Williamson J D, Simmons B H, el-Naggar A, Medeiros L J
Department of Anatomic Pathology, University of Texas M.D. Anderson Cancer Center, Houston, USA.
Am J Clin Pathol. 2000 Oct;114(4):564-70. doi: 10.1309/GUT1-F58A-V4WV-0D8P.
We describe 5 cases of mucoepidermoid carcinoma (MEC) involving Warthin tumor (WT) of the parotid gland. The WT size ranged from 1.7 to 6.0 cm. The MECs were much smaller, 0.3 to 1.7 cm. In 3 cases, the WT completely surrounded the MEC, and in 2 cases neither WT nor MEC surrounded the other. Each MEC was low grade, 3 grade I and 2 grade II. One MEC had evidence of vascular invasion. All patients underwent partial or subtotal parotidectomy with negative resection margins. Clinical follow-up (range, 8-52 months) for 3 patients showed no evidence of recurrence. The pathogenetic relationship between WT and MEC in these cases is uncertain. In 4 cases, foci of squamous or mucous metaplasia were found in the WT component, associated with mild cytologic atypia in 3 tumors. However, a direct transition from WT to MEC was not identified. In 1 case, MEC was present 45 months before WT, suggesting that the recurrent MEC involved WT coincidentally. The small size and low grade of the MEC and the negative resection margins most likely explain the good outcome for the 3 patients with clinical follow-up data available.
我们描述了5例黏液表皮样癌（MEC）累及腮腺沃辛瘤（WT）的病例。WT大小为1.7至6.0厘米。MEC要小得多，为0.3至1.7厘米。3例中，WT完全包绕MEC，2例中WT和MEC均未包绕对方。每例MEC均为低级别，3例为I级，2例为II级。1例MEC有血管侵犯证据。所有患者均接受了部分或次全腮腺切除术，切缘阴性。3例患者的临床随访（范围8 - 52个月）显示无复发迹象。这些病例中WT与MEC之间的发病关系尚不确定。4例中，在WT成分中发现鳞状或黏液化生灶，3例肿瘤伴有轻度细胞学异型性。然而，未发现从WT直接转变为MEC的情况。1例中，MEC在WT出现前45个月就已存在，提示复发性MEC偶然累及WT。MEC的小尺寸、低级别以及阴性切缘很可能解释了3例有临床随访数据患者的良好预后。
