Epithelial-myoepithelial carcinoma of a minor salivary gland in the buccal mucosa: a case report
Epithelial-myoepithelial carcinoma of a minor salivary gland in the buccal mucosa: a case report
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颊粘膜小唾液腺上皮肌上皮癌：一例报告
DOI：
10.1007/s11282-015-0221-9
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发表时间：
2016
期刊：
影响因子：
2.2
通讯作者：
Nakayama E
中科院分区：
文献类型：
--
作者：
Tsuji T;Kitada H;Abe S;Ikeda H;Nakayama E
上皮肌上皮癌 (EMC) 是一种罕见的肿瘤，占所有唾液腺肿瘤的比例不到 1%。这种肿瘤最常累及腮腺，较少累及下颌下腺或小唾液腺。本病例报告描述了由颊粘膜小唾液腺引起的 EMC。一名71岁的日本男性因左颊部出现无痛粘膜下肿块被转诊至我院。患者表示，肿瘤已经存在四年多了，无痛感，但体积不断增大。口腔检查显示有一个可移动、边界清晰的肿块，大小约为 19 × 15 毫米；其表面大部分被正常粘膜覆盖。磁共振成像显示肿块边界清晰，内部相对均匀。切开活检的组织学诊断结果为疑似多形性腺瘤或源自唾液腺的低度恶性肿瘤。患者在全身麻醉下接受手术切除以获得明确诊断，并根据整个标本的组织病理学和免疫组织化学检查诊断为EMC。由于部分区域手术切缘呈阳性，患者接受了术后外部放疗（总计 60 Gy，2 Gy/天）。术后恢复顺利，功能恢复良好。肿瘤切除和放疗四年后，没有检测到复发，也没有出现其他病变。
Epithelial–myoepithelial carcinoma (EMC) is a rare tumor constituting less than 1 % of all salivary gland tumors. This neoplasm most often involves the parotid glands, with less frequent involvement of the submandibular or minor salivary glands. This case report describes EMC arising from a minor salivary gland in the buccal mucosa. A 71-year-old Japanese man with a painless submucosal mass in the left buccal region was referred to our hospital. The patient stated that the tumor had been present for more than 4 years and was painless but increasing in size. Oral examination showed a mobile, well-defined mass of approximately 19 × 15 mm; its surface was covered mostly by normal mucosa. Magnetic resonance imaging showed a mass with well-defined borders and relative homogeneity internally. Incisional biopsy led to a histological diagnosis of a suspected pleomorphic adenoma or low-grade malignant tumor originating from the salivary gland. The patient underwent surgical excision under general anesthesia to obtain a definitive diagnosis, and EMC was diagnosed based on histopathological and immunohistochemical examination of the whole specimen. Because the surgical margins were positive in some areas, the patient underwent external postoperative radiotherapy (total of 60 Gy at 2 Gy/day). Recovery was uneventful, and good function returned after postoperative treatment. Four years after tumor resection and radiotherapy, no recurrence had been detected and no other lesions had developed.