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骨内黏液表皮样癌——一种罕见但复发性实体的病例系列

Intraosseous Mucoepidermoid Carcinoma-Case Series of a Rare but Recurring Entity.

作者信息

Choudhari Rajat, Patel Pinakin, Singh Suresh, Lakhera Kamal Kishor, Patel Yashasvi

机构信息

Department of Surgical Oncology, Sawai Man Singh Medical College and Attached Hospitals, Jaipur, Rajasthan 302004 India.

出版信息

Indian J Surg Oncol. 2025 Feb;16(1):320-325. doi: 10.1007/s13193-024-02092-9. Epub 2024 Sep 16.

Abstract

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.

摘要

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%。

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Treatment Outcomes and Patterns of Disease Recurrence of Patients with Carcinoma of the Buccal Mucosa.颊黏膜癌患者的治疗结果与疾病复发模式
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本文引用的文献

1
Advances in the Treatment of Mucoepidermoid Carcinoma.黏液表皮样癌的治疗进展
World J Oncol. 2022 Feb;13(1):1-7. doi: 10.14740/wjon1412. Epub 2021 Dec 8.
3
"Ossifying" mucoepidermoid carcinoma: A deceptive clinical presentation.骨化型黏液表皮样癌:一种具有欺骗性的临床表现。
Oral Surg Oral Med Oral Pathol Oral Radiol. 2021 Feb;131(2):217-220. doi: 10.1016/j.oooo.2020.10.011. Epub 2020 Oct 16.
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Mucoepidermoid carcinoma.黏液表皮样癌
BMJ Case Rep. 2014 Aug 1;2014:bcr-2013-202776. doi: 10.1136/bcr-2013-202776.
8
Salivary gland tumours.唾液腺肿瘤
Oral Dis. 2002 Sep;8(5):229-40. doi: 10.1034/j.1601-0825.2002.02870.x.

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