Franzen A, Koegel K, Knieriem H J, Pfaltz M
Klinik für HNO-Krankheiten und Plastische Wiederherstellungschirurgie, Katholisches Krankenhaus Essen-Werden.
HNO. 1998 Sep;46(9):821-5. doi: 10.1007/s001060050319.
Basal cell adenocarcinoma is a rare entity that was first defined as a malignant salivary gland tumor in 1991. We present another case report and discuss pathology, pathogenesis, differential diagnosis, therapy and prognosis on the basis of currently available literature. Although histomorphologic features of the tumors are similar to basal cell adenomas, proof of an infiltrative and destructive growth is essential for diagnosis. Adenoid cystic carcinoma and basaloid squamous carcinoma must also be considered in any differential diagnosis. Tumor development within a pre-existing basal cell adenoma and de novo development are discussed. Most of the tumors appear to be benign clinically. Facial pain is rare and facial nerve palsy was noted in only one case. Metastases have occurred in less than 10% of patients, with only one involving the lung. Due to their biologic behavior and prognosis, basal cell adenocarcinomas should be classified as low-grade carcinomas. The therapy of choice is parotidectomy with preservation of the facial nerve. Neck dissection has to be added in cases with cervical metastases. Radiation is advisable in patients with recurrent disease. Since there is a nearly 30% local recurrence rate, intensive follow-up is necessary.
基底细胞腺癌是一种罕见的肿瘤，1991年首次被定义为恶性唾液腺肿瘤。我们报告另一例病例，并根据现有文献讨论其病理、发病机制、鉴别诊断、治疗及预后。尽管肿瘤的组织形态学特征与基底细胞腺瘤相似，但诊断必须有浸润性和破坏性生长的证据。在任何鉴别诊断中还必须考虑腺样囊性癌和基底样鳞状癌。文中讨论了肿瘤在既往存在的基底细胞腺瘤内发生以及新发的情况。大多数肿瘤临床看来是良性的。面部疼痛罕见，仅1例出现面神经麻痹。不到10%的患者发生转移，仅1例转移至肺。鉴于其生物学行为和预后，基底细胞腺癌应归类为低级别癌。首选治疗方法是保留面神经的腮腺切除术。有颈部转移的病例必须加做颈部清扫术。复发病例建议行放疗。由于局部复发率近30%，因此需要密切随访。
