Nayyar Vivek, Roychoudhury Ajoy, Bhalla Ashu Seith, Mishra Deepika
Department of Oral Pathology and Microbiology, CDER, All India Institute of Medical Sciences, New Delhi, India.
Department of Oral and Maxillofacial Surgery, CDER, All India Institute of Medical Sciences, New Delhi, India.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2022 Oct;134(4):e277-e280. doi: 10.1016/j.oooo.2022.01.022. Epub 2022 Feb 3.
Adrenocortical carcinoma (ACC) is an uncommon primary cancer in the adrenal gland. Its incidence of showing metastasis in the head and neck region is very rare. Herein, we present a case of a 46-year-old man who presented with complaints of pain and numbness on the left side of the lower face for 4 months. Radiographic examination revealed an osteolytic lesion with an ill-defined border in the left body region of the mandible. Histopathologic examination revealed a tumor composed of sheets of oval to polygon-shaped tumor cells predominantly displaying abundant eosinophilic granular cytoplasm. These tumor cells showed features of a high degree of anaplasia. On immunohistochemical examination, tumor cells were focally positive for synaptophysin, inhibin, vimentin, pancytokeratin (pan-CK), cytokeratin (CK)5/6, CD68, and CK8/18 and immunonegative for CK7, chromogranin, melan-A, S100, SMA, and SATB2. The Ki-67 proliferation index was approximately 20%. To the best of our knowledge, this is the first case of metastatic oncocytic ACC to the oral cavity region.
肾上腺皮质癌（ACC）是肾上腺一种罕见的原发性癌症。其在头颈部区域发生转移的情况非常罕见。在此，我们报告一例46岁男性患者，他因左侧下脸部疼痛和麻木4个月前来就诊。影像学检查显示下颌骨左侧体部有一个边界不清的溶骨性病变。组织病理学检查显示肿瘤由成片的椭圆形至多边形肿瘤细胞组成，这些细胞主要表现为丰富的嗜酸性颗粒细胞质。这些肿瘤细胞显示出高度间变的特征。免疫组化检查显示，肿瘤细胞突触素、抑制素、波形蛋白、全细胞角蛋白（pan-CK）、细胞角蛋白（CK）5/6、CD68和CK8/18呈局灶性阳性，而CK7、嗜铬粒蛋白、黑素A、S100、平滑肌肌动蛋白（SMA）和SATB2呈免疫阴性。Ki-67增殖指数约为20%。据我们所知，这是第一例转移性嗜酸细胞性肾上腺皮质癌累及口腔区域的病例。
