Foss R D, Ellis G L, Auclair P L
Department of Oral Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000, USA.
Am J Surg Pathol. 1996 Dec;20(12):1440-7. doi: 10.1097/00000478-199612000-00002.
Current classification schemes for salivary gland neoplasms categorize cystadenocarcinomas on the basis of a recurring histomorphologic pattern of cystic, and often, papillary growth without features of other specific types of salivary gland tumors. To ascertain the clinicomorphologic spectrum and biologic behavior of this tumor, the clinicopathologic features of 57 cystadenocarcinomas from the files of the Armed Forces Institute of Pathology were studied. Excluding five Veterans Administration military cases, men and women were equally affected. Patients ranged in age from 20 to 86 years (mean, 58.8; median, 64), and patients aged over 50 years accounted for 71% of cases. Thirty-seven tumors (65%) occurred in major salivary glands, 35 in the parotid, and two in the sublingual glands. The 20 minor salivary gland tumors (35%) involved, in descending order, the lips, buccal mucosa, palate, tongue, retromolar area, and floor of mouth. Grossly, the lesions were cystic or multicystic masses that ranged in size from 0.4 to 6.0 cm. Microscopically, all tumors demonstrated an invasive, cystic growth pattern, and 75% had a conspicuous papillary component. The predominant cell type varied among tumors and included small cuboidal cells (35 cases), large cuboidal cells (nine cases), and tall columnar cells (seven cases). Six cases exhibited an admixture of cell types. Ruptured cysts with hemorrhage and granulation tissue were common. All 40 patients with follow-up data were either alive or had died of other causes and were free of tumor a mean interval of 59 months after their initial surgery. Three tumors recurred locally (mean interval, 76 months). Three tumors were metastatic to regional lymph nodes at the time of diagnosis, and one patient developed a regional lymph node metastasis after 55 months. Salivary gland cystadenocarcinomas represent a distinct group of malignancies that have an indolent biologic behavior.
当前唾液腺肿瘤的分类方案是根据一种反复出现的组织形态学模式对囊腺癌进行分类的，这种模式为囊性，且通常为乳头状生长，不具有其他特定类型唾液腺肿瘤的特征。为了确定该肿瘤的临床形态学谱和生物学行为，对武装部队病理研究所档案中的57例囊腺癌的临床病理特征进行了研究。排除5例退伍军人管理局的军事病例后，男性和女性受影响的比例相同。患者年龄范围为20至86岁（平均58.8岁；中位数64岁），50岁以上的患者占病例的71%。37例肿瘤（65%）发生于大唾液腺，其中35例位于腮腺，2例位于舌下腺。20例小唾液腺肿瘤（35%）按发生频率由高到低依次累及唇、颊黏膜、腭、舌、磨牙后区和口底。大体上，病变为囊性或多囊性肿块，大小从0.4至6.0厘米不等。显微镜下，所有肿瘤均表现为浸润性囊性生长模式，75%具有明显的乳头状成分。不同肿瘤的主要细胞类型各不相同，包括小立方形细胞（35例）、大立方形细胞（9例）和高柱状细胞（7例）。6例表现为细胞类型的混合。伴有出血和肉芽组织的破裂囊肿很常见。所有40例有随访数据的患者均存活或死于其他原因，初次手术后平均59个月无肿瘤。3例肿瘤局部复发（平均间隔76个月）。3例肿瘤在诊断时发生区域淋巴结转移，1例患者在55个月后出现区域淋巴结转移。唾液腺囊腺癌代表一组具有惰性生物学行为的独特恶性肿瘤。
