Ghosh Amrita, Asthana Anupam Kumar
Department of Pathology, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India.
Acta Cytol. 2008 Nov-Dec;52(6):733-5. doi: 10.1159/000325632.
Metastasizing pleomorphic adenoma (MPA) is a rare, incompletely understood enigmatic entity having the histologic appearance of benign pleomorphic adenoma and clinically malignant behavior. We report a case of MPA of the parotid gland that metastasized to the scapular region 6 years after the appearance of the primary lesion in the left parotid gland.
A 35-year-old woman presented with a palpable soft to firm mass of 3-cm diameter in the left scapular region that was slightly mobile over the underlying structures and a small swelling at the operated site of the parotid region. The patient had a prior history of surgical removal of recurrent pleomorphic adenoma of the left parotid salivary gland. Fine needle aspiration cytology (FNAC) smears of both sites demonstrated the 3 components (i.e., stromal, mesenchymal and epithelial) of benign pleomorphic adenoma with benign features. The diagnosis was MPA.
The appearance of a mass lesion or subcutaneous nodule with a prior history of pleomorphic adenoma should alert for the possibilities of metastatic carcinoma, metastatic carcinosarcoma and MPA. With well-established cytomorphology of pleomorphic adenoma, FNAC remains the investigation method of choice for metastatic workup of a case of locally recurrent pleomorphic adenoma.
转移性多形性腺瘤（MPA）是一种罕见的、尚未完全了解的神秘实体，具有良性多形性腺瘤的组织学表现和临床恶性行为。我们报告一例腮腺MPA，在左侧腮腺出现原发性病变6年后转移至肩胛区。
一名35岁女性，左侧肩胛区可触及一个直径3厘米的质软至质硬肿块，在其下方结构上可轻微移动，腮腺区手术部位有一个小肿块。该患者既往有左侧腮腺涎腺复发性多形性腺瘤手术切除史。两个部位的细针穿刺细胞学检查（FNAC）涂片均显示良性多形性腺瘤的三种成分（即间质、间叶和上皮），具有良性特征。诊断为MPA。
有多形性腺瘤病史的肿块性病变或皮下结节的出现应警惕转移性癌、转移性癌肉瘤和MPA的可能性。鉴于多形性腺瘤已确立的细胞形态学，FNAC仍然是局部复发性多形性腺瘤转移检查的首选方法。
