Eguchi Takanori, Basugi Akihiko, Kanai Ikuyo, Miyata Yukinaga, Suzuki Takamasa, Hamada Yoshiki
Department of Oral and Maxillofacial Surgery, School of Dental Medicine, Tsurumi University, Yokohama.
Department of Oral and Maxillofacial Surgery.
Medicine (Baltimore). 2019 Oct;98(43):e17688. doi: 10.1097/MD.0000000000017688.
Oral adenosquamous carcinoma (ASC) is rare and its origins are controversial. We here present a patient with oral ASC that developed after surgery for oral squamous cell carcinoma (SCC).
A 70-year-old man with SCC on the oral floor underwent surgical resection. However, the enlarged ulcer presented on the oral floor 9 month after surgery.
The biopsy of the ulcer revealed a SCC. Imaging examinations detected enhancement of a large lesion expanded to the tongue, but no evidence of regional lymph node or distant metastasis was shown. Based on these results, local recurrence of the cancer was diagnosed (cT4aN0M0).
The surgery for the recurrent tumor was performed.
The pathological examination of the surgical specimen indicated recurrent tumor was ASC. Thus, histopathological and immunohistochemical analyses of both the initial SCC and the subsequent ASC were performed in an attempt to explore the origin of the ASC. As the results, pathological review of both tumors suggested the subsequent ASC was developed from the tumor cells with adenoid phenotype in the initial SCC.
This report suggests that the oral ASC was origin from the oral SCC, which can contribute to new knowledge for pathogenesis of oral cancer.
口腔腺鳞癌（ASC）较为罕见，其起源存在争议。我们在此报告一例口腔鳞状细胞癌（SCC）手术后发生的口腔ASC患者。
一名70岁男性，口腔底部患有SCC，接受了手术切除。然而，术后9个月口腔底部出现了增大的溃疡。
溃疡活检显示为SCC。影像学检查发现一个扩展至舌部的大病变有强化，但未显示区域淋巴结或远处转移的证据。基于这些结果，诊断为癌症局部复发（cT4aN0M0）。
对复发性肿瘤进行了手术。
手术标本的病理检查表明复发性肿瘤为ASC。因此，对最初的SCC和随后的ASC进行了组织病理学和免疫组织化学分析，试图探究ASC的起源。结果显示，对两种肿瘤的病理复查表明，随后的ASC起源于最初SCC中具有腺样表型的肿瘤细胞。
本报告表明口腔ASC起源于口腔SCC，这可为口腔癌的发病机制提供新知识。
