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腮腺巨大癌肉瘤样癌一例。

A case of giant sarcomatoid carcinoma ex-pleomorphic adenoma of the parotid gland.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Tahar Sfar Hospital, Mahdia, Tunisia.

Department of Pathology, Fattouma Bourguiba Hospital, Monastir, Tunisia.

出版信息

Pan Afr Med J. 2020 Sep 1;37:2. doi: 10.11604/pamj.2020.37.2.21653. eCollection 2020.

Abstract

Carcinoma ex pleomorphic adenoma is a rare malignant parotid neoplasm arising from primary or recurrent benign pleomorphic adenoma. Histologically, it can be sub-classified by upwards of eight different variations (e.g., myoepithelial carcinoma, salivary duct carcinoma, adenoid cystic carcinoma sarcomatoid carcinoma). We present the fourth case in the literature of sarcomatoid carcinoma arising from an underlying pleomorphic adenoma of the parotid gland. We present a case of a 47-year-old female who consulted for a left parotid mass of 15cm long axis. There was no facial paralysis. Fine needle aspiration cytology smears showed a pleomorphic adenoma. The parotid MRI showed a left parotid mass, with heterogeneous signal (hyposignal T1 and hypersignal T2 and in diffusion sequences). The patient underwent a total parotidectomy with a pleomorphic adenoma on extemporaneous examination. Histological examination of the part revealed a pleomorphic adenoma on which a sarcomatoid carcinoma developed. Therefore, a second operation occurred. We performed selective lymph node dissection carrying out the sectors I, II and III followed by radiotherapy. The evolution was favorable. In addition to its rarity, our case joins historical cases by its huge size.

摘要

癌在多形性腺瘤中是一种罕见的恶性腮腺肿瘤,起源于原发性或复发性良性多形性腺瘤。组织学上,它可以通过 8 种以上的不同变异进行亚分类(例如,肌上皮癌、唾液腺癌、腺样囊性癌、肉瘤样癌)。我们报告了第四例来源于腮腺多形性腺瘤的肉瘤样癌。我们报告了一例 47 岁女性,因左腮腺长达 15 厘米的肿块就诊。无面瘫。细针抽吸细胞学涂片显示为多形性腺瘤。腮腺 MRI 显示左腮腺肿块,信号不均匀(T1 低信号和 T2 高信号及扩散序列)。患者接受了全腮腺切除术,大体检查发现多形性腺瘤。组织学检查显示多形性腺瘤上发生了肉瘤样癌。因此,进行了第二次手术。我们进行了选择性淋巴结清扫,包括 I、II 和 III 区,然后进行了放疗。病情进展良好。除了其罕见性之外,我们的病例还因其巨大的体积而与历史病例相吻合。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5ac/7501749/d541853af586/PAMJ-37-2-g001.jpg

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