Department of Oral Diagnosis, Area of Pathology, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
Pathology Division, Centro Clínico de Cabeza y Cuello/Hospital Herrera Llerandi, Guatemala City, Guatemala.
Histopathology. 2018 Oct;73(4):585-592. doi: 10.1111/his.13664. Epub 2018 Jul 9.
Sebaceous carcinomas are uncommon malignant cutaneous tumours originating from the pilosebaceous unit. Although its occurrence is mostly common in peri-ocular glands, other anatomical regions of the head and neck may be affected, including major and minor salivary glands.
We describe a series of sebaceous adenocarcinomas of the parotid and submandibular glands. The mean age was 62.1 (range = 31-90) years. Two patients (20%) presented regional or distant metastasis to mandible and lungs. All cases were positive for cytokeratins (AE1AE3 and CK-5), epithelial membrane antigen and adipophilin and negative for androgen receptor, Factor XIIIa, S-100, vimentin and perforin. MLH1 and MSH2 were expressed in the nuclei of most tumour cells, and one case showed loss of MSH2 expression. Proliferative index (assessed by Ki-67 expression) and microvessel density (CD34-positive vessels) were higher in metastasis-associated cases. P63 expression was noted in the periphery of the tumour nests, in the basaloid cells, with a mean of 69.2% nuclear positivity.
The sebaceous adenocarcinoma of salivary glands is rare and may show an unfavourable outcome; therefore, its correct diagnosis may be challenging. For this reason, immunohistochemical studies, including adipophilin in particular, constitute an important diagnostic tool.
皮脂腺癌是一种罕见的来源于毛囊皮脂腺单元的恶性皮肤肿瘤。虽然其发生主要常见于眼周腺体，但头颈部的其他解剖区域也可能受到影响，包括大、小唾液腺。
我们描述了一系列发生于腮腺和颌下腺的皮脂腺癌。平均年龄为 62.1 岁（范围=31-90 岁）。有 2 名患者（20%）出现了下颌骨和肺部的局部或远处转移。所有病例均对细胞角蛋白（AE1AE3 和 CK-5）、上皮膜抗原和脂滴蛋白呈阳性，雄激素受体、因子 XIIIa、S-100、波形蛋白和穿孔素呈阴性。MLH1 和 MSH2 在大多数肿瘤细胞的核内表达，有 1 例 MSH2 表达缺失。转移相关病例的增殖指数（通过 Ki-67 表达评估）和微血管密度（CD34 阳性血管）更高。P63 在肿瘤巢的外周和基底样细胞中表达，核阳性率平均为 69.2%。
唾液腺的皮脂腺癌罕见且预后不良，因此正确诊断可能具有挑战性。为此，免疫组织化学研究，尤其是脂滴蛋白，构成了重要的诊断工具。
