Yoshizaki Tomokazu, Himi Yuji, Minato Hiroshi, Ogawa Ikuko, Nikai Hiromasa, Furukawa Mitsuru
Department of Otolaryngology, School of Medicine, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-0934, Japan.
Auris Nasus Larynx. 2002 Jan;29(1):91-4. doi: 10.1016/s0385-8146(01)00104-3.
Malignant myoepitheliomas of the salivary gland are very rare tumors which may either arise de novo or develop in a pre-existing pleomorphic adenoma. We report a case of malignant myoepithelioma of the minor salivary gland that progressed from benign pleomorphic adenoma. The original pleomorphic adenoma was resected in 1979 (the '79 tumor). The first recurrent tumor was operated in 1995 (the '95 tumor). The '95 tumor was diagnosed as pleomorphic adenoma. Although the myoepithelial tumor component was more prevalent in the '95 tumor, histological features of the first recurrent tumor were similar to the '79 tumor. The second recurrent tumor showed more aggressive clinical features (the '98 tumor). It also showed massive growth of myoepithelial tumor cells with bone invasion, which led to the diagnosis of the '98 tumor as malignant myoepithelioma. With adequate surgical margin, the patient has been free from tumor recurrence for 20 months.
涎腺恶性肌上皮瘤是非常罕见的肿瘤，可原发产生或在先前存在的多形性腺瘤中发生。我们报告1例从小涎腺良性多形性腺瘤进展而来的恶性肌上皮瘤病例。最初的多形性腺瘤于1979年切除（“79肿瘤”）。首次复发肿瘤于1995年手术（“95肿瘤”）。“95肿瘤”被诊断为多形性腺瘤。尽管肌上皮瘤成分在“95肿瘤”中更普遍，但首次复发肿瘤的组织学特征与“79肿瘤”相似。第二次复发肿瘤表现出更具侵袭性的临床特征（“98肿瘤”）。它还显示肌上皮瘤细胞大量生长并侵犯骨质，这使得“98肿瘤”被诊断为恶性肌上皮瘤。通过足够的手术切缘，患者已无肿瘤复发20个月。
