.L contributed the preparing of the manuscript. B.W, HZ.Q, G.L and K.L participated in reviewing the manuscript. All authors approved the version submitted for publication. All authors read and approved the final manuscript. Funding This work was supported by grants to Hongzhi Quan from Hunan Province Natural Science Foundation (2023JJ30814) and Fundamental Research Funds for Central Universities of Central South University(1053320184374). Data Availability We declared that materials described in the manuscript, including all relevant raw data, will be freely available to any scientist wishing to use them for non-commercial purposes, without breaching participant confidentiality. All data generated or analyzed during this study are included in this published article. Competing interests The authors declare that they have no competing interests. Ethics approval and consent to participate A written informed consent was obtained from the patient for publication of this case report and any accompanying images. Consent for publication The participant was informed and signed an informed consent form. The participant agreed that her medical data will be used for publication. References Mathew NK, Zhang KY, Batstone MD. Myopericytoma of the coronoid process: a case report and review of the literature. Oral and Maxillofacial Surgery Cases. 2015;1(2):25-8. Agrawal N, Nag K. Myopericytoma of the thoracic spine: a case report and review of literature. Spine J. 2013;13(11):e23-7. Jung YI, Chung YK, Chung S. Multiple myopericytoma of the face and parotid gland. Arch Plast Surg. 2012;39(2):158-61. Xia L, Chen Y, Geng N, Jiang J, Yang M, Zhang W. Multifocal myopericytoma in the maxillofacial region: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010;109(2):e59-62. Granter SR, Badizadegan K, Fletcher CD. Myofibromatosis in adults, glomangiopericytoma, and myopericytoma: a spectrum of tumors showing perivascular myoid differentiation. Am J Surg Pathol. 1998;22(5):513-25. 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Indian J Dermatol. 2020;65(2):169-71. Table 【Table 1】The Case Reports of Myopericytoma Occurring in the Oral Cavity No Year-author Age/ gender Location Treatment Follow up Immunohistochemistry α-SMA Desmin CD34 Caldesmon Ki-67 1 2007- Fumio Ide(24) 45/F Right buccal mucosa Excision No recurrence 9 years later + - - + 2 2008- Alvaro C. Laga(27) 72/M on the edentulous alveolar ridge of the right mandible Excision No recurrence 18 months + - - + 3 2009- Silvana Sapelli(21) 28/M Upper lip Excision No recurrence 3 years + - 4 2009-Lau, Patrick P. L(10) 42/M Tongue NA Not specified + - 5 2015- Shaista M Vasenwala(20) 14/M Upper lip Excision No recurrence + +Weakly 6 2020-lana kei yamamoto almeida(26) 12/F gingival on the palatine surface Excision No recurrence 5 years + - 35% 7 2019- M. Ralli(19) 46/M upper lip Excision No recurrence 8 months + - + <5% 8 2019- Wu-tong Ju(6) 46/F Parotid Excision No recurrence 56 months + - or + focally - or +focally <8% 9 10/M Tongue Excision No recurrence 51 months 10 41/F Buccal Excision No recurrence 27 months 11 61/M Tongue Excision No recurrence 25 months 12 62/F Submandibular Excision No recurrence 8 months 13 2018- Eric Strayer(7) 42/F lower lip on the left side Excision Recurrence occurred 3 months after the first resection and no recurrence 6 months after the second resection + - 14 2012- Tadashi Terada(28) 61/M right cheek mucosa Excision No recurrence 6 months + - - 40% 15 2010- Lili Xia(4) 43/F right parotid gland Excision Recurrence twice + - - 16 2007- Vivekanand Datta(11) 36/F on the anterior left lateral tongue Excision No recurrence + - 17 2013- Sevtap Akbulut(9) 61/F left mid-lateral tongue Excision No recurrence 18 months + - - 5% 18 2012- Yun-Ik Jung(3) 40/F Left parotid gland Excision No recurrence 4 years + - + 19 2015- Ninan K. Mathew(1) 12/M coronoid process Excision No recurrence 2 years + - - - 20 2021- Dalit Porat Ben Amy(25) 6/M posterior right maxilla Excision No recurrence 8 years + 21 2013-Fanglong Wu(15) 42/F right parotid gland Excision No recurrence 5 years + + - 22 2011-Byung Hak Rho(37) 70/F left side of the neck Excision No recurrence 20 months + + 23 2002- M E McMenamin(29) 80/F Left side of neck Marginal Excision AWD at 24 months (Liver metastases at 14 months) + - 24 2005-QingLI(38) 48/F Right submandibular Excision No recurrence 8 months + - 25 2009- Zhi-Gang Chu(17) 41/F right parotid gland Excision No recurrence 9 months + - - 26 2014- Anthony Simon Bates(14) 66/M right parotid region Excision No recurrence 18 months + + 27 2010- Tadashi Terada(39) 56/F Neck Excision No recurrence 4 years + - + + 8% 28 2010- Jerzy Kuczkowski(16) 65/M Left parotid gland Excision No recurrence 2 years + - 29 2008-V. Maheshwari(40) 42/M Right neck Excision NA + - 30 2006- Thomas Mentzel(36) 22/M Temporal region NA NA 31 2016- H ector M. Prado–Calleros(41) 38/F right carotid triangle Excision No recurrence 8 years + 32 2016-Mark B. Chaskes(42) 23/F left supraclavicular fossa Excision No recurrence 5 months + - - 33 2013- Eun Kyung Kim(43) 44/F Right cheek Excision + - - + 34 2021- Tuleen Sawaf(44) 56/F Left mastoid excision No recurrence 6 months + - 35 2021-Yao Pan(13) 62/M left parotid gland Excision 17 months + - 36 48/F right parotid gland Excision 5 years + - - 37 2022- Marcus Wei Ping Tan(18) 24/F Lower lip Excision 43 months 38 2022-Nicholas J. Roig(12) 30/F parotid gland Excision 5 months + - - + 15% 39 2017- Stefano Rubino(8) 48/M Tongue base Excision NA + <5% 40 2023-Jonathan C. Slack(45) 21month-old/M perioral region Excision 3 months + - + 41 2020-Dua Cebeci(46) 44/F forehead Excision 8 months + - +focally Additional Declarations No competing interests reported. Cite Share Download PDF Status: Published Journal Publication published 19 Apr, 2024 Read the published version in BMC Oral Health → Version 1 posted Editorial decision: Revision requested 29 Jan, 2024 Reviews received at journal 20 Jan, 2024 Reviewers agreed at journal 05 Jan, 2024 Reviewers invited by journal 05 Jan, 2024 Editor assigned by journal 05 Jan, 2024 Editor invited by journal 05 Jan, 2024 Submission checks completed at journal 05 Jan, 2024 First submitted to journal 30 Dec, 2023 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-3824306","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":265539509,"identity":"d84228b1-ed98-4a25-a9cb-825c598a31c4","order_by":0,"name":"Bin Wei","email":"","orcid":"","institution":"Xiangya Stomatological Hospital, Central South University","correspondingAuthor":false,"prefix":"","firstName":"Bin","middleName":"","lastName":"Wei","suffix":""},{"id":265539510,"identity":"8e3db37b-0719-41c2-92cd-4d2a557e95f5","order_by":1,"name":"Gui Liu","email":"","orcid":"","institution":"Xiangya Stomatological Hospital, Central South University","correspondingAuthor":false,"prefix":"","firstName":"Gui","middleName":"","lastName":"Liu","suffix":""},{"id":265539511,"identity":"a7c688bb-c83a-4a5b-a768-120318eb60e4","order_by":2,"name":"Kun Li","email":"","orcid":"","institution":"Xiangya Stomatological Hospital, Central South University","correspondingAuthor":false,"prefix":"","firstName":"Kun","middleName":"","lastName":"Li","suffix":""},{"id":265539512,"identity":"df668208-4dc9-4d3c-908e-43cbca53bd57","order_by":3,"name":"Hongzhi Quan","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA8klEQVRIiWNgGAWjYBACAxDB2CAB4X1AEiROC+MMErRAOMw8xGgxZ+89/PLnDgsGvhvJzx7b1NQlNrA3b5NgqLmDU4tlz7k0C8kzEgySN9LMjXOOHU5s4DlWJsFw7Bluh93IMTMwbJMAMhLMpHMbDiQ2SOSYSTA2HMavJRGsJf2btGUD0GHybwhqMX5wEKwlx0yasYEZaAsPAS1nzpgxNrZJ8EieeVMm2XPssHEbT1qxRcIxPFqO9xh//NlWJ8d3PH2bxI+aOtl+9sMbb3yowa0FCNhA8cjDcADGBREJ+DQAIxCSTA7gVzUKRsEoGAUjGAAAe81TndoXkvoAAAAASUVORK5CYII=","orcid":"","institution":"Xiangya Stomatological Hospital, Central South University","correspondingAuthor":true,"prefix":"","firstName":"Hongzhi","middleName":"","lastName":"Quan","suffix":""}],"badges":[],"createdAt":"2023-12-30 15:14:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-3824306/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-3824306/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s12903-024-04106-y","type":"published","date":"2024-04-20T02:49:09+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":49331977,"identity":"d705d191-bc2f-42f1-86d4-59a0a9d29cad","added_by":"auto","created_at":"2024-01-08 19:23:54","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":2336222,"visible":true,"origin":"","legend":"\u003cp\u003e(A)relatively uniform oval or spindle-shaped myoid cells arranged in a concentric or whirlpool pattern (box) (bar=200μm；amplified section bar=50μm).(B)In the clefts, a few red blood cells (short arrow) were observed within the blood vessels, and some tumor cells exhibited vacuolar changes with nuclei located centrally within the cells (long arrow) (bar=200μm；amplified section bar=50μm).(C)In some areas, there were concentric or whirlpool-like structures, and the matrix between them showed mucinous degeneration(box) (bar=200μm；amplified section bar=50μm). (D)Neural fibers (arrows) could be observed in cross-sections located within the center of the tumor (bar=200μm；amplified section bar=50μm). (E) The myoid cells exhibited acidophilic cytoplasm, uniform nuclear chromatin, and lacked notable nuclear pleomorphism (bar=50μm).\u003cstrong\u003e \u003c/strong\u003e(F)The fibrous capsule had a clear boundary (arrows) with the surrounding normal tissue (bar=200μm).\u003c/p\u003e","description":"","filename":"Figure1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3824306/v1/c11d5ccc26ecd630b44d0e5f.jpg"},{"id":49331978,"identity":"5e3a17e0-a206-4a3c-9bf1-5a7e96988aef","added_by":"auto","created_at":"2024-01-08 19:23:54","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":1295110,"visible":true,"origin":"","legend":"\u003cp\u003e(A)Positivity for α-SMA accentuates the perivascular arrangement (bar=50μm). (B)Positivity for CD99 suggesting the possibility of diseases such as T-cell lymphoblastic lymphoma or thymic epithelial tumors (bar=50μm). (C) The tumor cells are negative for CD34 but endothelial cells lining the lumen of small blood vessels are positive(bar=50μm). (D) Tumor cells showing a high Ki-67 labeling index (20%) (bar=50μm) (E) The tumor cells are negative for p53 (bar=50μm). (F) The tumor cells are negative for Desmin (bar=50μm).\u003c/p\u003e","description":"","filename":"Figure2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-3824306/v1/811ccdae6dab0f7cedf86890.jpg"},{"id":55037913,"identity":"4b07f32b-2877-4938-a9f2-221abefe98e2","added_by":"auto","created_at":"2024-04-21 02:49:18","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":968171,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-3824306/v1/5a84fa7d-3e7e-4870-991e-e61185cde5dd.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Pediatric Upper Lip Myopericytoma: A Case Report and Comprehensive Review","fulltext":[{"header":"Background","content":"\u003cp\u003eMyopericytoma (MPC) is a histopathologically benign subcutaneous tumor distinguished by the concentric organization of oval to spindle-shaped myoid cells surrounding delicate vascular channels, exhibiting a distinctive concentric perivascular cell proliferation.(1) Myopericytoma can manifest at any age but is most prevalent in middle-aged individuals. It typically originates in subcutaneous tissues, frequently impacting the distal extremities, but it can also arise in the proximal extremities, neck, thoracic spine, and various other regions. Nevertheless, documented cases of MPC within the oral cavity are exceedingly scarce. (2)Clinically, it manifests as painless subcutaneous nodules characterized by slow growth, and the disease course may span several years. While it frequently appears as a solitary nodule, multiple lesions are not uncommon. Multiple lesions often develop asynchronously, typically affecting a specific anatomical region, such as the foot or head-neck region. (3)To date, a comprehensive literature review has unveiled a total of 41 documented cases of myopericytoma manifesting in the oral cavity (Table 1). In this report, we present a case involving myopericytoma located in the upper lip of a 7-year-old girl.\u003c/p\u003e\n\u003cp\u003e【Table 1】The Case Reports of Myopericytoma Occurring in the Oral Cavity\u003c/p\u003e"},{"header":"Case Presentation","content":"\u003cp\u003eOn August 10, 2023, a 7-year-old girl was brought to Xiang Ya Stomatological Hospital in Hunan Province, China. Her mother reported the discovery of a painless swelling on the inner aspect of the upper lip two weeks before the visit. The patient had a history of overall good health, with no known drug allergies or other systemic medical conditions. During a specialized examination, an upper lip lesion was identified on the left side. The lesion exhibited a color resembling that of the surrounding mucosa, had a firm texture, unclear borders, and dimensions measuring approximately 0.5 x 1.0 x 1.0 cm. The treatment involves surgical excision. Subsequently, the excised lesion was dispatched to the pathology department for thorough examination. Following consultation with the pathology department at Xiang Ya Hospital, the comprehensive pathological assessment, which encompassed hematoxylin and eosin (HE) staining and immunohistochemistry, conclusively established the diagnosis of a benign myopericytoma originating from the mesenchyme in the upper lip.\u003c/p\u003e"},{"header":"Histological Features","content":"\u003cp\u003eHistological Features: Grossly, the lesion displayed indistinct boundaries with surrounding tissues and was enclosed by a complete capsule, measuring approximately 0.5 x 1.0 x 1.0 cm. Microscopic examination of hematoxylin and eosin-stained sections revealed the following characteristics: First， the presence of relatively uniform oval or spindle-shaped myoid cells arranged in concentric or whirlpool patterns. Additionally, there were some blood vessels with occasional red blood cells in the lumens, and certain tumor cells displayed vacuolar changes with centrally located nuclei. Furthermore, the myoid cells exhibited acidophilic cytoplasm, uniform nuclear chromatin, and lacked notable nuclear pleomorphism. In specific regions, mucinous degeneration was detected within the matrix between concentric circles or whirlpool structures. Moreover, the fibrous capsule exhibited distinct demarcation from the surrounding normal tissues. Cross-sections within the central part of the tumor revealed the presence of nerve fibers【Fig 1A～1F】. To corroborate the diagnosis, immunohistochemical staining was conducted, yielding the following outcomes: SMA (+++), CD99 (+), Ki-67 (20%), P53 (wild type), Desmin (-), and CD34 (-)【Fig 2A～2F】. Consequently, the ultimate diagnosis aligns with a benign myopericytoma originating from the mesenchyme in the upper lip.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe term myopericytoma (MPC) was first introduced by Granter et al. in 1998. (4)This category encompasses tumors in adults displaying features akin to infantile myofibromatosis, as well as glomangiopericytoma (GPC), glomus tumors, and angioleiomyoma (ALM). In the same year, Kutzner, from the Friedrichshafen Institute of Dermatopathology, introduced the concept of perivascular myoma, essentially referring to the same tumor.(5) In both instances, the tumor cells exhibit characteristics associated with perivascular myoid cells or myopericytic differentiation. MPC most commonly originates in the subcutaneous tissues of the skin, with a predilection for the distal extremities.(2) The lower limbs are the primary sites of occurrence, followed by the upper limbs, head, neck, and trunk.(6, 7, 8, 9, 10, 11)In literature reports related to oral myopericytomas, there have been 6 cases occurring in the tongue, 10 cases in the salivary glands,(3, 4, 6, 12, 13, 14, 15, 16, 17) and 5 cases in the lips.(7, 18, 19, 20, 21) There have been reports of a few cases occurring in AIDS patients with concurrent EBV infection.(6) Unlike those occurring in soft tissues, such as the limbs, EBV-positive myopericytomas tend to be located in specific regions, such as around the bronchi, tongue, and periprostatic area, and they may exhibit multifocality.(22) While most MPC cases are benign, there have been a few reported instances of malignancy or recurrence. Oral presentations are exceedingly rare.(6, 10, 23, 24) Typically, they manifest as solitary, well-defined, slow-growing, painless nodules.(5, 25, 26) However, multiple lesions can also occur.(2) Benign tumors typically measure less than 2 cm in diameter, although tumors that have recurred may reach dimensions of 5.6*5.5*3 cm.(4) To date, 41 cases of oral MPC have been reported, with ages of onset ranging from 21 months to 80 years and a median age of 43 years. The incidence rate ratio between males and females is 17:24. Furthermore, MPCs can occur multifocally across various anatomical regions.(27) Multiple-nodular tumors or deep-seated lesions generally demonstrate a greater degree of invasiveness in comparison to superficial nodules.(4) Malignant transformation within the oral cavity has been reported twice in the literature. Malignant transformation within the oral cavity has been reported twice in the literature. In detailed, Tadashi Terada reported a case of malignant tumor occurring in the buccal mucosa of a 61-year-old male. Through immunohistochemical and HE staining tests, a pathological diagnosis of low-grade malignant myopericytoma was made due to the presence of some atypical and scattered mitotic figures, positive p53 expression in tumor cells, and a relatively high Ki67 labeling index.(28) A malignant myopericytoma was reported to occur in the left neck region of an 80-year-old female, as documented by M. E. McMenamin. Intraoperatively, a tumor of approximately 20 mm was identified, invading into the sternocleidomastoid muscle. Nine months after excision, a tumor with morphological similarities measuring 70 mm was discovered in the liver, suggesting a metastatic lesion.(29) Ultrastructurally, tumor cells display characteristics consistent with pericytic differentiation.(30) In molecular genetics research, Anna Dahle\u0026acute;n identified a t(7;12)(p21-22;q13-15) translocation in 5 cases of perivascular tumors. This translocation leads to the fusion of the ACTB gene on 7p22 with the GLI gene on 12q13.(31) However, there have been no reports of extensive case series analyzing these lesions or providing a more comprehensive characterization of their biological potential. Some researchers, including Jeffrey K. Mito and Peter M. Sadow, have proposed that BRAF mutations may constitute a novel genetic anomaly in the pathogenesis of myopericytomas, along with related biomarkers. Nevertheless, this viewpoint remains a topic of debate.(32, 33)\u003c/p\u003e\n\u003cp\u003eA definitive diagnosis necessitates an excisional biopsy followed by histological examination. The primary characteristic of MPC is the concentric arrangement of pericytic myoid cells around thin-walled vascular channels.(1)\u0026nbsp;In this case, the hematoxylin and eosin (HE) staining results reveal identical pathological features: relatively uniform oval or spindle-shaped myoid cells arranged in concentric circles or whirlpool patterns. Even in specific areas, mucinous degeneration is detected within the matrix between concentric circles or whirlpool structures. Additionally, some blood vessels contain occasional red blood cells, and certain tumor cells exhibit vacuolar changes with centrally located nuclei. Clinical differential diagnoses encompass fibrous proliferation, pyogenic granuloma, giant cell lesions, ossifying fibroma, and benign odontogenic (or hamartomatous) lesions. While clinical features may appear similar, microscopic features are distinctive. Fibrous proliferation is characterized by mature connective tissue stroma. Pyogenic granuloma is identified by numerous dilated capillaries within a loose inflammatory stroma. Giant cell lesions manifest as a mixture of giant cells resembling osteoclasts, often with associated hemorrhage and hemosiderin-laden macrophages in the periphery. Ossifying fibroma displays calcifications within a highly cellular fibroblastic stroma. Additionally, odontogenic lesions can be ruled out in lip lesions since they lack odontogenic epithelium.(26)\u0026nbsp;Histological differential diagnoses include conditions such as myofibroma, glomus tumor, angioleiomyoma, and solitary fibrous tumor.(4)\u0026nbsp;Myofibromas characteristically display well-defined areas with low cellularity and zoning. Glomus tumors are composed of cuboidal cells with clear cell borders and round central nuclei, lacking spindled cell morphology.(5)\u0026nbsp;Angioleiomyomas show significant proliferation of thick-walled vessels.(26)\u0026nbsp;Nevertheless, immunohistochemical differentiation is still necessary. In terms of immunohistochemistry, MPCs consistently demonstrate strong immunoreactivity for SMA, smooth muscle actin heavy chain, muscle-specific actin, and muscle-specific actin.(5, 7, 34)\u0026nbsp;Most cases are negative for Desmin, although some occasional cases with focal Desmin reactivity have been reported. This suggests that possible precursor cell sources may include pericytic or myofibroblastic cells.(5)\u0026nbsp;Strong SMA expression and negative CD34 staining effectively differentiate MPCs from other perivascular myoid tumors, such as solitary fibrous tumors and myofibromas.(1, 3, 21)\u0026nbsp;The distinctive feature distinguishing MPC from angioleiomyoma is the concentric arrangement of cells and the absence of Desmin staining, a characteristic more frequently observed in MPC. As anticipated, we performed immunohistochemical testing on the specimen, including SMA, Desmin, and CD34. The test results are consistent with the reported characteristics of MPC in the literature: SMA (+++), Desmin (-), CD34 (-). It is noteworthy that a study by Atsuji Matsuyama et al. demonstrated that up to 20% of angioleiomyoma cases exhibit focal perivascular concentric growth. This suggests that this feature alone cannot serve as a reliable means of differentiation between these two tumors.(35)\u0026nbsp;Additionally, while angioleiomyomas generally exhibit positive staining, they do not display positivity within concentric cell structures. This necessitates further immunohistochemistry and consideration of molecular differences for improved discrimination between MPC and angioleiomyoma. Differentiating MPC from epithelioid smooth muscle cell tumors, such as Pecomas, can be accomplished by observing their negativity for HMB45.(28)\u003c/p\u003e\n\u003cp\u003eThus, pathological examination remains the gold standard for distinguishing MPC. Vickie Y. Jo and colleagues conducted immunohistochemical staining for nuclear \u0026beta;-catenin in 50 soft tissue tumors located in the nasal sinuses or oral cavity. They recorded the staining intensity and extent in a semi-quantitative manner. Solitary fibrous tumors (SFTs) all exhibited nuclear \u0026beta;-catenin expression, and 90% of synovial sarcomas showed varying degrees of staining intensity from weak to strong. In contrast, none of the myopericytoma cases exhibited this expression.(36)\u0026nbsp;Therefore, the immunohistochemical expression of nuclear \u0026beta;-catenin can be considered significant for distinguishing it from other diseases. In this case, the immunohistochemical staining results for nuclear \u0026beta;-catenin were also negative, thereby excluding the possibility of solitary fibrous tumor. Immunohistochemical antibodies may lack absolute specificity, but they provide a degree of relative specificity. Multiple antibody combinations are frequently employed to enhance diagnostic accuracy. In the future, distinguishing these types of lesions may be facilitated through cytogenetics and/or molecular genetic studies. The immunohistochemical findings from the 41 cases are summarized in Table 1.\u003c/p\u003e\n\u003cp\u003eThe standard treatment for benign MPC is surgical excision, typically resulting in a favorable prognosis.(25) Extensive local excision is recommended to prevent recurrence, followed by meticulous follow-up. Among the 41 reported cases, only two patients experienced recurrences.(4, 7) These recurrences typically stem from unclear margins, tumor extension into other areas, or exceedingly rare malignant transformations. A single case report detailed an MPC situated in the parotid area, which recurred as a larger and multicentric lesion after two incomplete excisions.(4) While benign MPCs occurring in the lips are relatively straightforward to surgically remove, their removal often necessitates considering the patient\u0026apos;s age, lesion location, and potential postoperative adverse reactions. Compared to the case reported by Dalit Porat Ben Amy, which involved a 6-year-old boy with an MPC in the upper jaw involving teeth, our patient\u0026mdash;a 7-year-old girl with a lesion in the upper lip that did not involve teeth\u0026mdash;underwent a relatively straightforward excision.(25) Given the child\u0026apos;s young age, we chose a conservative direct excision, and she exhibited an excellent recovery during a three-month follow-up visit, showing no signs of recurrence.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eMPC\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003emyopericytoma\u003c/p\u003e\n\u003cp\u003eGPC\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eglomangiopericytoma\u003c/p\u003e\n\u003cp\u003eALM\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eangioleiomyoma\u003c/p\u003e\n\u003cp\u003eNA not available\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors would like to express their sincere thanks to Dr. Yi Xiang from the Department of Pathology at Changsha Stomatological Hospital for her support in histopathology and immunohistochemistry.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor contributions\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eB.W contributed to the conception and design of study. B.W, HZ.Q, G.L and K.L contributed to the data acquisition of study. B.W, HZ.Q, G.L and K.L contributed the preparing of the manuscript. B.W, HZ.Q, G.L and K.L participated in reviewing the manuscript. All authors approved the version submitted for publication. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis work was supported by grants to Hongzhi Quan from Hunan Province Natural Science Foundation (2023JJ30814) and Fundamental Research Funds for Central Universities of Central South University(1053320184374).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe declared that materials described in the manuscript, including all relevant raw data, will be freely available to any scientist wishing to use them for non-commercial purposes, without breaching participant confidentiality. All data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eA written informed consent was obtained from the patient for publication of this case report and any accompanying images.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe participant was informed and signed an informed consent form. The participant agreed that her medical data will be used for publication.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eMathew NK, Zhang KY, Batstone MD. 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Myopericytoma of the parotid gland--a pathological conundrum. J Craniomaxillofac Surg. 2010;38(8):595-6.\u003c/li\u003e\n\u003cli\u003eChu ZG, Yu JQ, Yang ZG, Zhu ZY, Yuan HM. Myopericytoma involving the parotid gland as depicted on multidetector CT. Korean J Radiol. 2009;10(4):398-401.\u003c/li\u003e\n\u003cli\u003eTan MWP, Wei Tay AY, Tang PY, Chew KY, Nicholas Yeo EM. Myopericytoma: A Review of Twenty-Three Cases Over Twelve Years and a Case Report of a Rare Neoplasm. Am J Dermatopathol. 2022;44(9):623-31.\u003c/li\u003e\n\u003cli\u003eRalli M, D\u0026apos;Aguanno V, De Vincentiis L, de Vincentiis M, Corsi A. Glomangiopericytoma-type glomus tumour/myopericytoma of the lip. Br J Oral Maxillofac Surg. 2019;57(9):923-5.\u003c/li\u003e\n\u003cli\u003eVasenwala SM, Afroz N, Ansari HA, Khan AH, Basari R, Rehman S. Myopericytoma of lip: a rare lesion in an unusual location. Indian J Pathol Microbiol. 2015;58(2):211-3.\u003c/li\u003e\n\u003cli\u003eSapelli S, Ribas M, Martins WD, de Noronha L, Gomes AP. Myopericytoma of the lip: report of case. Head Neck. 2009;31(4):561-4.\u003c/li\u003e\n\u003cli\u003eRamdial PK, Sing Y, Deonarain J, Singh B, Allopi L, Moodley P. Periampullary Epstein-Barr virus-associated myopericytoma. Hum Pathol. 2011;42(9):1348-54.\u003c/li\u003e\n\u003cli\u003eIde F, Mishima K, Yamada H, Saito I, Horie N, Shimoyama T, et al. Perivascular myoid tumors of the oral region: a clinicopathologic re-evaluation of 35 cases. J Oral Pathol Med. 2008;37(1):43-9.\u003c/li\u003e\n\u003cli\u003eIde F, Obara K, Yamada H, Mishima K, Saito I. Intravascular myopericytoma of the oral mucosa: a rare histologic variant in an uncommon location. Virchows Arch. 2007;450(4):475-7.\u003c/li\u003e\n\u003cli\u003ePorat Ben Amy D, Yaffe V, Kawar R, Akrish S, Abu El-Naaj I. Oral myopericytoma: a rare pediatric case report and a review of the literature. BMC Oral Health. 2021;21(1):176.\u003c/li\u003e\n\u003cli\u003eAlmeida LKY, Jabur RO, Silveira HA, Polanco XBJ, da Silva RAB, Ribeiro-Silva A, et al. Gingival ossifying myopericytoma in a pediatric patient: Immunohistochemical analysis and literature review. Oral Oncology. 2020;107.\u003c/li\u003e\n\u003cli\u003eLaga AC, Tajirian AL, Islam MN, Bhattacharyya I, Cohen DM, Plamondon CJ, et al. Myopericytoma: report of two cases associated with trauma. J Cutan Pathol. 2008;35(9):866-70.\u003c/li\u003e\n\u003cli\u003eTerada T. Myopericytoma of low grade malignancy in the oral cavity. Rare Tumors. 2012;4(1):e9.\u003c/li\u003e\n\u003cli\u003eMcMenamin ME, Fletcher CD. Malignant myopericytoma: expanding the spectrum of tumours with myopericytic differentiation. Histopathology. 2002;41(5):450-60.\u003c/li\u003e\n\u003cli\u003eDiaz-Flores L, Gutierrez R, Garcia MP, Diaz-Flores L, Jr., Valladares F, Madrid JF. Ultrastructure of myopericytoma: a continuum of transitional phenotypes of myopericytes. Ultrastruct Pathol. 2012;36(3):189-94.\u003c/li\u003e\n\u003cli\u003eDahlen A, Fletcher CD, Mertens F, Fletcher JA, Perez-Atayde AR, Hicks MJ, et al. Activation of the GLI oncogene through fusion with the beta-actin gene (ACTB) in a group of distinctive pericytic neoplasms: pericytoma with t(7;12). Am J Pathol. 2004;164(5):1645-53.\u003c/li\u003e\n\u003cli\u003eMito JK, Jo VY. BRAF V600E is not a consistent feature of myopericytoma. J Cutan Pathol. 2016;43(12):1248-9.\u003c/li\u003e\n\u003cli\u003eSadow PM, Priolo C, Nanni S, Karreth FA, Duquette M, Martinelli R, et al. Role of BRAFV600E in the first preclinical model of multifocal infiltrating myopericytoma development and microenvironment. J Natl Cancer Inst. 2014;106(8).\u003c/li\u003e\n\u003cli\u003eJo VY, Fletcher CDM. Nuclear \u0026beta;-Catenin Expression is Frequent in Sinonasal Hemangiopericytoma and Its Mimics. Head and Neck Pathology. 2016;11(2):119-23.\u003c/li\u003e\n\u003cli\u003eMatsuyama A, Hisaoka M, Hashimoto H. Angioleiomyoma: a clinicopathologic and immunohistochemical reappraisal with special reference to the correlation with myopericytoma. Hum Pathol. 2007;38(4):645-51.\u003c/li\u003e\n\u003cli\u003eMentzel T, Dei Tos AP, Sapi Z, Kutzner H. Myopericytoma of skin and soft tissues: clinicopathologic and immunohistochemical study of 54 cases. Am J Surg Pathol. 2006;30(1):104-13.\u003c/li\u003e\n\u003cli\u003eRho BH, Lee SK, Kwon SY. Myopericytoma of the neck: sonographic appearance and sonographically guided needle biopsy. J Clin Ultrasound. 2011;39(8):469-72.\u003c/li\u003e\n\u003cli\u003eLi Q, Chen HJ, Zhang HY, Li XJ, Bu H. [Myopericytoma in the right submandible: a case report]. Zhonghua Bing Li Xue Za Zhi. 2005;34(5):318-9.\u003c/li\u003e\n\u003cli\u003eTerada T. Minute myopericytoma of the neck: a case report with literature review and differential diagnosis. Pathol Oncol Res. 2010;16(4):613-6.\u003c/li\u003e\n\u003cli\u003eMaheshwari V, Alam K, Jain A, Sharma SC. Myopericytoma of neck region - A case report. Indian J Otolaryngol Head Neck Surg. 2008;60(2):179-80.\u003c/li\u003e\n\u003cli\u003ePrado-Calleros HM, Galarza-Lozano D, Arrieta-Gomez JR, Pombo-Nava A, Parraguirre-Martinez S, Gutierrez CJ. Myopericytoma arising adjacent to the common carotid artery: Case report and systematic review of deep located neck myopericytomas. Head Neck. 2016;38(9):E2479-82.\u003c/li\u003e\n\u003cli\u003eChaskes MB, Bishop JW, Bobinski M, Farwell DG. Myopericytoma of the Neck Originating From the Middle Scalene: A Case Report. Ear Nose Throat J. 2020;99(7):NP72-NP4.\u003c/li\u003e\n\u003cli\u003eKim EK, Lee JH, Kim SY, Kim GM. Myopericytoma of the facial cheek. Ann Dermatol. 2013;25(1):122-4.\u003c/li\u003e\n\u003cli\u003eSawaf T, Wasman J, Mowry SE. A Rare Case of Myopericytoma in the Mastoid. Otol Neurotol. 2021;42(9):e1404-e5.\u003c/li\u003e\n\u003cli\u003eSlack JC, Hollowell ML, Khouri KS, Church AJ, Ganske IM, Delano S, et al. Expanding the Spectrum of Perioral Myogenic Tumors in Pediatric Patients: An SRF::NCOA2 Fused Perivascular Tumor of the Philtrum. Pediatr Dev Pathol. 2023;26(1):65-71.\u003c/li\u003e\n\u003cli\u003eCebeci D, Yaşar Ş, G\u0026uuml;neş P, Aytekin S. Cutaneous Myopericytoma on the Forehead: A Rare Localization. Indian J Dermatol. 2020;65(2):169-71.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Table","content":"\u003cp\u003e【Table 1】The Case Reports of Myopericytoma Occurring in the Oral Cavity\u003c/p\u003e\n \u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"885\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\" rowspan=\"2\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\" rowspan=\"2\"\u003e\n \u003cp\u003eYear-author\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\" rowspan=\"2\"\u003e\n \u003cp\u003eAge/\u003c/p\u003e\n \u003cp\u003egender\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\" rowspan=\"2\"\u003e\n \u003cp\u003eLocation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\" rowspan=\"2\"\u003e\n \u003cp\u003eTreatment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\" rowspan=\"2\"\u003e\n \u003cp\u003eFollow up\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"36.3431151241535%\" colspan=\"5\"\u003e\n \u003cp\u003eImmunohistochemistry\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"20.496894409937887%\"\u003e\n \u003cp\u003e\u0026alpha;-SMA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"20.496894409937887%\"\u003e\n \u003cp\u003eDesmin\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"17.70186335403727%\"\u003e\n \u003cp\u003eCD34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"26.39751552795031%\"\u003e\n \u003cp\u003eCaldesmon\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.906832298136646%\"\u003e\n \u003cp\u003eKi-67\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2007- Fumio Ide(24)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e45/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eRight buccal mucosa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence 9 years later\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2008- Alvaro C. Laga(27)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e72/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eon the edentulous alveolar ridge of the right mandible\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e18 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2009- Silvana Sapelli(21)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e28/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eUpper lip\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e3 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2009-Lau, Patrick P. L(10)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e42/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eTongue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNot specified\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2015- Shaista M Vasenwala(20)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e14/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eUpper lip\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e+Weakly\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2020-lana kei yamamoto almeida(26)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e12/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003egingival on the palatine surface\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e35%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2019- M. Ralli(19)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e46/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eupper lip\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e8 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026lt;5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\" rowspan=\"5\"\u003e\n \u003cp\u003e2019- Wu-tong Ju(6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e46/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eParotid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e56 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\" rowspan=\"5\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\" rowspan=\"5\"\u003e\n \u003cp\u003e- or + focally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\" rowspan=\"5\"\u003e\n \u003cp\u003e- or +focally\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\" rowspan=\"5\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\" rowspan=\"5\"\u003e\n \u003cp\u003e\u0026lt;8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.185185185185185%\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e10/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.03703703703704%\"\u003e\n \u003cp\u003eTongue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.925925925925927%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e51 months\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.185185185185185%\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e41/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.03703703703704%\"\u003e\n \u003cp\u003eBuccal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.925925925925927%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e27 months\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.185185185185185%\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e61/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.03703703703704%\"\u003e\n \u003cp\u003eTongue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.925925925925927%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e25 months\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"10.185185185185185%\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.11111111111111%\"\u003e\n \u003cp\u003e62/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"37.03703703703704%\"\u003e\n \u003cp\u003eSubmandibular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"15.74074074074074%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"25.925925925925927%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e8 months\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2018- Eric Strayer(7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e42/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003elower lip on the left side\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eRecurrence occurred 3 months after the first resection and no recurrence 6 months after the second resection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2012- Tadashi Terada(28)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e61/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eright cheek mucosa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e40%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2010- Lili Xia(4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e43/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eright parotid gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eRecurrence twice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2007- Vivekanand Datta(11)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e36/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eon the anterior left lateral tongue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2013- Sevtap Akbulut(9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e61/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eleft mid-lateral tongue\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e18 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e5%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2012- Yun-Ik Jung(3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e40/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eLeft parotid gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e4 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2015- Ninan K. Mathew(1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e12/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003ecoronoid process\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2021- Dalit Porat Ben Amy(25)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e6/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eposterior right maxilla\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e8 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2013-Fanglong Wu(15)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e42/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eright parotid gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2011-Byung Hak Rho(37)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e70/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eleft side of the neck\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e20 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2002- M E McMenamin(29)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e80/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eLeft side\u003c/p\u003e\n \u003cp\u003eof neck\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eMarginal Excision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eAWD at 24 months\u003c/p\u003e\n \u003cp\u003e(Liver metastases\u003c/p\u003e\n \u003cp\u003eat 14 months)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2005-QingLI(38)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e48/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eRight submandibular\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2009- Zhi-Gang Chu(17)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e41/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eright parotid gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e9 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2014- Anthony Simon Bates(14)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e66/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eright parotid region\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e18 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2010- Tadashi Terada(39)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e56/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eNeck\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e4 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e8%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2010- Jerzy Kuczkowski(16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e65/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eLeft parotid gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e2 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2008-V. Maheshwari(40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e42/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eRight neck\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2006- Thomas Mentzel(36)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e22/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eTemporal region\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNA\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2016- H ector M. Prado\u0026ndash;Calleros(41)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e38/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eright carotid triangle\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u003c/p\u003e\n \u003cp\u003e8 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2016-Mark B. Chaskes(42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e23/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eleft supraclavicular\u003c/p\u003e\n \u003cp\u003efossa\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e5 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2013- Eun Kyung Kim(43)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e44/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eRight cheek\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2021- Tuleen Sawaf(44)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e56/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eLeft mastoid\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eexcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003eNo recurrence\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e6 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\" rowspan=\"2\"\u003e\n \u003cp\u003e2021-Yao Pan(13)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e62/M\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eleft parotid gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003e17 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"5.835543766578249%\"\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.36604774535809%\"\u003e\n \u003cp\u003e48/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"21.220159151193634%\"\u003e\n \u003cp\u003eright parotid gland\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.018567639257295%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.854111405835544%\"\u003e\n \u003cp\u003e5 years\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.753315649867375%\"\u003e\n \u003cp\u003e+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"8.753315649867375%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.559681697612732%\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"11.273209549071618%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.36604774535809%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2022- Marcus Wei Ping Tan(18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e24/F\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"18.058690744920995%\"\u003e\n \u003cp\u003eLower lip\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.6749435665914225%\"\u003e\n \u003cp\u003eExcision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"12.641083521444695%\"\u003e\n \u003cp\u003e43 months\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"7.44920993227991%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"6.433408577878104%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"9.593679458239277%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"5.417607223476298%\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd width=\"4.966139954853273%\"\u003e\n \u003cp\u003e38\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd width=\"14.89841986455982%\"\u003e\n \u003cp\u003e2022-Nicholas J. 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It is marked by the concentric proliferation of tumor cells surrounding blood vessels within subcutaneous tissues. Its primary occurrence is observed among middle-aged adults and is typically located in the distal extremities, although cases have been documented in the proximal extremities and the head-neck region. Nevertheless, its manifestation within the oral cavity is exceedingly uncommon. So far, literature reviews have uncovered just two cases in children under the age of 10, alongside a mere five reported occurrences of myopericytoma in the lip region. In this report, we present a case involving myopericytoma located in the upper lip of a 7-year-old girl. Additionally, we furnish a comprehensive review and analysis of all documented cases, contributing to an improved comprehension of this condition.\u003c/p\u003e","manuscriptTitle":"Pediatric Upper Lip Myopericytoma: A Case Report and Comprehensive Review","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-01-08 19:23:50","doi":"10.21203/rs.3.rs-3824306/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2024-01-29T17:04:44+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2024-01-20T10:22:23+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"fcc1c737-36bf-4809-bf05-1405268a645b","date":"2024-01-05T22:31:58+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2024-01-05T17:06:47+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-01-05T17:03:36+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2024-01-05T17:00:48+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-01-05T16:56:45+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Oral Health","date":"2023-12-30T14:58:44+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-oral-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ohea","sideBox":"Learn more about [BMC Oral Health](http://bmcoralhealth.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/ohea/default.aspx","title":"BMC Oral Health","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"9511ae02-5bd2-43c6-be86-30a4bcf972b0","owner":[],"postedDate":"January 8th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2024-04-21T02:49:09+00:00","versionOfRecord":{"articleIdentity":"rs-3824306","link":"https://doi.org/10.1186/s12903-024-04106-y","journal":{"identity":"bmc-oral-health","isVorOnly":false,"title":"BMC Oral Health"},"publishedOn":"2024-04-20 02:49:09","publishedOnDateReadable":"April 20th, 2024"},"versionCreatedAt":"2024-01-08 19:23:50","video":"","vorDoi":"10.1186/s12903-024-04106-y","vorDoiUrl":"https://doi.org/10.1186/s12903-024-04106-y","workflowStages":[]},"version":"v1","identity":"rs-3824306","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-3824306","identity":"rs-3824306","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}