Division of Oral Pathology, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan.
Int J Oral Maxillofac Surg. 2011 Jun;40(6):647-50. doi: 10.1016/j.ijom.2010.11.009. Epub 2010 Dec 15.
The authors report a case of adenoid cystic carcinoma (ACC) complicated with sialolithiasis of the submandibular gland. The patient was a 43-year-old female with a history of papillotubular carcinoma of the breast almost at the same time. She had noticed a swelling in her sublingual area for 10 years, which was later diagnosed by her dentist to be due to a sialolith in the left submandibular gland. After several years of observation, the patient was referred to have her left submandibular gland, containing the stone, surgically removed with a diagnosis of atrophic sialadenitis. Histopathologically, the submandibular gland was extensively replaced with fibrous granulation tissue, in which there were small but invasive foci of ACC. The present case indicates that ACC could arise in the background of chronic sialadenitis. It is suggested that long-standing sialadenitis cases should be carefully examined to exclude suspicion of malignancy before surgery.
作者报告了一例腺样囊性癌（ACC）合并下颌下腺涎石症的病例。患者为 43 岁女性，几乎同时患有乳腺乳头管状癌。她发现舌下区肿胀 10 年，后来被牙医诊断为左下颌下腺涎石。经过几年的观察，患者因左下颌下腺含有结石而被转诊行手术切除，诊断为萎缩性唾液腺炎。组织病理学检查显示，下颌下腺被广泛纤维肉芽组织取代，其中存在少量但具有侵袭性的 ACC 病灶。本病例提示 ACC 可能在慢性唾液腺炎的背景下发生。建议在手术前仔细检查长期存在的唾液腺炎病例，以排除恶性肿瘤的可能性。
