Mantsopoulos Konstantinos, Goncalves Miguel, Koch Michael, Iro Heinrich, Agaimy Abbas
Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Department of Otorhinolaryngology, Head and Neck Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), Erlangen, Germany.
Ann Diagn Pathol. 2018 Jun;34:166-169. doi: 10.1016/j.anndiagpath.2018.04.002. Epub 2018 Apr 18.
Pleomorphic adenoma (PA) of the submandibular gland is known to have a very low recurrence rate. The aim of this study was to investigate the histopathological and capsular characteristics of submandibular gland PA, looking for any differences between submandibular PA and the reported data for PA of the parotid gland as possible explanation for its low recurrence rate. We reviewed 72 submandibular gland PAs resected at our center between 2000 and 2016. Patient age ranged from 14 to 77 years (mean, 47.2). At least follow (range, 12 to 170 months; mean, 82), none of the 72 patients developed a local recurrence. Histologically, all of the tumors were encased by a complete and intact anatomical capsule (100%). Pseudopodia were detected in 11 (15.3%) and satellite nodules in 3 (4.2%) cases. The histological subtype (according to Seifert et al.) was classic (mixed) in 39 (54.2%), stroma-rich/myxoid in 18/72 (25%) and cellular in 15 (20.8%) cases. A complete rim of healthy pericapsular tissue encasing the tumor and its capsule was observed in only 23/72 (31.9%) cases. In conclusion, submandibular PAs are characterized by consistent presence of an intact anatomical capsule, infrequent occurrence of pseudopodia, a remarkably infrequent occurrence lower frequency of secondary satellite tumor nodules and a comparatively lower proportion of the fragile risky myxoid subtype. Despite the fact that surgery of the submandibular gland can frequently lead to focal capsular exposure, the aforementioned capsular characteristics of submandibular gland PA are probably responsible for the excellent oncologic results.
已知颌下腺多形性腺瘤（PA）的复发率极低。本研究的目的是调查颌下腺PA的组织病理学和包膜特征，寻找颌下腺PA与腮腺PA报告数据之间的差异，以解释其低复发率的原因。我们回顾了2000年至2016年在本中心切除的72例颌下腺PA。患者年龄在14至77岁之间（平均47.2岁）。至少随访（范围12至170个月；平均82个月），72例患者均未出现局部复发。组织学上，所有肿瘤均被完整的解剖包膜包裹（100%）。11例（15.3%）检测到假足，3例（4.2%）检测到卫星结节。组织学亚型（根据Seifert等人的分类）为经典（混合）型39例（54.2%），富含基质/黏液样型18/72例（25%），细胞型15例（20.8%）。仅23/72例（31.9%）观察到肿瘤及其包膜周围有完整的健康包膜外组织边缘。总之，颌下腺PA的特征是始终存在完整的解剖包膜，假足发生率低，继发性卫星肿瘤结节发生率极低，黏液样脆弱风险亚型比例相对较低。尽管颌下腺手术经常会导致局部包膜暴露，但上述颌下腺PA的包膜特征可能是其良好肿瘤学结果的原因。
