Institute of Pathology Department of Otorhinolaryngology, Head and Neck Surgery, Grosshadern Medical Centre, Ludwig Maximilian University, Munich, Germany.
Histopathology. 2011 Oct;59(4):741-50. doi: 10.1111/j.1365-2559.2011.03937.x.
To investigate a large series of cases of carcinoma ex pleomorphic adenoma (CEPA) to determine prognostic factors.
Thirty cases of CEPA associated with primary pleomorphic adenoma (PA) and 11 cases of CEPA associated with recurrent PA were investigated. The median follow-up was 57.7 months, and ranged from 4 to 156 months. Purely intraductal carcinoma was found in 15 cases. Intraductal and extraductal intracapsular carcinoma together was found in one case. Extracapsular carcinoma was found in 25 cases. Prognosis was good for CEPA that was purely intraductal, extraductal intracapsular, or up to 5 mm extracapsular, and poor for CEPA that was 8 mm or more extracapsular. There were relatively more cases of CEPA with extracapsular invasion of 8 mm or more from recurrent PA than from primary PA, and the prognosis for CEPA associated with recurrent PA was worse than that for CEPA associated with primary PA.
The threshold for distinguishing minor extracapsular invasion with good prognosis from wide extracapsular invasion with poor prognosis is 5 mm. The worse prognosis for CEPA associated with recurrent PA indicates the necessity for close surveillance of patients with recurrent PA.
研究大量癌在多形性腺瘤中的病例，以确定预后因素。
研究了 30 例与原发性多形性腺瘤（PA）相关的癌在多形性腺瘤（CEPA）和 11 例与复发性 PA 相关的 CEPA 病例。中位随访时间为 57.7 个月，范围为 4 至 156 个月。15 例为单纯导管内癌，1 例为导管内和囊外腔内癌，25 例为囊外癌。对于单纯导管内、囊外腔内或直径达 5mm 以内的 CEPA，预后良好，而对于直径大于 8mm 的 CEPA，预后较差。与原发性 PA 相比，复发性 PA 中直径大于 8mm 的 CEPA 有更多的囊外侵犯病例，复发性 PA 相关的 CEPA 预后比原发性 PA 相关的 CEPA 更差。
区分具有良好预后的微小囊外侵犯和具有不良预后的广泛囊外侵犯的界限是 5mm。复发性 PA 相关的 CEPA 预后较差表明需要对复发性 PA 患者进行密切监测。
