Avondet Lucas, Adan Roque, Berenstein Barbara M, Zeballos Gonzalo, Brasquet Nicole, Silva Ángeles Da, Bazan Candela, Coliva Gisela, Garcia Ximena
Alexander Fleming Cancer Institute, Head and Neck Unit, 1180 Cramer, Buenos Aires 3201, Argentina.
Alexander Fleming Cancer Institute, Pathological Anatomy Service, 1180 Cramer, Buenos Aires 3201, Argentina.
Ecancermedicalscience. 2023 Sep 4;17:1599. doi: 10.3332/ecancer.2023.1599. eCollection 2023.
Mucoepidermoid carcinoma starts in the salivary glands and accounts for 5%-10% of all salivary gland tumours. Its intraosseous occurrence is rare and only accounts for 2%-3% of all mucoepidermoid carcinomas. This neoplasm often follows a long and indolent course. Also, given its ambiguous presentation and similarities to other dental pathologies, it often has a late diagnosis. In this instance, we present the case of a patient with an asymptomatic mandibular lesion, who underwent mandibular resection and reconstruction with fibula free flap.
A 32-year-old male patient reported discomfort when chewing, which was attributable to a self-detected mass localised in proximity to teeth 47 and 48. The lesion presented as a slight swelling without clear expression in the oral cavity mucosa. The rest of the physical examination revealed no abnormalities. Both the panoramic radiograph and computed tomography of the maxillary bones revealed lytic lesions in proximity to teeth 47 and 48, close to the mandibular angle. An incisional biopsy was performed, for which the pathological anatomy showed low-grade mucoepidermoid carcinoma. A resection was then performed, which involved a right hemimandibulectomy with ipsilateral cervical lymphadenectomy. The reconstruction was performed with a right fibula-free flap. Upon histological evaluation of the surgical specimen, an intermediate-grade mucoepidermoid carcinoma was found. The patient presented good post-operative evolution. Following a multidisciplinary assessment, the use of adjuvant radiation therapy was deemed necessary. The patient currently presents good evolution and has regular check-ups.
Intraosseous mucoepidermoid carcinoma is a rare salivary gland tumour. Given its low frequency, there are no studies that accurately describe its biological behaviour and prognosis.
黏液表皮样癌起源于唾液腺，占所有唾液腺肿瘤的5%-10%。其发生于骨内的情况罕见，仅占所有黏液表皮样癌的2%-3%。这种肿瘤通常病程较长且进展缓慢。此外，鉴于其表现不明确且与其他牙科病变相似，其诊断往往较晚。在此，我们报告一例无症状下颌骨病变患者的病例，该患者接受了下颌骨切除并用游离腓骨瓣进行重建。
一名32岁男性患者报告咀嚼时不适，原因是自行发现位于47和48号牙附近的肿物。病变表现为轻微肿胀，在口腔黏膜中无明显表现。其余体格检查未发现异常。上颌骨全景X线片和计算机断层扫描均显示47和48号牙附近、靠近下颌角处有溶骨性病变。进行了切开活检，病理解剖显示为低级别黏液表皮样癌。随后进行了手术切除，包括右半侧下颌骨切除及同侧颈淋巴结清扫。用右游离腓骨瓣进行重建。对手术标本进行组织学评估时，发现为中级黏液表皮样癌。患者术后恢复良好。经过多学科评估，认为有必要使用辅助放疗。患者目前恢复良好并定期接受检查。
骨内黏液表皮样癌是一种罕见的唾液腺肿瘤。鉴于其发病率低，尚无研究能准确描述其生物学行为和预后。
