多形性腺瘤中鳞状化生的一个具有挑战性的病例：诊断和临床陷阱
A challenging case of squamous metaplasia in a pleomorphic adenoma: diagnostic and clinical pitfalls.
作者信息
Brisebois Simon, Chababi Atallah Myrna, Borduas Martin, Fortier Pierre-Hugues
机构信息
Otolaryngology and Head and Neck Surgery Division, Department of Surgery, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada
Department of Pathology, Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, QC, Canada.
出版信息
J Surg Case Rep. 2015 Sep 14;2015(9):rjv113. doi: 10.1093/jscr/rjv113.
Squamous metaplasia in a pleomorphic adenoma (PA) has been reported, but rarely has it been documented as being extensive enough to cause significant misdiagnosis. We present a case of a 37-year-old man presenting with a 1.7-cm minor salivary gland PA of the palate. It exhibited extensive squamous metaplasia mimicking a squamous cell carcinoma (SCC) on multiple preoperative biopsies. The final diagnosis was only made after a complete oncological excision with margins and free flap reconstruction. Florid squamous metaplasia in a PA, although rare, should be recognized and distinguished from SCC. Failure to differentiate these entities can lead to patient overtreatment.
多形性腺瘤（PA）中鳞状化生已有报道，但很少有文献记载其范围广泛到足以导致严重误诊。我们报告一例37岁男性，其腭部有一个1.7厘米的小唾液腺PA。在多次术前活检中，它表现出广泛的鳞状化生，酷似鳞状细胞癌（SCC）。最终诊断是在进行了切缘阴性的根治性切除和游离皮瓣重建后才得以明确。PA中的显著鳞状化生虽然罕见，但应予以识别并与SCC区分开来。未能区分这些病变可能导致患者接受过度治疗。
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