Moret A, Tabareau-Delalande F, Joly A, de Muret A, Goga D, Laure B
Service de chirurgie maxillo-faciale et plastique de la face, CHU Trousseau, 37044 Tours cedex, France.
Service d'anatomie et cytologie pathologiques, CHU Trousseau, 37044 Tours, France.
Rev Stomatol Chir Maxillofac Chir Orale. 2014 Jun;115(3):172-7. doi: 10.1016/j.revsto.2013.12.008. Epub 2014 Jan 20.
Myoepithelial carcinomas are unusual tumors most often located in salivary glands. It is very rarely located in lacrimal glands; only 5 cases have been reported. We report a sixth case.
An 88-year-old male patient presented with diplopia, painless right sided exophthalmia, as well as eyeball deviation due to a tumor located at upper external quadrant of the orbit. A biopsy initially suggested a sarcoma. The pathological analysis of the biopsy allowed diagnosing a myoepithelial carcinoma of the lacrimal gland. Despite the monoblock resection of the tumor, a recurrence was observed 3 months after removal. The patient died 8 months after the initial surgery.
This case illustrates the clinical and pathological characteristics of a myoepithelial carcinoma. This tumor has a high grade of malignancy, and is very rarely described in lacrimal glands. The morphological diagnosis of this tumor is difficult with a problematic differential diagnosis with fusiform cells sarcomas (leiomyosarcoma, undifferentiated sarcoma), and epithelial-myoepithelial carcinoma.
肌上皮癌是一种罕见的肿瘤,最常发生于涎腺。它极少发生于泪腺;仅报道过5例。我们报告第6例。
一名88岁男性患者,因眼眶外上象限的肿瘤出现复视、右侧无痛性眼球突出以及眼球偏斜。活检最初提示为肉瘤。活检的病理分析确诊为泪腺肌上皮癌。尽管肿瘤整块切除,但切除后3个月出现复发。患者在初次手术后8个月死亡。
本病例说明了肌上皮癌的临床和病理特征。该肿瘤恶性程度高,在泪腺中极为罕见。该肿瘤的形态学诊断困难,与梭形细胞肉瘤(平滑肌肉瘤、未分化肉瘤)以及上皮-肌上皮癌的鉴别诊断存在问题。