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鼻中隔肌上皮瘤:涎腺外累及的罕见病例。

Myoepithelioma of the Nasal Septum: A Rare Case of Extrasalivary Gland Involvement.

作者信息

da Cunha Gustavo Barreto, Camurugy Tatiane Costa, Ribeiro Thiago Cavalcante, Costa Nara Nunes Barbosa, Azevedo Amanda Canário Andrade, Vinhaes Eriko Soares de Azevedo, de Andrade Nilvano Alves

机构信息

Santa Casa de Misericórdia da Bahia, Hospital Santa Izabel, Salvador, BA, Brazil.

出版信息

Case Rep Otolaryngol. 2017;2017:7057989. doi: 10.1155/2017/7057989. Epub 2017 Jan 10.

Abstract

. The myoepithelioma is a rare benign tumor, most frequently found in the salivary glands. The extrasalivary gland involvement is even rarer and few cases involving the nasal cavity have been reported in the literature. . MES, a 54-year-old woman, complaining of progressive nasal obstruction and mild epistaxis through the right nostril which had developed 1 year previously. Computed tomography scan showed tumor with heterogeneous contrast enhancement occupying the right nasal cavity, moving contralaterally in the nasal septum. Excisional biopsy was performed through endoscopic surgery of the mass that was inserted at the nasal septum. Pathological and immunohistochemical exams concluded myoepithelioma. . The main symptoms of nasal myoepitheliomas are nasal obstruction and epistaxis. Immunohistochemistry is necessary to confirm the diagnosis, typically positive for cytokeratin and S-100, calponin, smooth muscle actin, myosin, vimentin, glial fibrillary acidic protein (GFAP), and carcinoembryonic antigen. The main marker for myoepithelioma is the S-100 protein. In our case, it was positive for cytokeratin, S-100, calponin, actin smooth muscle, and GFAP. In all cases reported in the literature surgical treatment was performed and the recurrence was associated with incomplete tumor resection. . The myoepithelioma is a rare differential diagnosis of nasal tumors and its treatment is the total lesion excision.

摘要

肌上皮瘤是一种罕见的良性肿瘤,最常发生于涎腺。涎腺外受累更为罕见,文献中仅有少数鼻腔受累病例的报道。患者MES,54岁女性,主诉渐进性鼻塞及右侧鼻孔轻度鼻出血,症状已持续1年。计算机断层扫描显示肿瘤呈不均匀强化,占据右侧鼻腔,并向鼻中隔对侧移位。通过对插入鼻中隔的肿物进行内镜手术切除活检。病理及免疫组化检查确诊为肌上皮瘤。鼻腔肌上皮瘤的主要症状为鼻塞和鼻出血。免疫组化对确诊至关重要,通常细胞角蛋白、S-100、钙调蛋白、平滑肌肌动蛋白、肌球蛋白、波形蛋白、胶质纤维酸性蛋白(GFAP)及癌胚抗原呈阳性。肌上皮瘤的主要标志物是S-100蛋白。在我们的病例中,细胞角蛋白、S-100、钙调蛋白、平滑肌肌动蛋白及GFAP均呈阳性。文献报道的所有病例均行手术治疗,复发与肿瘤切除不完全相关。肌上皮瘤是鼻腔肿瘤的一种罕见鉴别诊断,其治疗方法为完整切除病变。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9309/5259606/ec3408c167bc/CRIOT2017-7057989.001.jpg

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