Heptinstall L, Carroll C, Siddiqi J, Kamel D, Petkar M
Department of Histopathology, Broomfield Hospital, Court Road, Chelmsford, Essex, CM1 7ET, UK.
Department of Oral and Maxillofacial Surgery, Basildon University Hospital, Basildon, UK.
Head Neck Pathol. 2017 Dec;11(4):506-512. doi: 10.1007/s12105-017-0821-2. Epub 2017 May 17.
Sclerosing mucoepidermoid carcinoma of the salivary gland (SMEC) is a rare subtype of mucoepidermoid carcinoma (MEC), first described in 1987 by Chan and Saw. As far as we are aware, only 30 cases have been published since then. Most cases were located in the parotid gland with some cases described in the submandibular and minor salivary glands. SMEC typically presents as a long-standing mass, with a non-specific enhancing appearance on imaging and is often non-diagnostic on fine needle aspiration, making pre-operative diagnosis very difficult. It is characterised by dense sclerosis within an otherwise typical MEC, frequently with lymphoid proliferation and eosinophils at the periphery. The histological diagnosis of SMEC can be challenging, as the sclerosis may obscure the other morphological features, which can lead to misdiagnosis. Grading can also be difficult, and the prognostic value of grading for SMEC remains unclear. Herein is described a new case of SMEC, presenting clinically as chronic sialadenitis in the left submandibular gland of a 41 year old male. A brief literature review and the issues surrounding diagnosis and grading are also discussed.
涎腺硬化性黏液表皮样癌（SMEC）是黏液表皮样癌（MEC）的一种罕见亚型，于1987年由Chan和Saw首次描述。据我们所知，自那时以来仅发表了30例病例。大多数病例位于腮腺，也有一些病例见于颌下腺和小涎腺。SMEC通常表现为长期存在的肿块，影像学上呈非特异性强化表现，细针穿刺活检常无诊断价值，导致术前诊断非常困难。其特征是在典型的MEC内有致密的硬化，外周常伴有淋巴细胞增生和嗜酸性粒细胞浸润。SMEC的组织学诊断具有挑战性，因为硬化可能掩盖其他形态学特征，从而导致误诊。分级也可能困难，且SMEC分级的预后价值仍不明确。本文描述了一例新的SMEC病例，临床上表现为一名41岁男性左侧颌下腺的慢性涎腺炎。还讨论了简要的文献综述以及围绕诊断和分级的问题。
