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颊黏膜假血管性鳞状细胞癌——1例罕见病例报告及文献复习

Pseudovascular squamous cell carcinoma of the buccal mucosa-a rare case report and review of literature.

作者信息

Dhekial Rituparna, Bezbaruah Rukmini, Choudhury Arpan, Das Anupam, Gupta Sakshi

机构信息

Department of Oncopathology, Dr. B. Borooah Cancer Institute, Guwahati 781016, Assam, India.

Department of Surgical Oncology, Dr. B. Borooah Cancer Institute, Guwahati 781016, Assam, India.

出版信息

Ecancermedicalscience. 2024 Nov 18;18:1802. doi: 10.3332/ecancer.2024.1802. eCollection 2024.

Abstract

Squamous cell carcinoma is the most common malignancy of the head and neck. Pseudovascular squamous cell carcinoma (PSCC) is a rare variant that occurs commonly in the skin of the head and neck. However, oral cavity involvement is extremely rare, with only a few cases reported to date. This variant is associated with an adverse prognosis. Morphologically, the tumour shows marked acantholysis and anastomosing channels mimicking vascular neoplasms. This rare variant poses a diagnostic challenge for pathologists and the accurate diagnosis can be made with the help of immunohistochemical (IHC) studies. A 72-year-old male patient was referred to our hospital with a fast-growing left-sided oral ulcer for more than 1 month. Wide local excision with segmental mandibulectomy was performed and the specimen was sent to our department. On gross examination, a large, soft, lobulated mass was identified in the lower alveolus and the buccal mucosa. On microscopic examination, the tumour was composed of malignant epithelial cells arranged in nests, trabeculae and irregular anastomosing channels. Marked acantholysis and pseudo vascular spaces lined by atypical cells were seen. IHC examination revealed tumour cells positive for CK, P40, P63 and Vimentin and negative for CD31, CD34, S100 and HMB45. The pathological diagnosis was confirmed as PSCC. A short history of the case and a review of literature is discussed here.

摘要

鳞状细胞癌是头颈部最常见的恶性肿瘤。假血管性鳞状细胞癌(PSCC)是一种罕见的变体,常见于头颈部皮肤。然而,口腔受累极为罕见,迄今为止仅有少数病例报道。这种变体与不良预后相关。在形态学上,肿瘤表现出明显的棘层松解和相互吻合的通道,类似血管肿瘤。这种罕见的变体给病理学家带来了诊断挑战,借助免疫组织化学(IHC)研究可做出准确诊断。一名72岁男性患者因左侧口腔溃疡快速生长1个多月转诊至我院。进行了广泛局部切除并节段性下颌骨切除术,标本送至我科。大体检查时,在下牙槽和颊黏膜发现一个大的、柔软的、分叶状肿块。显微镜检查显示,肿瘤由排列成巢状、小梁状和不规则相互吻合通道的恶性上皮细胞组成。可见明显的棘层松解和由非典型细胞衬里的假血管间隙。免疫组织化学检查显示肿瘤细胞CK、P40、P63和波形蛋白阳性,CD31、CD34、S100和HMB45阴性。病理诊断确诊为PSCC。本文讨论了该病例的简要病史并对文献进行了回顾。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6bc4/11735131/95b883cdf072/can-18-1802fig1.jpg

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