Psarris Alexandros, Koufopoulos Nektarios, Grivas Anastasios, Papatheodorou Dimitrios C, Khaldi Lubna
Gynecology, Anti-Cancer Hospital of "Saint Savvas", Athens, GRC.
Pathology, Attikon University Hospital, Medical School of Athens, Athens, GRC.
Cureus. 2020 Jan 27;12(1):e6789. doi: 10.7759/cureus.6789.
Salivary gland adenocarcinoma not otherwise specified (NOS) is a malignant epithelial tumor composed of ductal/glandular structures with or without cystic formation. Histologically it is classified as high grade with relevant biological behavior. Although both minor and major glands may be involved, the majority (60%) implicate the parotid gland. Location, regional lymph node status, and histological grade are some of the factors that predict the progress of the disease and the development of metastases. Long follow-up is considered the standard option as distant metastases (DM) may occur despite regional control. Primary sites of DM, besides lymph nodes, include bone, lung, and liver. Herein we report a unique case of a 68-year-old female with a previous history of high-grade adenocarcinoma NOS of her right parotid gland. On her biannual follow-up examination, MRI revealed an abnormal increase in the size of a known uterine leiomyoma of the posterior uterine wall. Positron emission tomography-CT (PET-CT) showed increased uptake in the uterus and lungs. On frozen section, adenocarcinoma was found at the center of the leiomyoma. Histological and immunohistochemical findings were consistent with secondary involvement by the salivary gland adenocarcinoma NOS. Treatment consisted of cyclophosphamide, adriamycin, and cisplatin with poor outcome. The patient was lost to follow-up. Review of the literature indicates that no similar case has been reported in the English literature.
未另行特指的涎腺腺癌（NOS）是一种恶性上皮性肿瘤，由导管/腺管结构组成，可有或无囊性形成。组织学上它被归类为具有相关生物学行为的高级别肿瘤。虽然小涎腺和大涎腺均可受累，但大多数（60%）累及腮腺。部位、区域淋巴结状态和组织学分级是预测疾病进展和转移发生的一些因素。长期随访被认为是标准选择，因为尽管区域得到控制，但仍可能发生远处转移（DM）。DM的原发部位除淋巴结外，还包括骨、肺和肝。在此，我们报告一例独特病例，一名68岁女性，既往有右侧腮腺高级别未另行特指的腺癌病史。在她的半年一次随访检查中，MRI显示子宫后壁已知的平滑肌瘤大小异常增加。正电子发射断层扫描-CT（PET-CT）显示子宫和肺部摄取增加。冰冻切片显示平滑肌瘤中心为腺癌。组织学和免疫组化结果与未另行特指的涎腺腺癌继发性累及一致。治疗包括环磷酰胺、阿霉素和顺铂，但效果不佳。该患者失访。文献回顾表明，英文文献中尚未报道过类似病例。
