Department of Oral Diagnosis, Piracicaba Dental School, Universidade Estadual de Campinas (UNICAMP), Piracicaba, SP, Brazil; Department of Pathology, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Department of Ophthalmology and Otorhinolaryngology, Head and Neck Surgery, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas, SP, Brazil.
Oral Oncol. 2024 Nov;158:107005. doi: 10.1016/j.oraloncology.2024.107005. Epub 2024 Aug 22.
A 56-year-old female was referred to our service for management of a malignant salivary gland neoplasm with compromised margins that had been biopsied previously at another service. The patient reported a twenty-year history of a lesion in the oral cavity with progressive and exuberant growth over the past two years, associated with local pain and dyspnea. Physical examination revealed an erythematous, ulcerated, and hemorrhagic lesion measuring approximately 3 cm on the left soft palate and tonsillar pillar. Computed tomography revealed an expansile lesion in the topography of the left soft palate, growing predominantly toward the lumen of the nasopharynx and partially invading the left wall of this region. The patient underwent surgery and histopathologic examination revealed an infiltrative and aggressive epithelial neoplasia with large vacuolated and eosinophilic cytoplasm, vesicular nuclei, and prominent nucleoli. The neoplastic cells were arranged in a solid, microcystic, tubular, and follicular pattern with eosinophilic luminal secretion. Mitotic figures were frequent and all margins were affected by the neoplasia. Morphologic and immunohistochemical features supported the diagnosis of secretory carcinoma, and the patient is currently being followed for further therapeutic intervention.
一位 56 岁女性因先前在其他医疗机构活检的边缘受损的恶性涎腺肿瘤而被转至我院。该患者报告称,二十年来口腔内有一处病变,过去两年内病变不断进展并迅速生长,伴有局部疼痛和呼吸困难。体格检查发现左软腭和扁桃体柱上有一个红斑、溃疡和出血的病变,大小约为 3 厘米。计算机断层扫描显示左软腭有一个扩张性病变,主要向鼻咽腔腔生长,并部分侵犯该区域的左壁。患者接受了手术,组织病理学检查显示一种具有大空泡和嗜酸性细胞质、泡状核和明显核仁的侵袭性上皮肿瘤。肿瘤细胞排列成实性、微囊状、管状和滤泡状,伴有嗜酸性腔内分泌物。有丝分裂象频繁,所有边缘均受肿瘤累及。形态学和免疫组织化学特征支持分泌性癌的诊断,目前正在对患者进行随访以进行进一步的治疗干预。