Andreasen Simon, Bjørndal K, Agander T K, Wessel I, Homøe P
Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, Lykkebævej 1, 4600, Køge, Denmark.
Department of Otolaryngology Head and Neck Surgery and Audiology, Rigshospitalet, Blegdamsvej 9, Copenhagen, Denmark.
Eur Arch Otorhinolaryngol. 2016 Nov;273(11):3847-3856. doi: 10.1007/s00405-016-4000-y. Epub 2016 Mar 25.
Tumors of the salivary glands are a heterogeneous group of diseases most often originating in the major salivary glands. Only a minor proportion of mainly malignant tumors arise in the sublingual gland. Due to the rarity of sublingual gland tumors (SGTs), little is known about the clinicopathologic characteristics, prognostic factors, and clinical course. We present a large national series of histopathologically revised SGTs from the past 35 years in Denmark with clinicopathologic correlation. Twenty nine cases were identified, of which 96.6 % were malignant and 16/28 (57.1 %) were adenoid cystic carcinomas (ACC). Patient demography was similar to salivary gland tumors in other locations. All fine needle aspiration cytologies (FNACs) interpreted as benign were from ACCs. Metastatic disease was found in 12.5 % of ACCs at diagnosis with one third of all ACC patients having metastases at the end of follow-up. Stage >II and T-stage >2 were significantly associated with shortened disease-specific survival (DSS) (p = 0.005 and <0.001, respectively), whereas perineural invasion and involved margins was not. No parameters were associated with disease-free survival. In conclusion, the majority of SGTs are malignant, most frequently ACC with a high rate of metastatic spread. The diagnostic value of FNAC in SGTs seems inferior to what is found for other major salivary glands. DSS is determined by stage and T-stage and not by histopathological parameters. International collaboration is warranted to confirm and elaborate these findings in larger materials.
唾液腺肿瘤是一组异质性疾病,最常起源于大唾液腺。只有一小部分主要为恶性的肿瘤发生于舌下腺。由于舌下腺肿瘤(SGTs)罕见,对其临床病理特征、预后因素及临床病程了解甚少。我们展示了丹麦过去35年中经过组织病理学修订的一系列大型SGTs病例,并进行临床病理相关性分析。共识别出29例病例,其中96.6%为恶性,28例中有16例(57.1%)为腺样囊性癌(ACC)。患者人口统计学特征与其他部位的唾液腺肿瘤相似。所有被细针穿刺抽吸活检(FNAC)诊断为良性的病例均为ACC。诊断时12.5%的ACC患者出现转移,随访结束时所有ACC患者中有三分之一发生转移。分期>II期和T分期>2期与疾病特异性生存期(DSS)缩短显著相关(分别为p = 0.005和<0.001),而神经周围侵犯和切缘受累情况则不然。没有参数与无病生存期相关。总之,大多数SGTs是恶性的,最常见的是ACC,转移扩散率高。FNAC在SGTs中的诊断价值似乎低于其他大唾液腺。DSS由分期和T分期决定,而非组织病理学参数。有必要进行国际合作,以在更大规模的材料中证实并详细阐述这些发现。