Choudhari Rajat, Patel Pinakin, Singh Suresh, Lakhera Kamal Kishor, Patel Yashasvi
Department of Surgical Oncology, Sawai Man Singh Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India.
Indian J Surg Oncol. 2025 Feb;16(1):320-325. doi: 10.1007/s13193-024-02092-9. Epub 2024 Sep 16.
Salivary gland tumors constitute 3-6% of all head and neck neoplasms. Mucoepidermoid carcinoma (MEC) is the most common malignant neoplasm, and 2-4% of these tumors can occur in the mandible. This is the largest single report of five cases, all treated within a span of 1 year. After obtaining approval from the institutional ethics committee, a retrospective review was done of the cases where an intraosseous MEC was treated with surgical resection. Five patients were diagnosed as intraosseous MEC and treated within a span of 1 year. All patients underwent a wide local excision with hemimandibulectomy and modified radical neck dissection with a flap reconstruction. Four patients underwent a pectoralis major myocutaneous flap, of which 2 were bipaddle and 1 received a fibular free flap. Four patients received adjuvant radiotherapy and 1 was observed. All of them had good surgical outcome and 3 of them had a DFS of 12 months until follow-up whereas 1 developed a local recurrence. Intraosseous MEC presents with a painless growth in the jaw and may spread beyond the mandible to involve the oral cavity. Primary treatment consists of surgical resection with mandibulectomy and adjuvant radiotherapy for high-risk cases. They have an excellent prognosis with survival up to 98% for low-grade tumors.
唾液腺肿瘤占所有头颈部肿瘤的3% - 6%。黏液表皮样癌（MEC）是最常见的恶性肿瘤，其中2% - 4%的肿瘤可发生在下颌骨。这是对5例病例的最大规模单篇报告，所有病例均在1年内接受治疗。在获得机构伦理委员会批准后，对采用手术切除治疗骨内MEC的病例进行了回顾性研究。5例患者被诊断为骨内MEC，并在1年内接受治疗。所有患者均接受了广泛的局部切除，包括半侧下颌骨切除术和改良根治性颈清扫术，并进行了皮瓣重建。4例患者采用了胸大肌肌皮瓣，其中2例为双叶皮瓣，1例接受了游离腓骨皮瓣。4例患者接受了辅助放疗，1例进行观察。所有患者手术效果良好，其中3例随访至12个月无病生存，1例出现局部复发。骨内MEC表现为颌骨无痛性生长，可能扩散至下颌骨以外累及口腔。主要治疗方法包括下颌骨切除的手术切除以及高危病例的辅助放疗。低级别肿瘤预后良好，生存率高达98%。
