Mansour P, George M K, Pahor A L
Department of Histopathology, Dudley Road Hospital, Birmingham.
J Laryngol Otol. 1992 Aug;106(8):727-32. doi: 10.1017/s0022215100120717.
Ceruminous glands should no longer be regarded as purely apocrine glands, but as apoeccrine glands with both apocrine and eccrine modes of secretion. We present two cases of pleomorphic adenoma of ceruminous glands, among the rarest of such tumours. The use of such terms as 'ceruminoma' and 'hidradenoma' should finally be abandoned, and 'ceruminous gland tumour' used instead as a generic term. Classification should be based on Wetli's prototype (adenoma, pleomorphic adenoma, adenoid cystic carcinoma and adenocarcinoma), with the addition of benign eccrine cylindroma and syringocystadenoma papilliferum; the inclusion of mucoepidermoid carcinoma should await full validation. Wide local excision is necessary for all tumours, with only follow-up for histologically benign neoplasms. Malignant tumours need early aggressive surgery and radiotherapy. If marginal invasion cannot be assessed histologically, then adenoma and adenocarcinoma cannot be distinguished and we suggest that the tumour be reported as 'of uncertain malignant potential'. Long-term studies are needed to confirm or refute the view that all ceruminous gland tumours are potentially malignant.
耵聍腺不应再被视为单纯的顶泌汗腺，而应看作是具有顶泌和外泌两种分泌方式的顶浆分泌腺。我们报告两例耵聍腺多形性腺瘤，此类肿瘤极为罕见。“耵聍瘤”和“汗腺腺瘤”等术语最终应摒弃，而用“耵聍腺肿瘤”作为通用术语。分类应基于韦特利的原型（腺瘤、多形性腺瘤、腺样囊性癌和腺癌），再加上良性外泌汗腺圆柱瘤和乳头状汗腺囊腺瘤；黏液表皮样癌的纳入尚待充分验证。所有肿瘤均需广泛局部切除，组织学上为良性肿瘤的仅进行随访。恶性肿瘤需要早期积极手术和放疗。如果无法通过组织学评估边缘浸润情况，那么腺瘤和腺癌就无法区分，我们建议将肿瘤报告为“恶性潜能不确定”。需要进行长期研究来证实或反驳所有耵聍腺肿瘤都具有潜在恶性这一观点。
