minor salivary gland tumor

涎腺小肿瘤
  • 文章类型: Case Reports
    背景:涎腺肿瘤相对罕见。大多数小唾液腺肿瘤是恶性的,良性肿瘤占肿瘤的18%。多形性腺瘤(PA)是最常见的涎腺肿瘤。嘴唇PA并不常见,其中9.8%发生在上唇。我们正在增加罕见的上唇PA(良性混合肿瘤)的知识。
    方法:我们报告了一名28岁男性的上唇PA(良性混合瘤)。他的抱怨是上唇无痛肿胀。一个无痛的,非招标,界限分明,轻微移动,无柄,结节状,并且在他的上唇左侧注意到5.0cmx2.0cm的橡胶状(一致性)肿瘤。上面的皮肤没有固定,颜色正常。没有溃疡,触诊未引起疼痛或出血。没有外伤史。钝性解剖用于完全切除结节,发白,和包膜肿瘤。显微镜检查显示界限清楚且部分包裹的双相病变,具有粘液软骨样基质的大小叶和基底细胞的中间细胞结节,形成良好的小管,含有曙红分泌,和肌上皮细胞的巢穴.诊断为PA(良性混合瘤)。
    结论:钝性解剖表明可以保留上唇的外观和功能。
    BACKGROUND: Salivary gland tumors are relatively rare. Most minor salivary gland tumors are malignant with benign tumors accounting for 18% of the tumors. Pleomorphic adenoma (PA) is the most common salivary gland tumor. Lip PA is uncommon with 9.8% occurring in the upper lip. We are adding on the knowledge of the rare upper lip PA (benign mixed tumor).
    METHODS: We report an upper lip PA (benign mixed tumor) in a 28-year-old man. His complaint was a painless swelling on the upper lip. A painless, non-tender, well-circumscribed, slightly mobile, sessile, nodular, and rubbery (in consistency) tumor measuring 5.0 cm x 2.0 cm was noted on the left side of his upper lip. The overlying skin was not fixed and of normal color. There was no ulceration, and palpation did not elicit pain or bleeding. There was no history of trauma. Blunt dissection was used to completely excise the nodular, whitish, and encapsulated tumor. Microscopy showed a well-circumscribed and partly encapsulated biphasic lesion, with large lobules of myxo-chondroid stroma and intervening cellular nodules of basaloid cells, well-formed tubules containing eosinic secretion, and nests of myoepithelial cells. A diagnosis of PA (benign mixed tumor) was confirmed.
    CONCLUSIONS: Blunt dissection is indicated to preserve the cosmesis and function of the upper lip.
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  • 文章类型: Case Reports
    肌上皮瘤是一种罕见的由唾液腺引起的口面区域良性肿瘤。这些肿瘤由缺乏导管分化的特定肌上皮细胞组成,最初被认为是一种多形性腺瘤。虽然它们通常来自腮腺,有少数病例从上颚和口腔的小唾液腺出现。肌上皮瘤类似于许多其他由腭引起的肿瘤,包括多形性腺瘤。本报告描述了一名23岁患者的上颚小唾液腺肌上皮瘤病例,并成功治疗了病变。
    Myoepithelioma is an uncommon benign tumor of the orofacial region arising from the salivary glands. These tumors are composed of specifically myoepithelial cells lacking ductal differentiation and were initially considered as a type of pleomorphic adenoma. Though they commonly arise from the parotid gland, there are a few cases that emerge from the minor salivary glands of the palate and oral cavity. Myoepitheliomas resemble many other tumors arising from the palate including pleomorphic adenoma. This report depicts a case of myoepithelioma of the minor salivary gland of the palate in a 23-year-old patient and the successful management of the lesion.
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  • 文章类型: Case Reports
    背景:尽管多形性腺瘤(PA)是小唾液腺和大唾液腺中最常见的肿瘤,它在上唇颊表面的存在是罕见的。
    方法:一名70岁男性主诉是最近上唇颊部肿块迅速增长。可见明确的肿块,大小为3×2cm,粘膜完整,无局部淋巴结肿大。核心针活检报告提示PA。进行肿瘤的完全切除。缺损较大,无法进行初次闭合。计划使用FAMM皮瓣进行重建。4周后,皮瓣被上皮覆盖,产生了令人满意的效果。
    结论:PA的明确诊断取决于组织病理学检查。以下特征有助于将PA与其他肿瘤区分开来;肾小管肺泡和腺样结构,软骨细胞中的立方体或多边形细胞的岛,透明质化,纤维脂肪或粘液性低细胞基质,对高碘酸Schiff和Alcian染色呈阳性。尽管有这些特点,PA与真皮混合瘤的区别可能具有挑战性,尤其是当标本来自上唇时。FAMM的主要优点。F是薄而柔韧的皮瓣,具有较宽的旋转弧度;适用于粘膜缺损的重建;耐术后放疗,易于收获。
    结论:FAMM皮瓣是一种可靠的重建技术,适用于中等大小的口内缺损,对供体部位的发病率有限。它提供了口腔的功能重建,术后并发症的风险较低。
    BACKGROUND: Although pleomorphic adenoma (PA) is the most common neoplasm of both minor and major salivary glands, its presence in the buccal surface of upper lip is rare.
    METHODS: A 70-year-old male presented with a chief complaint of recent rapid growth of a mass in the buccal aspect of the upper lip. A well-circumscribed mass measuring 3 × 2 cm with intact overlying mucosa without regional lymphadenopathy was evident. Core needle biopsy report was suggestive of PA. Complete excision of the tumor was performed. The defect was large and primary closure was not possible. Reconstruction with FAMM flap was planned. After 4 weeks, the flap was covered with epithelia and created a satisfactory result.
    CONCLUSIONS: The definite diagnosis of PA is based on histopathological examination. The following features help to differentiate PA from other tumors; tubuloalveolar and gland-like structures, islands of cuboidal or polygonal cells in a chondroid, hyalinized, fibroadipose or mucinous hypocellular stroma which are stained positively for periodic acid-Schiff and Alcian. Despite these characteristics, differentiation of PA from dermal mixed tumor may be challenging especially when the specimen is from the upper lip. The main advantages of FAMM.F are being thin and pliable flap, having wide arc of rotation; being suitable for reconstruction of mucosal defects; resistance against postoperative radiotherapy and easy harvesting.
    CONCLUSIONS: The FAMM flap is a reliable reconstruction technique for medium-sized intraoral defects with limited morbidity to the donor site. It provides functional reconstruction of the oral cavity with a low risk of post-operative complications.
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  • 文章类型: Case Reports
    分泌性癌(SC)是一种罕见的口腔唾液腺肿瘤,显微镜下可以模拟腺泡细胞癌(ACC)和粘液表皮样癌(MEC)。唾液腺分泌性癌(SC)最近已在头颈部世界卫生组织的第四版中添加。这些肿瘤大多数位于腮腺,很少报道在颊粘膜的小唾液腺中。据报告,这项工作符合SCARE标准。
    方法:42岁男性高血压,按职业划分的店主,没有成瘾史,没有拔牙或外伤,以左侧颊粘膜结节性病变为主诉5年。在临床检查中,足够的张口,有2.4×2厘米界限好的牙本质患者,结节状,非招标,左颊粘膜靠近上肺泡可见良性病变。覆盖的粘膜看起来正常,没有临床上可触及的颈淋巴结病。组织病理学显示唾液腺肿瘤有利于分泌性癌。MRI扫描显示左侧颊粘膜产生的分叶强化结节状病变,大小为2.3*1.3*1.7cm,靠近左上肺泡,不涉及任何骨髓浸润的皮质区域,双侧对称水平IIa反应性颈淋巴结。进行了广泛的局部切除和同侧选择性颈清扫[1、2、3级]。术后期间很顺利,没有观察到感觉异常的抱怨。最终组织病理学报告显示分泌性癌。来自I级的六个淋巴结中有两个对转移性癌呈阳性,没有额外的淋巴结延伸。肿瘤的最后阶段是pT1N2bMx。患者接受术后辅助放疗6周,共收到30份和6000厘格雷的总剂量。
    SC在临床上表现为无痛,无痛且症状持续时间长,粘膜正常。但组织病理学上有颈淋巴结转移。这改变了最终分期,并为该患者增加了辅助治疗。临床和病理诊断的差异可能是由于颊粘膜的小唾液腺中出现的SC的惰性临床行为。在目前的情况下,缺乏酶原颗粒和存在嗜酸性细胞浆和嗜酸性分泌物质的小细胞模式提示SC。
    结论:本病例报告为一例罕见的颊粘膜小唾液腺SC,根据临床表现,这是缓慢的,但在最终的组织病理学报告中,它有宫颈淋巴结转移,改变了疾病的最终阶段,需要辅助放疗。尽管分泌性癌通常被认为具有良好的预后,并且被认为是低级别癌,复发和颈淋巴结转移的数量有限。但有时它们确实会转移到颈淋巴结,因此可以进行准确及时的颈淋巴结清扫术,以确定最终分期,并在需要时开始其他治疗方式,以获得更好的疾病结局。
    UNASSIGNED: Secretory carcinoma (SC) is an uncommon salivary gland neoplasm of the oral cavity that microscopically may mimic acinic cell carcinoma (ACC) and mucoepidermoid carcinoma (MEC). Secretory carcinoma (SC) of the salivary gland has been recently added in fourth edition of the head and neck world health organization. Most of these tumors are located on the parotid gland with very few cases reported in the minor salivary glands of the buccal mucosa. This work has been reported in line with the SCARE criteria.
    METHODS: A 42 years old hypertensive male, shop keeper by occupation, with no prior addiction history, no dental extraction or trauma, presented with complaint of nodular lesion on left buccal mucosa for five years. On Clinical examination, adequate mouth opening, dentulous patient with 2.4 × 2 cm well circumscribed, nodular, non-tender, benign looking lesion was observed on left buccal mucosa near upper alveolus. Overlying mucosa appeared normal with no clinically palpable cervical lymphadenopathy. Histopathology revealed salivary gland neoplasm favoring secretory carcinoma. MRI scan showed lobulated enhancing nodular lesion arising from left buccal mucosa of size 2.3 ∗ 1.3 ∗ 1.7 cm, close to left superior alveolus without involving any cortical areas of marrow infiltration, with bilateral symmetrical level IIa reactive cervical nodes. Wide local excision and ipsilateral selective neck dissection [level 1, 2, 3] was done. Post-operative period was smooth with no complain of paresthesia observed. The final histopathology report showed secretory carcinoma. Two out of six lymph nodes from level I were positive for metastatic carcinoma with no extra nodal extension. Final stage of the tumor was pT1N2bMx. Patient underwent post-operative adjuvant radiotherapy for period of 6 weeks, received total 30 fractions and total dose of 6000 centigray.
    UNASSIGNED: SC behaved clinically an indolent being painless and having long duration of symptoms with normal overlying mucosa. But histopathologically there was cervical node metastasis. That changed final staging and added adjuvant treatment for this patient. The discrepancy in clinical and pathological diagnosis might be due to the indolent clinical behavior of SC arising in the minor salivary gland of buccal mucosa. In the present case, the absence of zymogen granules and presence of microcytic pattern with eosinophilic cytoplasm and eosinophilic secretory material were suggestive of SC.
    CONCLUSIONS: This case report represents a rare case of SC of minor salivary glands of buccal mucosa, which was indolent as per clinical presentation but on final histopathological report it had cervical nodal metastasis that changed the final stage of the disease, for which adjuvant radiotherapy was needed. Although Secretory carcinomas are generally considered having a favorable prognosis and are regarded as low- grade carcinomas with limited number of recurrence and cervical nodal metastasis, but sometimes they do metastasize to cervical nodes for which accurate and timely intervention in the form of neck dissection may be performed to establish final staging and start additional treatment modality if required for better outcome of the disease.
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  • 文章类型: Journal Article
    唾液腺肿瘤占头颈部肿瘤的2-3%,他们中的大多数是良性的。多形性腺瘤主要存在于腮腺和下颌下腺,很少见于小唾液腺。小唾液腺的肿瘤通常是恶性的。口内多形性腺瘤最常见的部位是腭,唇和颊粘膜。在这里,我描述了一个非常罕见的小唾液腺多形性腺瘤及其使用CO2激光的新颖管理。在大约一年的随访期后,没有发现复发。
    Salivary gland tumours account for 2-3% of tumours occurring in head and neck region, majority of them being benign. Pleomorphic Adenoma present mainly in Parotid gland and Sub-mandibular gland and rarely in minor salivary glands. The tumours of minor salivary glands are generally malignant. The commonest sites of intra oral Pleomorphic adenoma are palate, lip and buccal mucosa. Here I describe a very rare case of Pleomorphic Adenoma in minor salivary glands and its novel management using CO2 Laser. There was no recurrence seen after a follow-up period of around one year.
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  • 文章类型: Case Reports
    多形性腺瘤是最常见的唾液腺肿瘤,约占所有唾液腺肿瘤的60%。由于其广泛的细胞形态多样性,它也被称为“混合肿瘤”。多形性腺瘤唾液腺多发生在腭,但是上唇的牵连很少见。本报告描述了一例62岁的男性,无症状的结节性肿胀伴上唇,后来在切除活检中被诊断为多形性腺瘤。
    Pleomorphic adenoma is the most common salivary gland tumor which accounts for about 60% of all salivary neoplasms. It is also known as \"mixed tumor because of its wide cytomorphologic diversity\". Pleomorphic adenoma salivary glands mostly occurs on the palate, but the involvement of the upper lip is rare. The present report describes a case of a 62-year-old male with asymptomatic firm nodular swelling attached with upper lip which was later diagnosed as pleomorphic adenoma in the excisional biopsy.
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  • 文章类型: Journal Article
    未经证实:多形性腺瘤(PA)是最常见的良性唾液腺肿瘤,但是嘴唇PA很少见。虽然这种肿瘤可以通过影像学或组织活检明确诊断,如果它相当大,嘴唇上的PA相对较小,他们提出了与其他嘴唇病变相似的发现,这可能使术前诊断变得困难。
    UNASSIGNED:我们分析了过去20年来在我们部门治疗的口腔区域和嘴唇上的病变的所有PA,我们将它们与相关文献一起讨论。
    UNASSIGNED:我们发现11.8%(n=6)的PA发生在嘴唇上(上唇:9.8%,下唇:2.0%),嘴唇的所有肿块病变中约有1%是PAs。嘴唇PAs的平均尺寸为1.5±0.7cm(范围,0.7-2.2厘米)。对于术前诊断援助,超声检查(US)(n=4),磁共振(MR)(n=3),或不使用成像(n=2)。所有病例均行切除活检,到目前为止,没有观察到复发或恶变。
    未经评估:LipPA相对罕见。因为几乎所有这些病变都很小,与腭部病变相比,术前诊断更为困难。这种肿瘤也容易长期被忽视,并有复发和恶变的潜力。因此,有必要进行包括包膜和周围组织的切除,术后应继续仔细随访.
    UNASSIGNED: Pleomorphic adenoma (PA) is the most frequent benign salivary gland tumor, but a lip PA is rare. Although this tumor may be definitively diagnosed by imaging or a tissue biopsy if it is reasonably large, PAs on the lip are relatively small, and they present findings that are similar to those of other lip lesions, which can make a preoperative diagnosis difficult.
    UNASSIGNED: We analyzed all PAs in the oral region and lesions on the lips treated in our department over the past 20 years, and we discuss them together with the relevant literature.
    UNASSIGNED: We found that 11.8% (n=6) of the PAs occurred on a lip (upper lip: 9.8%, lower lip: 2.0%), and ~1% of all mass lesions of the lips were PAs. The average size of the lip PAs was 1.5±0.7 cm (range, 0.7-2.2 cm). For preoperative diagnostic assistance, ultrasonography (US) (n=4), magnetic resonance (MR) (n=3), or no imaging (n=2) was used. An excisional biopsy was performed in all cases, and to date, no recurrence or malignant transformation has been observed.
    UNASSIGNED: Lip PA is relatively rare. Because almost all of these lesions are small, a preoperative diagnosis is more difficult compared to palatal lesions. This tumor is also prone to long-term neglect and has the potential for recurrence and malignant transformation. It is thus necessary to perform an excision that includes the capsule and surrounding tissues, and careful postoperative follow-up should be continued.
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  • 文章类型: Case Reports
    硬腭后部大量小唾液腺组织的发生率增加了唾液腺肿瘤的可能性,尤其是在口腔的这一部分。小唾液腺肿瘤几乎占所有唾液腺肿瘤的15%,其中粘液表皮样癌占35.9%。当前论文报道了一例硬腭后部粘液表皮样癌,这是偶然发现。它表现为明确的平滑肿胀,初步的影像学检查显示没有明显的骨骼变化,并提供了良性肿瘤的印象。组织病理学研究显示了中度粘液表皮样癌的特征。手术切除病灶,并定期随访3年。本文重点讨论了特定病变的快速临床诊断的幅度,所以提高生存率和降低发病率。
    Incidence of abundant minor salivary gland tissues in the posterior part of hard palate surges the likelihood of salivary gland neoplasm especially in this part of the oral cavity. Minor salivary gland tumor accounts for virtually 15% of all the salivary gland neoplasm, wherein mucoepidermoid carcinoma comprises of 35.9%. Current paper reports a case of mucoepidermoid carcinoma of the posterior part of the hard palate which was an incidental finding. It presented as well-defined smooth swelling, the preliminary radiographic investigation revealed no appreciable bony changes and offered an impression of a benign tumor. Histopathological investigation displayed features of mucoepidermoid carcinoma of intermediate grade. The lesion was surgically excised and the patient was under regular follow up for 3years. The paper focus on the magnitude of swift clinical diagnosis of specific lesions, so increasing the survival rate and reducing the morbidity.
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  • 文章类型: Case Reports
    多形性腺瘤(PA)是唾液腺最常见的良性病变之一,其中大部分发生在腮腺。PA起源于上皮和间充质元件,可以来自主要和次要唾液腺。在小唾液腺中,腭是最常受影响的部位,接着是嘴唇,脸颊,牙龈,嘴巴的地板,和舌头。没有口腔内粘膜受累的上唇PA是一种罕见的实体。在这篇文章中,我们报告了一例中年女性患者上唇PA的病例,并采用了一种新技术对其进行了手术治疗。术后6个月复查,患者表现出良好的伤口愈合,疤痕形成很少。
    Pleomorphic adenoma (PA) is one of the most common benign lesions of the salivary glands, with a majority of them occurring in the parotid gland. PA has origin from the epithelial and mesenchymal elements and can arise from both major and minor salivary glands. Among minor salivary glands, the palate is the most commonly affected site, followed by lips, cheeks, gingiva, the floor of the mouth, and tongue. PA of the upper lip without intraoral mucosal involvement is a rare entity. In this article, we report a case of PA of the upper lip in a middle-aged female patient and its surgical management with a novel technique. During six months\' postoperative review, the patient showed excellent wound healing with very minimal scar formation.
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  • 文章类型: Journal Article
    涎腺肿瘤很少见,仅占头颈部肿瘤的2-3%。多形性腺瘤是一种良性肿瘤,常见于腮腺和其他主要唾液腺。它们很少会在腭的小唾液腺中发育。大多数小唾液腺肿瘤本质上是恶性的。此病例报告描述了一例年轻的男性耍蛇人在硬腭的小唾液腺中发展出混合肿瘤。
    Salivary gland tumors are rare and accounting for only 2-3% of tumors occurring in head and neck region. Pleomorphic adenoma is a benign neoplasm which is very commonly encountered in the parotid gland and other major salivary glands. Few times they can also develop in minor salivary glands of the palate. The majority of minor salivary gland tumors are malignant in nature. This case report describes a case of a young male snake charmer develops a mixed tumor in a minor salivary gland of the hard palate.
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