Carcinoma in basal cell adenoma of the parotid gland
Carcinoma in basal cell adenoma of the parotid gland
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DOI：
10.1016/s0344-0338(97)80074-x
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发表时间：
1997-01-01
影响因子：
2.8
通讯作者：
Nagao, K
中科院分区：
文献类型：
--
作者：
Nagao, T;Sugano, I;Nagao, K
腮腺基底细胞腺瘤（BCA）恶变的报道很少，一旦发生，主要表现为恶性基底样肿瘤，即基底细胞腺癌或腺样囊性癌。我们在此描述了 BCA 中发生的三例非基底细胞样癌。在我们的系列中，这种恶性肿瘤的发病率占所有腮腺肿瘤的 0.2%，占 BCA 的 4.3%。 1 例为唾液管癌，显示出恶性和良性成分之间转变的组织学证据。其余2例为包膜良好的腮腺肿瘤，由BCA和散在的恶变灶组成。恶性成分是腺癌，未另有说明（NOS），有时与肿瘤性肌上皮细胞（包括 BCA 细胞）混合。这两例BCA均被认为是囊内癌。 BCA 成分呈实心、管状和小梁状排列。这三例患者的预后差异很大；第一个病例在 27 个月后因病死亡，而后两个病例在手术后 4 年和 10 年仍健康存活。 Ki-67 标记指数表明癌中的细胞增殖活性比 BCA 至少高五倍。非基底样癌，如唾液管癌或腺癌 (NOS)，确实会在 BCA 中发生，就像多形性腺瘤恶变一样，尽管发生率可能极其罕见。
Malignant transformation of basal cell adenoma (BCA) of the parotid gland is rarely reported, and when occurred, may principally become manifest as a malignant basaloid tumor, i.e. basal cell adenocarcinoma or adenoid cystic carcinoma. We describe herein three cases of non-basaloid carcinoma arising in BCA. The incidence of this malignant tumor was 0.2% of all parotid gland tumors and 4.3% of BCAs in our series. One case was salivary duct carcinoma showing histologic evidence of transition between malignant and benign elements. The remaining two cases were well-encapsulated parotid gland tumors, which were composed of BCA and scattered foci of malignant transformation. Malignant components were adenocarcinoma, not otherwise specified (NOS), and sometimes intermixed with neoplastic myoepithelial cells included BCA cells. These two cases were regarded to be intracapsular carcinoma in BCA. BCA components showed solid, tubular and trabecular arrangements. The patients' prognosis was quite variable among these three cases; the first case died of disease after 27 months, whereas the latter two cases are alive and well for 4 and 10 years after surgery. Ki-67 labeling index indicated that cell proliferative activity was at least five times higher in carcinomas than BCAs. Non-basaloid carcinomas such as salivary duct carcinoma or adenocarcinoma, NOS, do develop in BCAs as in the case of a pleomorphic adenoma with malignant transformation, though the incidence may be extremely rare.