Small cell carcinoma of the oral cavity (cheek mucosa): a case report with an immunohistochemical and molecular genetic analysis.
Small cell carcinoma of the oral cavity (cheek mucosa): a case report with an immunohistochemical and molecular genetic analysis.
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发表时间：
2013
影响因子：
1.4
通讯作者：
T. Terada
中科院分区：
文献类型：
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作者：
T. Terada
口腔小细胞癌（SCC）是非常罕见的，在英国文献中只有一例报告。本文报告第二例口腔鳞状细胞癌。一位59岁的男性，在右颊黏膜发现一个5公分的口腔肿瘤。进行了活检。HE组织学是典型的SCC，由小上皮细胞组成，核深染，核塑形，核质比低，核仁阴性。免疫组化显示，肿瘤细胞呈全细胞角蛋白（PCK）WSS、PCK MNF-116、细胞角蛋白（CK）34 BE 12、CK 56、CK 14、波形蛋白、KIT（CD 117）、CD 56、突触素、p53蛋白和Ki-67抗原阳性（Ki-67标记= 70%）。肿瘤细胞对PCK AE 1/3、PSK CAM 5.2、CK 7、CK 8、CK 18、CK 19、CK 20、EMA、NSE、嗜铬粒蛋白、血小板衍生生长因子-α（PDGFRA）、CD 45、CD 45 RO、CD 3、CD 20、CD 30、CD 79 a和bcl-2呈阴性。在石蜡切片中使用PCR-直接测序方法进行的回顾性遗传分析未发现KIT（外显子9、11、13和17）和PDGFRA（外显子12和18）基因突变。各种影像学检查，包括CT和MRI以及上下消化道内窥镜检查，均未发现口腔肿瘤以外的肿瘤。因此，口腔肿瘤被认为是原发性的。口腔肿瘤迅速扩大，并出现颈淋巴结、肋骨和髂骨的远处转移。病人现在是治疗顺铂为基础的化疗16个月后，第一次表现。
Small cell carcinoma (SCC) of the oral cavity is extremely rare; only one case has been reported in the English Literature. The author herein reports the second case of SCC of the oral cavity. A 59-year-old man presented with oral tumor (5 cm) in the right cheek mucosa. A biopsy was taken. The HE histology was typical SCC consisting of small epithelial cells with hyperchromatic nuclei, molded nuclei, scant nucleocytoplasmic ratio, and negative nucleoli. Immunohistochemically, the tumor cells are positive for pancytokeratin (PCK) WSS, PCK MNF-116, cytokeratin (CK) 34BE12, CK5/6, CK14, vimentin, KIT (CD117), CD56, synaptophysin, p53 protein, and Ki67 antigen (Ki-67 labeling = 70%). The tumor cells are negative for PCK AE1/3, PSK CAM5.2, CK7, CK8, CK18, CK19, CK20, EMA, NSE, chromogranin, platelet-derived growth factor-α (PDGFRA), CD45, CD45RO, CD3, CD20, CD30, CD79a, and bcl-2. A retrospective genetic analysis using PCR-direct sequencing method in paraffin sections identified no mutations of KIT (exons 9, 11, 13 and 17) and PDGFRA (exons 12 and 18) genes. Various imaging modalities including CT and MRI and upper and lower gastrointestinal endoscopy did not identified no tumors other than the oral tumor. Thus, the oral tumor was thought primary. The oral tumor rapidly enlarged, and distant metastases to cervical lymph nodes, ribs and iliac bones emerged. The patient is now treated by cisplatin-based chemotherapy 16 months after the first manifestation.