소타액선에 발생한 다형성선종의 임상 및 병리학적 고찰

백석기(Seok-kee Baik),차인호(In-Ho Cha),김진(Jin Kim),이의웅(Eui-Wung Lee) 대한구강악안면외과학회 2003 대한구강악안면외과학회지 Vol.29 No.2

Pleomorphic adenoma is the most common salivary neoplasm mainly occurring in the major salivary glands - especially in parotid gland, which is characterized by variable histopathologic appearances and high recurrence rate with malignant transformation according to surgical situations. And this benign mixed tumor occurring in minor salivary glands is believed to shows same clinicopathologic appearances and relatively low recurrent rate compared with the case in major salivary glands. But there are few comparative studies of large series of pleomorphic adenoma occurring in minor salivary glands which includes different histopathologic appearance, clinical characteristics, treatment methods, recurrence rate, and malignant transformation. We retrospectively studied the 54 patients who were pathologically confirmed with pleomorphic adenoma occurring in minor salivary glands, and analyzed the clinico-histopathological appearance, surgical methods, recurrent cases. The results obtained are as follows. 1. The incidence of the tumor was most frequent in 4th & 5th decade, and in female. 2. Palate(90%) including hard & soft palate was the most frequent site for pleomorphic adenoma in minor salivary glands. 3. The exact duration could not be known due to asymptomatic slow growth patterns of the tumor. 4. The mean tumor size was 2.3cm. 5. 28 (52%) pleomorphic adenomas were classified as Cellular type (cell-rich), 17 (31%) specimen as Intermediate type(equal cell to stroma ratio), and 9 (17%) as Myxoid type(stroma-rich). 6. Surgically 51 cases (94%) were showed well-encapsulated tumors, but histopathologically only 34 specimen (63%) were wellencapsulated. Therefore pleomorphic adenomas in minor salivary glands also have to be excised more widely, not enucleated. And in case of suspicious malignancy or large tumor, preoperative incisional biopsy can be applied in the center of the tumor for prevention of rupture of tumor cell, and total excision with use of frozen biopsy for detection of malignancy and confirming the excision margin, and closed follow-up according to final histopathologic results is recommended.

소타액선 종양에 관한 임상적 고찰

이종수(Chong Soo Lee),최종욱(Jong Ouck Choi),이승호(Seung Ho Lee),정광윤(Kwang Yoo Jung),이남준(Nam Joon Lee) 대한두경부종양학회 1994 대한두경부 종양학회지 Vol.10 No.1

최근 7년간 저자들이 치험한 소타액선 종양 26례에 대하여 임상양상과 치료 결과를 분석하여 다음과 같은 성적을 얻었다. 1) 발생부위를 구개 10례 (38.5%), 비강 및 부비동 8례 (30.8%), 설근부 2례 (7.7%), 협부 점막 2례 (7.7%), 구순 1례(3.8%), 후두개곡 1례(3.8%), 구강저 1례(3.8%), 비인강 1례(3.8%)이었다. 2) 병리조직학적 소견은 양성 종양 10례, 악성종양 16례이었으며, 양성 종양은 전례가 다형성선종이었으며, 구개에서 6례로 가장 많았고, 악성종양은 비강 및 부비동 5례로 가장 많았으며, 선양낭성암종 9례, 악성혼합종 2례, 점액표피암종 2례, 다형성선암종 2례, 상피근상피성암 1례이었다. 악성화율은 61.5%이었다. 3) 치료는 양성 종양은 모두 적출술을 시행하였고 악성 종양은 광범위 적출술 4례(25.0%), 수술 및 방사선요법의 병합요법 9례(45.2%), 항암화학요법 및 방사선요법의 병합요법 1례(5.25%), 방사선 요법 2례(12.3%)등을 시행하였다. 4) 악성 종양에 대한 치료 결과는 근치적 치료를 시행한 8례에서는 무병생존 6례, 유병생존 1례, 유병사망 1례를 보였으며, 고식적 치료를 시행한 6례에서는 유병생존 2례, 유병사망 4례를 보였다. 이상의 성적에서 소타액선 종양은 대타액선 종양에 비하여 악성화 비율이 높고 선양낭성암종의 발생 빈도가 높아 그 침범 부위를 정확히 파악하는 것이 치료에 많은 도움을 줄 수 있으며, 고식적 치료의 범위를 확대하여 보다 적극적인 치료가 필요할 것으로 생각된다. Minor salivary gland tumors vary in their primary sites, histopathology and bilogical behavior. Therefore various factors are considered in selecting the treatment modality and predicting the prognosis. The prognosis of milignant tumors of minor salivary glands are worse than that of such lesions of major salivary glands. Authors experienced 26 cases of minor salivary gland tumors(10 benign tumors and 16 malignant tumors) during the past 7 years and analyzed their clinical characteristics. 1) The palate was the most common site of origin of minor salivary gland tumors (38.5%). 2) The most common benign tumor was pleomorphic adenoma and majority of them occur red in the palate(60.0%) and the remaining occured in the nasal cavity or the paranasal sinuses (30.0%), and the lip ( 10.0%). 3) In the case of malignant tumors the most frequent sites were the nasal cavity or the paranasal sinuses (31.3%) with the following histopathologic frequencies: adenoid cystic carcinoma(56.3%), malignant pleomorphic adenoma(12.5%), mucoepidermoid carcinoma(12.5%), polymorphic adenocarcinoma (12.5%), epthelial-myoepithelial carcinoma (6.25%). 4) Minor salivary gland tumors have high probability of malignancy and tumor extension is important to their treatment.

소타액선 종양의 고찰

태경(Kyung Tae),지용배(Yong Bae Ji),진봉준(Bong Jun Jin),이승환(Seung Hwan Lee),이형석(Hyung Seok Lee) 대한두경부종양학회 2005 대한두경부 종양학회지 Vol.21 No.2

Background and Objectives: Minor salivary gland tumors vary in their primary sites, histopathology and biological behavior. Therefore, various factors are considered in selecting the treatment modality and predicting the prognosis. We performed this study for the purpose of getting further understanding and more supporting ideas for the diagnosis and treatment of minor salivary gland tumor. Materials and Methods: A retrospective analysis of the patients with 52 cases of minor salivary gland tumor who were treated at the Hanyang University Hospital from 1996 to 2003 was performed. We analyzed demography, symptoms, histopathology, treatment and outcomes by the review of medical records. Results: Among 52 cases of minor salivary gland tumor, 46% were classified as benign and 54% were classified as malignant tumors. The most common benign tumor was pleomorphic adenoma. Adenoid cystic carcinoma(15/28) was the most common in malignant tumors. Eight patients were males and sixteen patients were females in benign tumors and 10 patients were males and 18 patients were females in malignant tumors. The most common site of benign tumor was the palate(17/22), whereas malignant tumors were most common in the nasal cavity and paranasal sinus(9/28). Asymptomatic mass was the most common symptom. According to the criteria given by the AJCC on staging, stage III and IV(21/28) were more common than stage I and 11(7/28). All benign tumors were treated with simple excision and had no recurrence. In malignant tumors, 25 patients underwent radical excisional operation and 13 patients of them had postoperative radiation therapy. Three of them were treated with additional chemotherapy. In whom treated with radical operation, 9 patients had recurrence. Three were recurred at the primary site with neck node metastasis, 3 were recurred at the primary site with lung metastasis, 1 was recurred at the primary site with neck node and lung metastasis, 1 was recurred only at neck node. Conclusion: In minor salivary gland tumor, malignant was more common than benign. Malignant tumor originated from minor salivary gland were more frequently diagnosed at advanced stage with high recurrence rate and distant metastasis. Early detection of the disease is needed to improve the prognosis of the patients with malignant tumors of the minor salivary glands.

연구개에 발생한 분비성암종 1례

이주호(Ju Ho Lee),하정호(Jung Ho Ha),노진(Jin Roh),장전엽(Jeon Yeob Jang) 대한두경부종양학회 2020 대한두경부 종양학회지 Vol.36 No.1

Secretory carcinoma of salivary gland origin is a recently described tumor that harbors a characteristic ETV6-NTRK3 translocation that is identical to secretory carcinoma of the breast. The majority of tumors were located in the parotid gland and other major salivary glands, while the minority occurred in a minor salivary gland. We present a case of a 71-year-old female who was diagnosed with low-grade salivary gland cancer presenting in the soft palate accompanying lymph node metastasis. Peroral wide excision, selective neck dissection, reconstruction with radial forearm free flap was performed. The final pathology report indicated secretory carcinoma of the soft palate. The patient was followed-up without evidence of recurrence for one year. At present, it is difficult to accurately assess prognosis and treatment for the secretory carcinoma of the minor salivary gland origin. Continuous follow-up with various cases is needed further.

소타액선 종양에 대한 임상적 고찰

박윤영,심윤상,오경균,이용식,박석진,권순욱 대한이비인후과학회 1998 대한이비인후과학회지 두경부외과학 Vol.41 No.7

구개부 소타액선에 발생한 호산성 과립세포종

박현진,김경원,조용석,이경호,강지연,최희원 충북대학교 의학연구소 2002 忠北醫大學術誌 Vol.12 No.2

호산성 과립세포는 타액선을 포함하여 갑상선, 부갑상선 등 주로 선조직에서 발견되는 커다란 과립상의 호산성 상피세포를 말한다. 호산성 과립세포종은 모든 타액선 종양중 약 1.5%의 비율로 발생하는 비교적 드문 양성 종양이며, 주로 노년의 이하선에서 발생하고 악하선과 소타액선에서는 드물게 발생한다. 임상적으로 크기는 약 3-4 ㎝이며 잘 분화된 낭으로 싸여있다. 조직학적 검사에서 광학현미경상 호산성 과립세포로 채워진 세포질이 관찰되며 전자현미경상 과립을 함유한 다량의 비대된 미토콘드리아가 관찰된다. 호산성 과립세포종은 본질적으로는 양성 종양이며 치료를 위하여 완전한 절제가 추천된다. 국소적인 재발은 드물며 다발성인 경우에는 재발하기도 한다. 증례는 38세의 남자 환자로서 구개부의 소타액선에 발생한 약 2.0×2.5 ㎝ 크기의 무통성의 종괴로 절제술을 시행하였으며, 광학현미경과 전자현미경을 이용한 조직병리 검사상 호산성 과립세포종으로 진단되었으며, 수술 후 특별한 합병증 없이 치유되었다. 저자들은 구개부의 소타액선에서는 아주 드물게 발생하는 호산성 과립세포종에 대하여 진단 및 치료를 시행하고 양호한 결과를 얻었기에 문헌 고찰과 함께 보고하는 바이다. Oncocytes are large, granular, eosinophilic epithelial cells mainly found in many glandular tissue including salivary glands, the thyroid, parathyroid, pituitary, adrenal gland, testicle, fallopian tube, liver and stomach etc. Oncocytoma, which originate from oncocytes are uncommon benign neoplasm that present approximately 1.5% of all salivary gland tumors. They typically occur in parotid gland of elderly patients and rarely in submandibular gland or minor salivary gland. On gross examination, they are usually 3 to 4 ㎝ is size and possess a well-defined capsule. Histologically oncocytoma peculiarly consisted of oncocyte which has cytoplasm, filled with eosinophilic granules on light microscopy and a large number of enlarged and morphologically altered mitochondria by electron microscopy. Oncocytomas are essentially benign tumors and complete excision is recommended. Local recurrence is extremely rare, but when it occurs, it may be multifocal. We report a case of oncocytoma raised from minor salivary gland of palate in 38 years old male patient with literature.

Sialolithiasis of minor salivary gland: a challenging diagnostic dilemma

Apostolos Matiakis,Fotios Tzermpos 대한구강악안면외과학회 2021 대한구강악안면외과학회지 Vol.47 No.2

Minor salivary gland sialolithiasis (MSGS) is a not uncommon oral mucosal disease. Its clinical appearance may mimic a mucocyst or other benign submucosal overgrowth. Stasis of saliva, which accompanies MSGS, usually results in minor salivary gland inflammation, with a chronic sialadenitis appearance. MSGS typically is a painless lesion but can become painful when the salivary gland parenchyma or excretory duct becomes infected, with or without pus. However, misdiagnosis of this condition is rather common, as the clinical appearance is asymptomatic. The most common location is the upper lip, and MSGS affects males and females, with a slight predilection for males. The sialolith causing MSGS may be obvious during surgical excision, as in the case reported. In other cases, sialolith may be absent or fragmented. Differential diagnosis includes mucocele, swelling due to local irritation like fibroma and diapneusia, chronic abscess of the oral mucosa, and neoplasms either benign (lymphangioma, pleiomorphic adenoma) or malignant. Histopathological examination is needed to establish clinical diagnosis.

구강 내 소타액선에 발생한 점액표피양 암종 1예

백훈희(Hun Hee Baek),홍석정(Seok Jung Hong),이미지(Mi Ji Lee),김승우(Seung Woo Kim) 대한두경부종양학회 2017 대한두경부 종양학회지 Vol.33 No.1

Salivary gland tumors comprise almost 5% of head and neck malignancies, and minor salivary gland tumor which account for 10-15% of all salivary gland neoplasm are infrequently malignant. The mucoepidermoid carcinoma (MEC) is second most common tumor in minor salivary gland. It usually presents as a painless, rubbery-hard or soft mass, which may be fixed or mobile into the underlying structure. The predilection sites of intraoral MEC are palate, cheek, mandible, lip, and tongue, etc. There are very few published reports of MEC occurred in retromolar trigone. Only one case has been reported so far. Recently, we experienced a-70-year old man with a mass in retromolar trigone, which was finally diagnosed as MEC. We report the unique case with literature review.

구개부에 발생한 다형선종 : 증례 보고 및 문헌 고찰

Joon Kyu Kim,Hyun Joong Yoon,Jae Il Lee,Sang Hwa Lee 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.5

Pleomorphic adenoma is the most common benign tumor of the salivary glands. About 90% of these tumors occur in the parotid gland and 10% of them occur in the minor salivary glands. The most common sites for pleomorphic adenoma of the minor salivary glands are the palate, followed by the lips and the cheeks. Pleomorphic adenoma of the palate presents clinically as a painless, slow-growing mass found on posterior lateral aspect. In this case report, we report a case of pleomorphic adenoma of the palate in a 36-year old male patient whose initial diagnosis was vascular mass such as hemangioma or lymphangiohemangioma by preoperative CT and MRI.

Pleomorphic Adenoma of the Palate : A Case Report with Literature Review

김준규,윤현중,이재일,이상화 대한구강악안면병리학회 2015 대한구강악안면병리학회지 Vol.39 No.5

Pleomorphic adenoma is the most common benign tumor of the salivary glands. About 90% of these tumors occur in the parotid gland and 10% of them occur in the minor salivary glands. The most common sites for pleomorphic adenoma of the minor salivary glands are the palate, followed by the lips and the cheeks. Pleomorphic adenoma of the palate presents clinically as a painless, slow-growing mass found on posterior lateral aspect. In this case report, we report a case of pleomorphic adenoma of the palate in a 36-year old male patient whose initial diagnosis was vascular mass such as hemangioma or lymphangiohemangioma by preoperative CT and MRI.