Hatta Chihiro, Terada Tomoaki, Okita Jun, Kakibuchi Masao, Kubota Akira, Sakagami Masafumi
Department of Otolaryngology, Hyogo College of Medicine, 1-1 Mukogawa, Nishinomiya, Hyogo 663-8501, Japan.
Auris Nasus Larynx. 2003 Aug;30(3):273-7. doi: 10.1016/s0385-8146(03)00096-8.
Undifferentiated carcinoma of the salivary gland is a rare malignant tumor, and is difficult to distinguish from other poorly differentiated types of carcinoma or sarcoma. The present study investigated clinical and pathological characteristics for undifferentiated carcinoma of the parotid gland.
Forty-four patients with previously untreated carcinoma of the major salivary glands were treated at our institution between 1986 and 1999. Of these, five patients (two males, three females) were diagnosed with undifferentiated carcinoma of the parotid gland and treated. For histological reinvestigation, multislices of resected specimens were made and diagnosed.
Although all patients were treated by radical surgery (more than subtotal parotidectomy), all died of distant metastasis, including two patients with locoregional relapse. Tumors in these two patients included a small portion of poorly differentiated epidermoid or mucoepidermoid carcinoma. The remaining three patients did not show any differentiated portions, and histological findings demonstrated heterogeneous patterns of lymphoepithelial carcinoma, small cell carcinoma and unclassified (a pattern of malignant hemangiopericytoma), respectively.
Investigation using multislice sections is needed to diagnose undifferentiated carcinoma of the salivary glands. Regarding prognosis, carcinoma that is too poorly differentiated but including slightly-differentiated portions should be considered undifferentiated carcinoma. All patients died of distant metastasis despite radical surgery, suggesting that chemotherapy is needed to improve patient outcomes.
涎腺未分化癌是一种罕见的恶性肿瘤，难以与其他低分化类型的癌或肉瘤相区分。本研究调查腮腺未分化癌的临床和病理特征。
1986年至1999年间，44例未经治疗的大涎腺癌患者在我院接受治疗。其中，5例患者（2例男性，3例女性）被诊断为腮腺未分化癌并接受治疗。为进行组织学复查，制作并诊断了切除标本的多张切片。
尽管所有患者均接受了根治性手术（超过腮腺次全切除术），但均死于远处转移，其中2例患者出现局部区域复发。这2例患者的肿瘤包括一小部分低分化表皮样癌或黏液表皮样癌。其余3例患者未显示任何分化部分，组织学检查结果分别显示为淋巴上皮癌、小细胞癌和未分类（恶性血管外皮细胞瘤样）的异质性模式。
诊断涎腺未分化癌需要使用多张切片进行检查。关于预后，分化太差但包含轻微分化部分的癌应被视为未分化癌。尽管进行了根治性手术，但所有患者均死于远处转移，提示需要化疗以改善患者预后。
