18515ASST Spedali Civili di Brescia, Brescia, Italy.
9297University of Brescia, Brescia, Italy.
Int J Surg Pathol. 2021 May;29(3):301-307. doi: 10.1177/1066896920941604. Epub 2020 Jul 16.
Carcinoma showing thymic-like differentiation (CASTLE) is a rare tumor most commonly occurring in the thyroid and soft tissues of the neck. We report the first case of CASTLE occurring in the sublingual gland. The patient, a 35-year-old healthy man, presented with a submucosal lesion located in the anterior right floor of the oral cavity and an ipsilateral neck mass. The lesion had been previously investigated by neck computed tomography and ultrasound-guided fine needle aspiration cytology and diagnosed as metastatic squamous cell carcinoma. After oral cavity magnetic resonance imaging, positron emission tomography, and a non-diriment, fine needle aspiration cytology of the sublingual mass, the patient was treated as affected by a sublingual gland malignancy with removal of primary tumor and neck dissection. Morphological and immunohistochemical findings were diagnostic for primary sublingual gland CASTLE. The patient received adjuvant radiotherapy and is free of disease 2 years after treatment. We describe the pathological features of the lesion and discuss the possible differential diagnoses.
具有胸腺样分化的癌（CASTLE）是一种罕见的肿瘤，最常见于甲状腺和颈部软组织。我们报告首例发生于舌下腺的 CASTLE 病例。患者为 35 岁健康男性，表现为位于口腔前右侧底部的黏膜下病变和同侧颈部肿块。该病变曾行颈部计算机断层扫描和超声引导下细针抽吸细胞学检查，诊断为转移性鳞状细胞癌。行口腔磁共振成像、正电子发射断层扫描和非定向、舌下腺肿物细针抽吸细胞学检查后，患者被诊断为舌下腺恶性肿瘤，行原发肿瘤切除术和颈部淋巴结清扫术。形态学和免疫组织化学检查结果诊断为原发性舌下腺癌。患者接受辅助放疗，治疗后 2 年无疾病。我们描述了病变的病理特征，并讨论了可能的鉴别诊断。
