Ritwik Priyanshi, Cordell Kitrina G, Brannon Robert B
Department of Pediatric Dentistry, Louisiana State University Health Sciences Center School of Dentistry, 1100 Florida Avenue, Box 139, New Orleans, LA 70119, USA.
J Med Case Rep. 2012 Jul 3;6:182. doi: 10.1186/1752-1947-6-182.
Because well-documented cases of mucoepidermoid carcinomas that are of minor salivary gland origin and occur in children and adolescents have rarely been reported, little information regarding their clinical features and biologic behavior is available. This case report represents a retrospective clinical analysis of five minor salivary gland mucoepidermoid carcinomas accessioned from a 35-year period at the Louisiana State University School of Dentistry and combines the data with 15 well-documented cases from the English language literature.
The five mucoepidermoid carcinomas in patients from birth to 19 years of age accounted for 1.3% of the accessioned minor salivary gland neoplasms. There were an additional 15 well-documented cases in the literature. Combining the data for the 20 mucoepidermoid carcinomas resulted in a mean age of 13.5 years and a 2.3:1 female-to-male ratio. Collectively, the hard palate, soft palate, and hard palate/soft palate junction accounted for 85% of the cases. Thirty-five percent of the cases presented as a fluctuant submucosal swelling with surface color alterations. The average duration was five months, and bone involvement occurred in seven cases. A histologic grade of low to intermediate predominated (95%). Surgical removal was the treatment in all cases. Thirteen cases had adequate follow-up of three years or more, and recurrence was documented in only one case. There were no cases of death or metastasis in this series.
In children and adolescents, mucoepidermoid carcinomas have a female predilection and occur most commonly on the hard or soft palate or both. A fluctuant submucosal lump with a bluish color is a helpful diagnostic clue. The histologic grades of most mucoepidermoid carcinomas in the first and second decades of life are low and, to a lesser degree, intermediate. Complete surgical excision is the treatment of choice and results in a recurrence rate of less than 10%.
由于起源于小唾液腺且发生于儿童和青少年的黏液表皮样癌的详细病例鲜有报道，因此关于其临床特征和生物学行为的信息有限。本病例报告对路易斯安那州立大学牙科学院35年间收录的5例小唾液腺黏液表皮样癌进行了回顾性临床分析，并将数据与英文文献中15例详细记录的病例相结合。
5例黏液表皮样癌患者年龄从出生至19岁，占收录的小唾液腺肿瘤的1.3%。文献中另有15例详细记录的病例。将这20例黏液表皮样癌的数据合并后，平均年龄为13.5岁，女性与男性比例为2.3:1。总体而言，硬腭、软腭以及硬腭/软腭交界处占病例的85%。35%的病例表现为波动性黏膜下肿胀伴表面颜色改变。平均病程为5个月，7例出现骨受累。组织学分级以低至中级为主（95%）。所有病例均采用手术切除治疗。13例患者进行了3年或更长时间的充分随访，仅1例有复发记录。本系列中无死亡或转移病例。
在儿童和青少年中，黏液表皮样癌女性多见，最常发生于硬腭或软腭或两者。波动性黏膜下蓝色肿块是一个有用的诊断线索。大多数10至20岁患者的黏液表皮样癌组织学分级为低级，少数为中级。完整手术切除是首选治疗方法，复发率低于10%。
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