下颌部浸润性微乳头状涎腺导管癌

Invasive micropapilary salivary duct carcinoma: a case report

报告1例下颌部浸润性微乳头状涎腺导管癌。患者男,52岁。下颌部皮肤肿物10年,临床表现为质硬、界限不清的肿块。皮损组织病理检查:真皮组织、皮下纤维脂肪组织及横纹肌组织内可见乳头状腺癌、微乳头状腺癌浸润或转移,细胞排列呈团块状或筛孔状,肿瘤团块周围有收缩间隙;肿瘤细胞细胞核异形性明显,核大深染。免疫组化:CK7(+)、雌激素受体(ER)(>95%,+++)、巨囊性病液体蛋白(GCDFP)-15(部分+)、GATA-3(+)、雄激素受体(AR)(>90%,++)及上皮细胞膜抗原(EMA)(+);CK20及甲状腺核转录因子(TTF)-1均(-)。诊断:浸润性微乳头状涎腺导管癌。治疗:予完整的局部扩大切除手术及颈部淋巴结清扫术。

A case of invasive micropapilary salivary duct carcinoma of mandibular is reported. A 52-year-old man presented with a firm and unboundary mass on his mandibular for ten years. Histopathological examination revealed infiltration or metastasis of papillary adenocarcinoma and micropapillary adenocarcinoma in dermal tissue, subcutaneous fibro-fat tissue and striated muscle. Tumor cells were arranged in masses or meshes, and there were contraction spaces around tumor masses. Obvious heteromorphosis of tumor cells with large and deep stained nuclei were seen. Immunohistochemical staining showed strong positive ER, AR and positive CK7, EMA, GATA-3 and GCDFP-15. CK20 and TTF-1 were negative. The diagnosis of invasive micropapilary salivary duct carcinoma was made. The patient was given extensive resection and radical neck dissection.