Al Burshaid Dhari, Douchet Catherine, Charlery-Adele Ambre
ORL Department, University Hospital Centre Dijon Bourgogne, 3 Ave Raymond Poincare, Dijon, Bourgogne-Franche-Comte, 21000, France.
Department of Histopathology, University Hospital Centre Dijon Bourgogne, Dijon, Bourgogne-Franche-Comte, France.
Radiol Case Rep. 2023 Jun 9;18(8):2827-2830. doi: 10.1016/j.radcr.2023.05.009. eCollection 2023 Aug.
The uncommon occurrence of primary squamous carcinoma of the submandibular gland makes it a challenge to diagnose and treat. Clinical as well as histopathological assessments are key elements for the diagnosis. Although no clear treatment guidelines exist, surgical excision with a neck dissection is the cornerstone of the treatment with or without adjuvant therapy. In this paper, we report a rare case of a primary squamous carcinoma in an 82-year-old lady with no history of smoking or alcohol use, who presented with a right sided cervical swelling of 3-month duration. An ultrasound guided fine needle aspiration cytology was negative, as well as a panendoscopy with systemic biopsy of the base of tongue and the homolateral palatine tonsil. In addition, a blind fine needle aspiration cytology from the mass during the panendoscopy was performed and was positive for squamous cell carcinoma. A PET scan showed hypermetabolism of the right submandibular gland with no distant lesions. Therefore, a submandibular gland excision was performed with a frozen section histopathological examination in favor of squamous cell carcinoma, therefore the intervention was completed by a selective neck dissection. High clinical suspicion should be present while dealing with this rare entity, as well as not underestimating the poor outcomes associated with it.
下颌下腺原发性鳞状细胞癌的罕见发生使其诊断和治疗具有挑战性。临床及组织病理学评估是诊断的关键要素。尽管目前尚无明确的治疗指南,但无论是否进行辅助治疗,手术切除加颈部清扫都是治疗的基石。在本文中,我们报告了一例罕见的原发性鳞状细胞癌病例,患者为一位82岁女性,无吸烟或饮酒史,右侧颈部肿胀3个月。超声引导下细针穿刺细胞学检查结果为阴性,经口全腔镜检查并对舌根和同侧腭扁桃体进行系统活检结果也为阴性。此外,在全腔镜检查期间对肿块进行了盲目细针穿刺细胞学检查,结果显示为鳞状细胞癌阳性。PET扫描显示右侧下颌下腺代谢亢进,无远处病变。因此,进行了下颌下腺切除术,并进行了冰冻切片组织病理学检查,结果支持鳞状细胞癌诊断,随后通过选择性颈部清扫完成了干预。在处理这种罕见疾病时,应保持高度的临床怀疑,同时也不应低估与之相关的不良预后。