Salivary gland cystadenocarcinomas - A clinicopathologic study of 57 cases
Salivary gland cystadenocarcinomas - A clinicopathologic study of 57 cases
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DOI：
10.1097/00000478-199612000-00002
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发表时间：
1996-12-01
影响因子：
5.6
通讯作者：
Auclair, PL
中科院分区：
文献类型：
--
作者：
Foss, RD;Ellis, GL;Auclair, PL
目前的涎腺肿瘤分类方案根据复发的囊性组织形态学模式对囊腺癌进行分类，并且通常是乳头状生长，而没有其他特定类型的涎腺肿瘤的特征。为了明确该肿瘤的临床形态学谱和生物学行为，我们研究了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。除了五个退伍军人管理局的军事案件，男性和女性受到同样的影响。患者年龄范围为20 - 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（65%）发生在大唾液腺，35例发生在腮腺，2例发生在舌下腺。小涎腺肿瘤20例（35%），依次为唇、颊粘膜、腭、舌、磨牙后区和口底。大体上，病变为囊性或多囊性肿块，大小为0.4 ~ 6.0 cm。显微镜下，所有肿瘤均呈浸润性囊性生长，75%有明显的乳头状成分。肿瘤的主要细胞类型不同，包括小立方细胞（35例），大立方细胞（9例）和高柱状细胞（7例）。6例病例表现出细胞类型的混合。囊肿破裂出血和肉芽组织是常见的。所有40例有随访数据的患者要么活着，要么死于其他原因，并且在初次手术后平均59个月内没有肿瘤。三个肿瘤局部复发（平均间隔，76个月）。3例肿瘤在诊断时转移至区域淋巴结，1例患者在55个月后发生区域淋巴结转移。涎腺囊腺癌是一组独特的恶性肿瘤，具有惰性的生物学行为。
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.