An essential question is then as follows: how are EMEC, CCC, and CCMEC interrelated?
The clear cells of CCMEC are generally smaller and more uniform in size and shape than the epithelioid clear cells of CCC.
(7,20,21) Table 2 summarizes the clinical distinctions between CCC (103 cases), EMEC (97 cases), and to a lesser extent, CCMEC (11 cases), based on cases culled from the literature and the cases reported in this article.
Relationship Between CCC, EMEC, and CCMEC: The Role of Myoepithelial Differentiation
Therefore, our experience extends the reported data, in that CCC lacks myoepithelial differentiation and appears distinct from EMEC and CCMEC, which have "obligate" myoepithelial differentiation.
(45) This characteristic has been cited as a reason why myoepithelium-rich tumors generally grow in a bulky lobulated fashion, rather than in an insidiously infiltrating pattern, as is seen here for EMEC and CCMEC. Yet, this tendency would still not explain the propensity for observed recurrences of EMEC, compared to the more infiltrative CCC.