Manteghi Alexander, Centric Aaron, Zwillenberg Seth, Minimo Corrado
Philadelphia College of Osteopathic Medicine.
Albert Einstein Medical Center.
Spartan Med Res J. 2016 Oct 24;1(1):5042. doi: 10.51894/001c.5042.
Epithelial-myoepithelial carcinoma (EMC) is a low grade tumor that comprises 1% of all salivary tumors. Local recurrence is not uncommon, but rarely does this tumor demonstrate distant metastasis. We describe a case of a 53-year old female presenting with an asymptomatic, slowly enlarging left submandibular neck mass. Excision of the left submandibular gland (SMG) revealed epithelial-myoepithelial carcinoma with extensive perineural invasion and microscopically positive margins. A subsequent left supraomohyoid neck dissection demonstrated no residual tumor. The patient was stable for one year until a magnetic resonance imaging (MRI) workup for low back pain revealed multiple sclerotic lesions in the iliac crest and lumbar spine, with an iliac crest biopsy demonstrating metastasis. 2.5 year post-operative positron emission tomography-computed tomography (PET-CT) revealed increased [18F]-fluorodeoxyglucose (FDG) avidity in the right iliac crest, pubic symphysis, thoracic and lumbar spine, 9th rib, and sternum concerning for local recurrence and further osseous metastasis. We report the first known case of a submandibular gland EMC with osseous metastasis and highlight the need for prolonged tumor surveillance.
上皮-肌上皮癌（EMC）是一种低度恶性肿瘤，占所有涎腺肿瘤的1%。局部复发并不少见，但该肿瘤很少发生远处转移。我们报告一例53岁女性患者，表现为左侧颌下颈部无症状、缓慢增大的肿块。左侧颌下腺切除术后病理显示为上皮-肌上皮癌，伴有广泛的神经周围侵犯，显微镜下切缘阳性。随后进行的左侧肩胛舌骨肌上颈清扫术未发现残留肿瘤。患者病情稳定一年，直到因腰痛行磁共振成像（MRI）检查时发现髂嵴和腰椎有多个硬化性病变，髂嵴活检证实为转移。术后2.5年的正电子发射断层扫描-计算机断层扫描（PET-CT）显示右髂嵴、耻骨联合、胸腰椎、第9肋骨和胸骨处[18F]-氟脱氧葡萄糖（FDG）摄取增加，考虑为局部复发和进一步的骨转移。我们报告了首例已知颌下腺EMC发生骨转移的病例，并强调了长期肿瘤监测的必要性。
