Adenoma versus carcinoid tumor of the middle ear: a study of 48 cases and review of the literature
Adenoma versus carcinoid tumor of the middle ear: a study of 48 cases and review of the literature
复制标题
DOI：
10.1038/modpathol.3880561
复制
发表时间：
2002-05-01
期刊：
影响因子：
7.5
通讯作者：
Thompson, LDR
中科院分区：
文献类型：
--
作者：
Torske, KR;Thompson, LDR
中耳类癌和中耳腺瘤是一种罕见的相互关系不明的肿瘤。事实上，文献中缺乏评估这些肿瘤的临床、组织学和免疫表型特征及其潜在关系的大型综合性系列文献。在1970年至1995年间，军队病理研究所的档案中发现了48例中耳腺瘤。除了对各种免疫组织化学试剂的反应性外，还对所有病例进行了细胞形态和构筑模式的评估。并获得临床随访。对文献进行了全面的回顾，着眼于中耳类癌和腺瘤之间的任何明显的区别或相似之处。其中女性21例，男性27例，年龄20~80岁，平均45.0岁。患者经历听力损失、肿块和/或疼痛的平均持续时间为1.7年。肿瘤的平均大小为0.8厘米，其中6个肿瘤延伸至中耳以外。组织学上，肿瘤呈中等细胞性，无包膜，排列成腺样、小梁状和固体状，由小细胞组成，核染色质呈“盐和胡椒”状分布。肿瘤细胞与角蛋白、角蛋白7、嗜铬粒蛋白和人胰腺多肽呈免疫反应。所有患者均接受手术治疗。无患者因病死亡(平均随访15.7年)。8例患者经手术治疗后复发，在最后一次随访(平均15.1年)时没有发现疾病迹象。我们的研究和文献回顾显示，中耳腺瘤和类癌基本上是无法区分的良性肿瘤。中耳腺瘤最准确地描述了它们的形态特征和临床行为，尽管中耳神经内分泌腺瘤可能是一个更准确的名称。
Carcinoid tumors and adenomas of the middle ear are rare neoplasms of indeterminate relationship to one another. Indeed, the literature is devoid of a large comprehensive series that evaluates the clinical, histologic, and immunophenotypic features of these tumors and their potential relationship. Forty-eight cases of middle ear adenoma between 1970 and 1995 were identified hi the files of the Armed Forces Institute of Pathology. All cases were evaluated for cytomorphology and architectural pattern, hi addition to their reactivity with various Immunohistochemical reagents. Clinical follow-up was also obtained. A comprehensive review of the literature was performed with an eye toward correlating any distinct differences or similarities between carcinoid tumors and adenomas of the middle ear. The patients included 21 women and 27 men, aged 20 to 80 years (mean, 45.0 y). Patients experienced hearing loss, mass, and/or pain for a mean duration of 1.7 years. The mean tumor size was 0.8 cm, with six tumors extending beyond the middle ear. Histologically, the tumors were moderately cellular and unencapsulated, arranged in glandular, trabecular, and solid patterns composed of small cells with "salt and pepper" nuclear chromatin distribution. The tumor cells were immunoreactive with keratin, keratin 7, chromogranin, and human pancreatic polypeptide. All patients had surgery. No patients died with their disease (mean follow-up, 15.7 y). Eight patients developed recurrences that were treated surgically and were without evidence of disease at last follow-up (mean, 15.1 y). Our study and the review of the literature showed adenomas and carcinoid tumors of the middle ear to be essentially indistinguishable benign tumors. Middle ear adenoma most correctly describes their morphologic features and clinical behavior, although neuroendocrine adenoma of the middle ear may be a more accurate designation.