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目的 分析涎腺恶性肌上皮瘤临床病理特点及生物学行为。方法 对 15例患者进行回顾性分析 ,包括发病情况、临床表现、组织病理学、治疗方法等。随访时间 3个月～ 2 4年。结果 15例中男性 7例 ,女性 8例 ,年龄 2 4～ 72岁 (平均 5 0岁 )。 6例肿物由良性肿瘤恶变而来。主要发生于腮腺及腭部小涎腺。临床上主要表现为 :快速生长或生长突然加速的包块 ,溃疡 ,骨质破坏和神经侵犯。所有肿瘤均在肿物外无瘤区扩大切除 ,部分病例实施了舌骨上清扫术或全颈淋巴清扫术。 15例中 8例系复发病例 ,3例经病理证实有颌下或颈淋巴结转移 ,1例肺转移。组织学检查发现 ,绝大多数肿物侵入周围涎腺组织或邻近脂肪、肌肉、骨组织 ,侵入程度不一。肿瘤细胞形态呈多样化 ,有透明型、梭形、上皮样型、浆细胞样型或混合型。本组以透明细胞为主 ,占 9例。结论 恶性肌上皮瘤区域淋巴结和远处转移率低但局部复发率很高。是一种低度恶性肿瘤 ,主要引起局部软组织及骨组织的破坏。
Objective To analyze the clinicopathological features and biological behavior of salivary gland malignant myoepithelioma. Methods 15 patients were retrospectively analyzed, including the incidence, clinical manifestations, histopathology, treatment methods. Follow-up time of 3 months to 24 years. Results Of 15 cases, 7 were male and 8 were female, ranging in age from 24 to 72 years (mean, 50 years). Six cases of malignant tumors come from benign tumors. Occurs mainly in the parotid and palate little salivary glands. The main clinical manifestations: rapid growth or growth suddenly accelerated mass, ulcers, bone destruction and nerve invasion. All of the tumors were enlarged and removed in the non-tumor area outside the tumor. In some cases, hyoid hyoid or total neck lymph dissection was performed. Among the 15 cases, 8 cases were relapsed, 3 cases had submandibular or cervical lymph node metastasis and 1 case had pulmonary metastasis. Histological examination found that the vast majority of tumor invasion into the surrounding salivary glands or adjacent fat, muscle, bone tissue, varying degrees of invasion. Tumor cells in a variety of shapes, transparent, fusiform, epithelial, plasma cell-like or mixed type. This group mainly of transparent cells, accounting for 9 cases. Conclusions Malignant myoepithelioma has a low regional lymph node metastasis rate but high local recurrence rate. Is a low grade malignant tumor that mainly causes the destruction of local soft tissue and bone tissue.