Hage Neemu, Balaji R, Singh Namit Kant, Sivakoti Sumitra, Shrinivas Somalwar B
Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India.
Department of Otorhinolaryngology and Head and Neck Surgery, All India Institute of Medical Sciences, Bibinagar, Hyderabad, Telangana, India.
Int J Surg Case Rep. 2024 Oct;123:110218. doi: 10.1016/j.ijscr.2024.110218. Epub 2024 Aug 28.
Basal cell adenoma is a rare, benign epithelial tumour of the salivary gland, comprising only 1-2 % of all salivary gland tumours. Predominantly found in the parotid gland, basal cell adenoma can also occur in minor salivary glands and are often confused with other benign and malignant salivary gland tumours. A thorough histopathological examination can provide a definitive diagnosis.
A 65-year-old woman presented with a painless mass in the right infra-auricular region. Imaging revealed a well-defined hypodense lesion in the deep lobe of the right parotid gland, initially suspected as mucoepidermoid carcinoma. Fine needle aspiration was inconclusive, leading to the decision to perform a total conservative parotidectomy. Histopathology confirmed basal cell adenoma, characterized by cystic areas filled with mucoid material and basaloid cells arranged in trabecular and tubular patterns.
Basal cell adenoma was classified as a distinct entity by the WHO in 1991. Cytologically, they imitate both benign and malignant salivary as well as non-salivary gland tumours. The histological hallmark of basal cell adenoma involves basaloid cells with small round nuclei showing no atypia, scant pale cytoplasm, and distinct peripheral palisading. Treatment involves surgical removal, with a more radical approach for certain variants such as the membranous type.
This case highlights the clinical, radiological, and histopathological features of basal cell adenoma, emphasizing the importance of accurate diagnosis and appropriate surgical management. Early detection and appropriate treatment are crucial for optimizing patient outcomes in basal cell adenoma management.
基底细胞腺瘤是一种罕见的唾液腺良性上皮性肿瘤，仅占所有唾液腺肿瘤的1%-2%。基底细胞腺瘤主要见于腮腺，也可发生于小唾液腺，常与其他唾液腺良恶性肿瘤相混淆。全面的组织病理学检查可提供明确诊断。
一名65岁女性患者，右侧耳下区域出现无痛性肿块。影像学检查显示右侧腮腺深叶有边界清晰的低密度病变，最初怀疑为黏液表皮样癌。细针穿刺活检结果不明确，因此决定行腮腺全切除术并采取保守治疗。组织病理学检查确诊为基底细胞腺瘤，其特征为含有黏液样物质的囊性区域以及呈小梁状和管状排列的基底样细胞。
1991年世界卫生组织将基底细胞腺瘤归类为一种独特的实体。在细胞学上，它们既类似良性和恶性唾液腺肿瘤，也类似非唾液腺肿瘤。基底细胞腺瘤的组织学特征包括具有小圆核、无异型性、淡染细胞质稀少以及明显周边栅栏状排列的基底样细胞。治疗方法为手术切除，对于某些变异型（如膜性型）则采取更激进的方法。
本病例突出了基底细胞腺瘤的临床、影像学和组织病理学特征，强调了准确诊断和适当手术管理的重要性。早期发现和适当治疗对于优化基底细胞腺瘤患者的治疗效果至关重要。
