腮腺癌肉瘤1例报告并文献复习

doi:10.12439/kqhm.1005-4979.2024.02.014

摘要/Abstract

摘要：

癌肉瘤（carcinosarcoma，CS）是一种由恶性上皮成分及恶性间叶成分构成的高度恶性肿瘤，发病率极低。本文报道1例由唾液腺导管癌和血管肉瘤构成的腮腺CS病例，并结合相关文献，对腮腺CS的发病情况、免疫组织化学结果分析、诊断及鉴别诊断、发病机制及组织来源和治疗及预后进行讨论，以提高临床医生对此疾病的进一步认知，完善腮腺CS病理学的进一步分类。

关键词: 腮腺, 癌肉瘤, 病理学, 免疫组织化学, 治疗

Abstract:

Carcinosarcoma (CS) is a highly malignant tumor composed of malignant epithelial elements and malignant mesenchymal elements, with a very low incidence rate. This paper reports a case of parotid carcinosarcoma composed of salivary duct carcinoma and angiosarcoma, and discusses the incidence, immunohistochemical analysis, diagnosis and differential diagnosis, pathogenesis, tissue source, treatment and prognosis of parotid carcinosarcoma in combination with relevant literature in order to improve clinicians' further understanding of the disease and improve the further classification of parotid carcinosarcoma pathology.

Key words: parotid gland, carcinosarcoma, pathology, immunohistochemistry, treatment

崔泽坤, 张心予, 胡雅琦, 郭燕军, 戚孟春. 腮腺癌肉瘤1例报告并文献复习[J]. 《口腔颌面外科杂志》, 2024, 34(2): 154-158.

CUI Zekun, ZHANG Xinyu, HU Yaqi, GUO Yanjun, QI Mengchun. Carcinosarcoma of parotid gland: A case report and literature review[J]. 《Journal of Oral and Maxillofacial Surgery》, 2024, 34(2): 154-158.

https://journal06.magtech.org.cn/Jweb_joms/CN/Y2024/V34/I2/154

图/表 3

图1 患者术前增强CT图像示右侧腮腺浅叶肿块 A.横断位增强CT示患者右侧腮浅叶有一约3.0 cm×2.0 cm的软组织影，内部可见密度减低区（红色箭头所指）；B.冠状位增强CT示患者右侧腮腺浅叶有一约4.0 cm×3.0 cm软组织影，内部可见密度减低区（红色箭头所指）。

Figure 1 Enhanced CT images showing a superficial lobe mass in the right parotid gland before surgery

图2 苏木精-伊红（hematoxylin and eosin，HE）染色病理结果（×100） A.癌肉瘤中的癌成分；B—E.癌肉瘤中的肉瘤成分；F.癌与肉瘤成分混杂。

Figure 2 Pathological features of hematoxylin and eosin（HE）stainings（× 100）

图3 免疫组织化学染色结果 A.CK上皮阳性表达（×10）；B.Vimentin阳性表达（×10）；C.CD-31阳性表达（×10）；D.Fli-1阳性表达（×10）；E.GCDFP-15阳性表达（×10）；F.Ki-67阳性率约为60%（×10）；G.ERG阳性表达（×40）；H.CD-34阳性表达（×40）；I.HER-2阳性表达（×20）。

Figure 3 Expression distribution of immunohistochemical stainings

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