Smoller B R, Narurkar V
Department of Dermatology, Stanford University Medical Center, California 94301.
J Dermatol Surg Oncol. 1992 May;18(5):365-8. doi: 10.1111/j.1524-4725.1992.tb03689.x.
Mucoepidermoid carcinomas are tumors that usually arise from salivary glands and have a characteristic histologic pattern of atypical squamous cells showing focal mucin production. Mucoepidermoid carcinomas are uncommon neoplasms that metastasize most commonly via lymphatic and hematogenous channels. We report what we believe to be the first case of a mucoepidermoid carcinoma arising from a sublingual salivary gland with metastasis to a distant site on the skin. The patient is a 58-year-old black woman who was initially diagnosed with a high grade mucoepidermoid carcinoma of the salivary glands of the tongue. Approximately 18 months after presentation, and 6 months following surgery, chemotherapy, and radiation therapy, the patient noted a firm nodule on her flank. Biopsy showed malignant squamous epithelium. Periodic acid-Schiff and alcian blue stains revealed focal mucin production. The histologic differential diagnosis included an eccrine carcinoma, mucin-producing adenocarcinoma with squamous differentiation, a primary cutaneous adenosquamous (mucoepidermoid) carcinoma and a malignant mixed tumor of the skin. Clinical correlation was essential in making the correct diagnosis. While mucoepidermoid carcinomas only uncommonly show distant metastasis, and even less frequently involve the skin, this entity should be included in the differential diagnosis of mucin-producing neoplasms in the skin.
黏液表皮样癌是一种通常起源于唾液腺的肿瘤，具有非典型鳞状细胞的特征性组织学模式，并伴有局灶性黏液产生。黏液表皮样癌是一种罕见的肿瘤，最常见的转移途径是通过淋巴和血行渠道。我们报告了我们认为首例起源于舌下唾液腺并转移至皮肤远处部位的黏液表皮样癌病例。患者为一名58岁的黑人女性，最初被诊断为舌唾液腺高级别黏液表皮样癌。在就诊约18个月后，以及手术、化疗和放疗6个月后，患者注意到其侧腹有一个坚实的结节。活检显示为恶性鳞状上皮。过碘酸-希夫染色和阿尔辛蓝染色显示局灶性黏液产生。组织学鉴别诊断包括汗腺癌、伴有鳞状分化的黏液腺癌、原发性皮肤腺鳞癌（黏液表皮样癌）和皮肤恶性混合瘤。临床相关性对于做出正确诊断至关重要。虽然黏液表皮样癌很少发生远处转移，累及皮肤的情况甚至更少见，但在皮肤黏液产生性肿瘤的鉴别诊断中应考虑到这一实体。
