Yamada Shin-ichi, Matsuo Takemitsu, Fujita Shuichi, Suyama Kazutaka, Yamaguchi Akira, Mizuno Akio
Department of Developmental and Reconstructive Medicine, Nagasaki, Japan.
Pathol Int. 2002 Oct;52(10):653-6. doi: 10.1046/j.1440-1827.2002.01408.x.
Malignant transformation of Warthin's tumor is extremely rare, although it is the second most common benign tumor of the parotid gland. We describe our experience of mucoepidermoid carcinoma arising in Warthin's tumor of the parotid gland in a 64-year-old man. He had a swelling in the left parotid-masseteric region. The removed tumor was well encapsulated and histopathologically comprised Warthin's tumor and low-grade mucoepidermoid carcinoma. The mucoepidermoid carcinoma infiltrated lymphoid stroma of the Warthin's tumor, but capsular invasion is not found. Considering the clinical course and physical examination, the lesion was diagnosed as mucoepidermoid carcinoma arising in Warthin's tumor because its features filled the criteria of malignant transformation of Warthin's tumor. There has been no recurrence or distant metastasis for 19 months. Histological change from Warthin's tumor to mucoepidermoid carcinoma may be implicated in squamous or goblet cell metaplasia of epithelial cells. It is considered that the neoplastic cells of Warthin's tumor acquire malignant genotypes simultaneously with this dual differentiation.
沃辛瘤恶变极为罕见，尽管它是腮腺第二常见的良性肿瘤。我们描述了一名64岁男性腮腺沃辛瘤发生黏液表皮样癌的病例。他左侧腮腺咬肌区有肿胀。切除的肿瘤包膜完整，组织病理学检查显示由沃辛瘤和低级别黏液表皮样癌组成。黏液表皮样癌浸润了沃辛瘤的淋巴间质，但未发现包膜侵犯。结合临床病程和体格检查，该病变被诊断为沃辛瘤发生的黏液表皮样癌，因为其特征符合沃辛瘤恶变的标准。19个月来无复发或远处转移。沃辛瘤向黏液表皮样癌的组织学变化可能与上皮细胞的鳞状或杯状细胞化生有关。据认为，沃辛瘤的肿瘤细胞在这种双重分化的同时获得了恶性基因型。
