Papa F, Sagliocco R, Cosimo O, Russo A, Claudio P P, Errico M, Lavorgna G
Cattedra di Chirurgia Maxillo-Facciale, Scuola di Specializzazione in Chirurgia Maxillo-Facciale, Università degli Studi di Napoli Federico II, Napoli.
Minerva Stomatol. 1997 Nov;46(11):615-20.
The authors report a case of carcinoma in an ex pleomorphic adenoma of the parotid gland that was recently referred to their attention. This form of carcinoma is not very frequent and in the literature it is reported in a percentage of cases ranging from 1.5 to 12%. The pathogenesis of this neoplasia is controversial and at the present state of the art there are authors who support the hypothesis of a malignant transformation of a previous pleomorphic adenoma, and those who sustain the onset of the tumour ex novo. At present, there is a tendency to differentiate the carcinoma ex pleomorphic adenoma from the malignant mixed tumour: the histological analysis of the former in fact shows a benign stromal component typical of pleomorphic adenoma associated with a malignant epithelial component, whereas in the malignant mixed tumour both the mesenchymal and epithelial components are malignant. The authors use this case report as a starting point to review their 20-year experience, of pleomorphic adenoma in order to evaluate the behaviour of this tumour, above all in relation to the phenomenon of recidivation and cancerization. They report recidivation in 3.5% of cases and no malignant degeneration. The surgical approach used varied depending on the site and size of the neoformation, as well as on whether the tumour was primary or recurrent.
作者报告了一例腮腺多形性腺瘤恶变的病例，该病例最近引起了他们的注意。这种癌的形式并不常见，文献报道其在病例中的比例为1.5%至12%。这种肿瘤的发病机制存在争议，在目前的技术水平下，有些作者支持先前多形性腺瘤发生恶性转化的假说，而另一些作者则支持肿瘤从头发生的观点。目前，有一种将多形性腺瘤恶变与恶性混合瘤区分开来的趋势：事实上，前者的组织学分析显示出典型的多形性腺瘤良性间质成分与恶性上皮成分相关，而在恶性混合瘤中，间充质和上皮成分均为恶性。作者以该病例报告为起点，回顾了他们20年来多形性腺瘤的治疗经验，以评估这种肿瘤的行为，尤其是与复发和癌变现象相关的行为。他们报告复发率为3.5%，未发生恶性变。所采用的手术方法因新生物的部位和大小以及肿瘤是原发性还是复发性而异。
