Fujii Hiroyuki, Noguchi Tadahide, Miura Tamaki, Fujii Nana, Isozaki Takenori, Fujita Akifumi, Niki Toshiro, Matsuki Mitsuru, Mori Harushi
Department of Radiology, Jichi Medical University, Tochigi, Japan.
Department of Dentistry, Oral and Maxillofacial Surgery, Jichi Medical University, Tochigi, Japan.
Radiol Case Rep. 2023 Aug 3;18(10):3626-3631. doi: 10.1016/j.radcr.2023.07.050. eCollection 2023 Oct.
Sclerosing microcystic adenocarcinoma (SMA) is a rare malignant tumor of the salivary glands that closely resembles cutaneous microcystic adnexal carcinoma (MAC). It was newly listed in the 5th edition of the WHO classification of head and neck tumors. This report describes the case of a 61-year-old woman who presented with masses on the floor of the mouth. The masses showed low signal intensity on T2-weighted images (T2WI) and with low apparent diffusion coefficient (ADC) values. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) revealed a plateau or persistence after rapid initial enhancement. Histopathologically, the tumors comprised small infiltrating strands of cells that formed small ducts and cysts embedded in thick fibrous stroma, consistent with SMA. Low signal intensity on T2WI with a low ADC value and a plateau or persistence after rapid initial enhancement on DCE-MRI reflect the fibrous and cellular components of the tumor and can be considered characteristic MRI findings of SMA.
硬化性微囊性腺癌（SMA）是一种罕见的涎腺恶性肿瘤，与皮肤微囊性附属器癌（MAC）极为相似。它在《世界卫生组织头颈部肿瘤分类》第5版中首次被列入。本报告描述了一名61岁女性患者，其口底出现肿物。这些肿物在T2加权成像（T2WI）上呈低信号强度，表观扩散系数（ADC）值较低。动态对比增强磁共振成像（DCE-MRI）显示在快速初始强化后呈平台期或持续强化。组织病理学检查显示，肿瘤由小的浸润性细胞条索组成，形成小导管和囊肿，并嵌入厚纤维基质中，符合硬化性微囊性腺癌的表现。T2WI上的低信号强度和低ADC值，以及DCE-MRI上快速初始强化后的平台期或持续强化反映了肿瘤的纤维和细胞成分，可被视为硬化性微囊性腺癌的特征性MRI表现。
