Chung J, Lee S K, Gong G, Kang D Y, Park J H, Kim S B, Ro J Y
Department of Pathology, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea.
J Korean Med Sci. 1999 Jun;14(3):338-41. doi: 10.3346/jkms.1999.14.3.338.
Sclerosing mucoepidermoid carcinoma with eosinophilia (SMECE) is a recently recognized malignant neoplasm of the thyroid gland. About 14 cases of SMECE have been reported and this is the first reported case in Korea. A 57-year-old woman presented with right neck mass for 20 years. Total thyroidectomy was performed under the impression of thyroid carcinoma. The resected thyroid gland showed a poorly circumscribed hard mass. Histologically, the tumor consisted of solid nests of large atypical cells with dense fibrous stroma. The tumor cells showed squamoid appearance with abundant eosinophilic cytoplasm. There were also rare mucin-containing cells within the nests. Within the hyalinized stroma, numerous eosinophils were found. The surrounding thyroid parenchyma displayed Hashimoto's thyroiditis. There was metastasis in a regional lymph node. Two years after initial surgery, she underwent a modified radical neck dissection due to recurrent neck mass. After the radiation therapy for eight weeks, laryngectomy and esophagectomy were performed due to a recurrent carcinoma in the esophageal wall. We report an additional case of SMECE, with metastasis to regional lymph nodes and esophagus. The tumor appears to be more aggressive than previously reported and a correct diagnosis can be rendered by just examining the metastatic lesions.
伴嗜酸性粒细胞增多的硬化性黏液表皮样癌（SMECE）是一种最近才被认识的甲状腺恶性肿瘤。目前已报道约14例SMECE，这是韩国首例报道病例。一名57岁女性因右颈部肿物20年就诊。在考虑甲状腺癌的情况下进行了全甲状腺切除术。切除的甲状腺显示出边界不清的硬块。组织学上，肿瘤由大的非典型细胞实性巢团组成，伴有致密的纤维性间质。肿瘤细胞呈鳞状外观，胞质丰富嗜酸性。巢团内也有罕见的含黏液细胞。在玻璃样变的间质内发现大量嗜酸性粒细胞。周围甲状腺实质显示桥本甲状腺炎。区域淋巴结有转移。初次手术后两年，因颈部肿物复发，她接受了改良根治性颈清扫术。在进行8周放疗后，因食管壁复发癌进行了喉切除术和食管切除术。我们报告了另一例SMECE病例，伴有区域淋巴结和食管转移。该肿瘤似乎比先前报道的更具侵袭性，仅通过检查转移灶即可做出正确诊断。
