Wang Huanhuan, Zhang Yuyu, Wang Bin, Wei Jinlong, Ji Rui, Dong Lihua, Jiang Xin
Department of Radiation Oncology.
Jilin Provincial Key Laboratory of Radiation Oncology and Therapy, The First Hospital of Jilin University.
Medicine (Baltimore). 2020 Oct 2;99(40):e22483. doi: 10.1097/MD.0000000000022483.
Epithelial-myoepithelial carcinoma (EMC) is a rare, low-grade malignancy that occurs primarily in the parotid gland and is most common in women aged 60 to 70 years. Cases of parotid EMC have been reported previously. Furthermore, some studies have suggested an increased risk of salivary gland tumors with secondary primary malignancies. There have been few reports of parotid EMC with other primary tumors.
A 62-year-old Chinese man visited the hospital with a complaint of a mass on his left cheek that had persisted for 20 years. Routine pulmonary computed tomography showed a local ground glass shadow in the lower lobe of the right lung.
The pathological diagnosis of lung was right lower lobe lung adenocarcinoma (pT1N0). Immunohistochemistry analysis showed that cytokeratin (CK)-7, NapsinA, and thyroid transcription factor-1 tested positive, while CK5/6, P40, and ALKD5F3 tested negative. The pathological diagnosis of left parotid gland: EMC. On immunohistochemistry staining, the outer cells expressed myoepithelial markers, such as CK5/6, P63, smooth muscle actin, while the inner cells expressed glandular epithelial markers, such as low-molecular-weight CK7 and CK8.
The patient underwent resection of the lung and parotid tumors, and received preventive radiotherapy in the parotid gland area.
The patient is in good condition. No symptom recurrence, distant metastatic spread or significant toxicity occurred during or after the treatment. The patient remains under regular surveillance.
We report a rare case of parotid EMC with a second primary lung adenocarcinoma. This case is the third case of primary lung cancer associated with parotid EMC reported to date and the first to be reported in nearly 30 years.
上皮-肌上皮癌(EMC)是一种罕见的低级别恶性肿瘤,主要发生于腮腺,最常见于60至70岁的女性。此前已有腮腺EMC病例的报道。此外,一些研究表明,继发原发性恶性肿瘤会增加唾液腺肿瘤的发病风险。腮腺EMC合并其他原发性肿瘤的报道较少。
一名62岁的中国男性因左侧脸颊肿物持续20年就诊。常规肺部计算机断层扫描显示右肺下叶有局部磨玻璃影。
肺部病理诊断为右下叶肺腺癌(pT1N0)。免疫组化分析显示,细胞角蛋白(CK)-7、NapsinA和甲状腺转录因子-1检测呈阳性,而CK5/6、P40和ALK D5F3检测呈阴性。左侧腮腺病理诊断为EMC。免疫组化染色显示,外层细胞表达肌上皮标志物,如CK5/6、P63、平滑肌肌动蛋白,而内层细胞表达腺上皮标志物,如低分子量CK7和CK8。
患者接受了肺部和腮腺肿瘤切除术,并在腮腺区域接受了预防性放疗。
患者状况良好。治疗期间及治疗后未出现症状复发、远处转移扩散或明显毒性反应。患者仍在接受定期监测。
我们报告了一例罕见的腮腺EMC合并第二原发性肺腺癌病例。该病例是迄今为止报道的第三例与腮腺EMC相关的原发性肺癌病例,也是近30年来报道的首例。