副唾液腺之單形性腺瘤：二病例報告及文獻回顧

兩個病例源自副唾液腺的單形性腺瘤(monomorphic adenoma)，第一個是管狀形(tubular type)基底細胞腺瘤(basal cell adenoma)，在顯微鏡下的發現包括了上皮細胞及肌上皮細胞(myoepithelial cell)；第二個病例則是嗜酸性腺瘤(oxyphilic adenoma)，手術切除後兩個月發現有再發的跡象，經第二次切除後追蹤觀察未見再發，由於單形性腺瘤並不常見，故提出報告並討論之。

關鍵字

單形性腺瘤；基底細胞腺瘤；嗜酸性腺瘤

並列摘要

The term ”monomorphic adenoma” was first used by Rauch, Seifert and Gorlin in 1970 to designate ”benign epithelial salivary gland tumors that are not pleomorphic adenoma”. According to the WHO (World Health Organization) classification on salivary gland tumor, there are three major groups of monomorphic adenoma: the adenolymphoma, the oxyphilic adenoma and ”other types”. Lesions included in the last category are (1) basal cell adenoma (2) canalicular adenoma (3) sebaceous adenoma… Those lesions categorized as ”other types” of monomorphic adenoma account for 1 to 3 percent of salivary gland neoplasm. They most frequently affect aged people (over 60 years of age) and the parotid gland is the most common site of occurrence. Usually, they are encapsulated and slowly growing. Simple enucleation without injury to the capsule is adequate. Oxyphilic adenoma is even more rare (less than 1% of all salivary gland tumors) and seldom found in persons less than 60 years of age. Most of the reported cases involved the parotid gland and have been treated by simple surgical excision. No metastasis has been reported but the rate of recurrence has not been determined. In this article, two cases of monomorphic adenoma, a basal cell adenoma and an oxyphilic adenoma, arising from minor salivary g1and are presented. The first patient was a 72-year-old woman. She visited the Department of Dentistry, National Taiwan University Hospital on August 1983 complaining a painless mass over the left side of the palate for one month. Clinical examination showed a tumor about 3.5×1.5 cm in size situating at the left side of the junction of the hard and soft palate. It was well demarcated and covered with intact oral mucosa. The consistency was elastic to firm. Incisional biopsy disclosed a basal cell adenoma. The tumor was totally excised and she had been regularly followed for 2 years without evidence of recurrence. The other patient was a 28-year-old female. She visited our department on May 1984 with the chief complaint of amass over right buccal mucosa. It had existed for two years. Except for occasional bleeding from the tumor surface, she didn't note any other abnormality. On examination, it was 1×0.5 cm in size, well defined without adhesion to the surrounding tissues. The overlying mucosa was smooth and intact. Excisional biopsy revealed an oxyphilic adenoma. She underwent another operation two months later because of tumor recurrence. After that, two years follow-up had not shown any sign of recurrence. Histopathologically, the tumor in the first case was well encapsulated and composed of an essentially monomer-phic population of darkly-stained basoloid cells. They were arranged in solid islands or tubular pattern. Occasionally, myoepithelial cells could be identified. The pathogenesis of this neoplasm, the significance of the myoepithelial cells in the tumor and its differentiation from the adenoid cystic carcinoma are discussed. As for the second case, most of the tumor cells (oncocytes) in the first specimen were round or polygonal in shape. The oncocytes were large, with eosinophilic cytoplasm and small, round nuclei. Cell outline was distinct and the cytoplasm was filled with many small, fine granules. Besides the tumor itself, focal aggregation of oncocytes in the adjacent minor salivary glands could also be illustrated. The specimen from the second operation displayed similar microscopic features. The possibility of multiple oncocytosis is discussed.

並列關鍵字

monomorphic adenoma ； basal cell adenoma ； oxyphilic adenoma ； minor salivary gland

國際替代計量

副唾液腺之單形性腺瘤：二病例報告及文獻回顧

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