Title Page Rapid-developed primary malignant myoepithelioma in cavernous sinus: case report and review of the literature

Background: Myoepithelial carcinoma, also called malignant myoepithelioma, is a relatively rare malignant tumor that occurs most frequently in the salivary glands. A few isolated cases have been described in other locations, including the lung, bronchus, oral cavity, nasopharynx and larynx. The region of cavernous sinus is an uncommon condition of involvement in myoepithelial carcinoma. To the best of our knowledge, this is the first report of myoepithelial carcinoma arising from cavernous sinus. Case presentation: Herein, we report a case of 48-year-old woman who presented with a 1-month history of diplopia and blepharoptosis and radiological evidence of a rapid developing cavernous sinus tumor. The patient underwent trans-sphenoidal biopsy and histological diagnosis showed a myoepithelial carcinoma. After diagnosis, the tumor grew rapidly and the clinical symptom deteriorated progressively, and therefore she received a pterional craniotomy with partial tumor removal. The patient eventually showed a worse prognosis, and was died two month after the initial operation. Because no organ of origin of the myoepithelial carcinoma, other than the cavernous sinus, was detected, this case was diagnosed as a primary intracranial myoepithelial carcinoma. Conclusion: The purpose of presenting this case report is to raise awareness among clinicians to consider myoepithelial carcinoma as a differential diagnosis when a cavernous sinus mass is identified. Furthermore, ideal management strategy for myoepithelial carcinoma is not known and the prognosis of myoepithelial carcinoma seems to be unfavorable; therefore, more cases are needed to enhance our knowledge of the diagnosis, treatment, and prognosis of this rare intracranial lesion.