Yang Shaodong, Li Lu, Zeng Ming, Zhu Xiaojie, Zhang Jiali, Chen Xinming
Department of Oral Histopathology, Faculty of Stomatology, Hainan Medical College, Haikou, Hainan, China.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 Jul;110(1):85-93. doi: 10.1016/j.tripleo.2010.02.023. Epub 2010 May 21.
Myoepithelial carcinoma (MC), also known as malignant myoepithelioma, is a rare malignant salivary gland neoplasm with a predilection for the parotid gland. We present the clinicopathological and immunohistochemical features of 7 cases of intraoral MC in attempt to better understanding this entity.
Seven intraoral MCs were retrieved from the files of the Department of Oral Pathology, School of Stomatology, Wuhan University, during a 10-year period. Immunohistochemical markers, including cytokeratin (CK) AE1/AE3, S100, vimentin, smooth muscle actin (SMA), p63, and maspin, were used to further characterize these lesions. A review of contemporary relevant literature is also provided.
The patients were 5 women and 2 men, and the age range was 37 to 75 years (mean 57.9 years). Three cases arose in the hard palate, 2 in the retromolar region, and 1 each in the tongue and the floor of the mouth. Histologically, the tumors exhibited a solid architecture with cells arranged in nodules, nests, trabeculae, or cords. The epithelioid cell type is the most frequently encountered, followed by clear cells. The tumor-associated matrix is more prevalent hyalinized than myxoid. Immunohistochemically, CK AE1/AE3, S100, vimentin, p63, and maspin were expressed in all cases. Positivity for SMA was seen in 3 tumors. Five patients with follow-up information showed no evidence of disease after a mean follow-up of 69.6 months (range 22-108 months).
Combining the current series with 21 additional cases in the literature indicated that myoepithelial carcinoma of intraoral minor salivary glands is generally a low-grade malignant tumor with little propensity for regional or distant metastasis and low recurrence. Awareness of the clinicopathological and immunohistochemical features of intraoral MC is necessary for accurate diagnosis. Wide local excision with tumor-free margins is the treatment of choice.
肌上皮癌（MC），也称为恶性肌上皮瘤，是一种罕见的涎腺恶性肿瘤，好发于腮腺。我们报告7例口腔内MC的临床病理及免疫组化特征，以更好地了解这一实体。
在10年期间，从武汉大学口腔医学院口腔病理科档案中检索出7例口腔内MC。采用免疫组化标记物，包括细胞角蛋白（CK）AE1/AE3、S100、波形蛋白、平滑肌肌动蛋白（SMA）、p63和maspin，对这些病变进行进一步特征分析。同时还对当代相关文献进行了综述。
患者中女性5例，男性2例，年龄范围为37至75岁（平均57.9岁）。3例发生于硬腭，2例发生于磨牙后区，舌部和口底各1例。组织学上，肿瘤呈实性结构，细胞排列成结节、巢状、小梁状或条索状。上皮样细胞型最为常见，其次是透明细胞。肿瘤相关基质玻璃样变比黏液样变更常见。免疫组化方面，所有病例均表达CK AE1/AE3、S100、波形蛋白、p63和maspin。3例肿瘤SMA呈阳性。5例有随访信息的患者，平均随访69.6个月（范围22 - 108个月）后无疾病证据。
将本系列病例与文献中另外21例病例相结合表明，口腔内小涎腺肌上皮癌一般为低级别恶性肿瘤，区域或远处转移倾向小，复发率低。了解口腔内MC的临床病理及免疫组化特征对于准确诊断很有必要。首选的治疗方法是在切缘无肿瘤的情况下进行广泛局部切除。
