Tortoledo M E, Luna M A, Batsakis J G
Arch Otolaryngol. 1984 Mar;110(3):172-6. doi: 10.1001/archotol.1984.00800290036008.
Clinical and pathologic differences exist between the several neoplasms encompassed by the term malignant mixed tumors of salivary glands. The majority of the neoplasms are carcinomas ex pleomorphic adenoma. True malignant mixed tumors (carcinosarcomas) are rare, and even more rare are the benign metastasizing mixed tumors. This study of 40 malignant mixed tumors indicates that two previously unreported variables, measured invasion in millimeters and histologic subclassifications of the malignant neoplasm, are valuable guides to prognosis and biologic behavior. All patients whose malignant neoplasm extended for more than 8 mm beyond residual capsule or benign residual tumor died of their disease. The extent of invasion also correlated with perineurial invasion, involvement of bone, and metastases to lymph nodes. Histologic subclassification points out that there is no prototypical carcinoma ex pleomorphic adenoma and that high- and low-grade carcinomas can be found. Only one of the patients with low-grade (terminal duct) carcinomas died of his disease during follow-up periods extending to over 20 years.
涎腺恶性混合瘤这一术语所涵盖的几种肿瘤存在临床和病理差异。大多数肿瘤是多形性腺瘤恶变。真正的恶性混合瘤（癌肉瘤）很罕见，而良性转移性混合瘤则更为罕见。这项对40例恶性混合瘤的研究表明，两个先前未报告的变量，即测量侵袭的毫米数和恶性肿瘤的组织学亚分类，是判断预后和生物学行为的有价值指标。所有恶性肿瘤超出残余包膜或良性残余肿瘤8毫米以上的患者均死于该疾病。侵袭范围还与神经周围侵犯、骨质受累以及淋巴结转移相关。组织学亚分类指出，不存在典型的多形性腺瘤恶变，并且可以发现高分化和低分化癌。在随访期超过20年的过程中，只有1例低分化（终末导管）癌患者死于该疾病。
