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上唇混合性唾液腺肿瘤还是腺样囊性癌?病例报告。

Hybrid salivary gland tumor of the upper lip or just an adenoid cystic carcinoma? Case report.

机构信息

Departamento de Atención a Salud, Universidad Autonoma Metropolitana Xochimilco, Mexico.

出版信息

Med Oral Patol Oral Cir Bucal. 2010 Jan 1;15(1):e43-7. doi: 10.4317/medoral.15.e43.

Abstract

UNLABELLED

A 65 year-old male patient with a one year-duration tumoral growth located in the upper lip was diagnosed on incisional biopsy as epithelial-myoepithelial carcinoma. After wide surgical excision the histopathological analysis revealed the lesion was composed predominantly (>90%) of adenoid cystic carcinoma. In new sections it was found a very small and isolated area of adenoid cystic carcinoma at the bottom of the incisional biopsy. As surgical margins were free of lesion, no adjuvant treatment was given. The occurrence of a transitory ischaemic attack at 36 months of follow-up led to a neurological and MRI evaluation, which disclosed a well-defined 3.5 x 3 cm lesion suggestive of metastasis, located on the right temporal area. The lesion was surgically removed and a histopathological diagnosis of neurocysticercosis was rendered. After 40 months of follow-up there is no evidence of recurrence.

CONCLUSION

True hybrid tumors of salivary glands are rare and treatment in each case should be done according to the component with the higher aggressiveness. However, the occurrence of epithelial-myoepithelial carcinoma areas within an adenoid cystic carcinoma seems to be a frequent finding, and because both lesions share a common origin, some authors consider that this may not be a true hybrid neoplasm but a variant of the latter.

摘要

背景

一名 65 岁男性患者,上唇有一年时间的肿瘤生长,经切开活检诊断为上皮-肌上皮癌。广泛手术切除后,组织病理学分析显示病变主要(>90%)由腺样囊性癌组成。在新的切片中,在切开活检的底部发现了一个非常小且孤立的腺样囊性癌区域。由于手术切缘无病变,未给予辅助治疗。在随访的 36 个月时发生一过性缺血性发作,导致进行神经学和 MRI 评估,显示右颞区有一个界限清楚的 3.5 x 3 厘米病变,提示转移。该病变被手术切除,组织病理学诊断为神经囊尾蚴病。在 40 个月的随访中,没有复发的证据。

结论

真正的唾液腺混合瘤很少见,每个病例的治疗应根据侵袭性更高的成分进行。然而,在腺样囊性癌中出现上皮-肌上皮癌区域似乎是一种常见的发现,因为这两种病变具有共同的起源,一些作者认为这可能不是真正的混合性肿瘤,而是后者的一种变体。

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