Salivary gland tumors(SGTs)make up a small portion(approximately 5%)of all head and neck tumors.Most of them are located in the parotid glands,while they are less frequently located in the submandibular glands,minor s...Salivary gland tumors(SGTs)make up a small portion(approximately 5%)of all head and neck tumors.Most of them are located in the parotid glands,while they are less frequently located in the submandibular glands,minor salivary glands or sublingual gland.The incidence of malignant or benign tumors(BTs)in the salivary glands varies according to the salivary gland from which they originate.While most of those detected in the parotid gland tend to be benign,the incidence of malignancy increases in other glands.The use of magnetic resonance imaging(MRI)in the diagnosis of SGTs is increasing every day.While conventional sequences provide sufficient data on the presence,localization,extent and number of the tumor,they are insufficient for tumor specification.With the widespread use of advanced techniques such as diffusion-weighted imaging,semiquantitative and quantitative perfusion MRI,studies and data have been published on the differentiation of malignant or BTs and the specificity of their subtypes.With diffusion MRI,differentiation can be made by utilizing the cellularity and microstructural properties of tumors.For example,SGTs such as high cellular Warthin’s tumor(WT)or lymphoma on diffusion MRI have been reported to have significantly lower apparent diffusion values than other tumors.Contrast agent uptake and wash-out levels of tumors can be detected with semiquantitative perfusion MRI.For example,it is reported that almost all of the pleomorphic adenomas show an increasing enhancement time intensity curve and do not wash-out.On quantitative perfusion MRI studies using perfusion parameters such as Ktrans,Kep,and Ve,it is reported that WTs can show higher Kep and lower Ve values than other tumors.In this study,the contribution of advanced MRI to the diagnosis and differential diagnosis of SGTs will be reviewed.展开更多
Salivary gland tumors represent 2% - 6.5% of all head and neck tumors. Since salivary gland tumors have various clinical features and histological types, it is often difficult to diagnose and treat them. The aim of th...Salivary gland tumors represent 2% - 6.5% of all head and neck tumors. Since salivary gland tumors have various clinical features and histological types, it is often difficult to diagnose and treat them. The aim of this study was to conduct a retrospective clinical-statistical analysis of 37 minor salivary gland tumors (MSGTs) treated in the Department of Oral Surgery at Nihon University School of Dentistry at Matsudo over a 16-year period. The frequencies and distributions of sex, age, occurrence site, preoperative examination (fine needle cytology and/or biopsy), treatment, and prognosis of the tumors were analyzed and compared with previous reports. The average age at diagnosis was 58.1 years (range 22 - 91 years). The peak occurrence of tumors was in the sixties (10 cases, 27.0%), followed by the forties (8 cases, 21.6%) and the seventies (7 cases, 18.9%). The average age of patients with benign tumors was 56.8 years (range 22 - 91 years). For malignant tumors, the average age was 61.7 years (range 42 - 81 years). The male-female ratio was 1:2.1 for all minor salivary gland tumors, 1:2.4 for benign tumors, and 1.5:1 for malignant tumors. There were 27 (73.0%) benign and 10 (27.0%) malignant tumors. Pleomorphic adenoma (PA) was the most common tumor (24 (64.9%) cases). Most salivary gland tumors originated from the palate (21 cases, 56.8%);the second most common site was the buccal mucosa (14 cases, 37.8%). For most patients, an intraoral mass was the primary presentation, and the second most common symptom was swelling. Surgical treatment was performed for all cases, both benign and malignant tumors. There was one case of local recurrence of PA, as well as one of multiple lung metastases after surgery for adenoid cystic carcinoma. Diagnosis and treatment of MSGTs are often delayed because the patients have few symptoms, and it is difficult to distinguish benign from malignant tumors. More cases need to be examined in the future, and the diagnostic accuracy of imaging and histopathological diagnosis needs to be improved.展开更多
<strong>Objective:</strong><span style="font-family:""><span style="font-family:Verdana;"> Concurrent chemoradiation value of the resected salivary tumor adjuvant conte...<strong>Objective:</strong><span style="font-family:""><span style="font-family:Verdana;"> Concurrent chemoradiation value of the resected salivary tumor adjuvant context against regular radiation therapy alone. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective randomized clinical trial. </span><b><span style="font-family:Verdana;">Patients:</span></b><span style="font-family:Verdana;"> 48 patients were randomized to either adjuvant postoperative radiology alone versus concurrent chemoradiotherapy (weekly cisplatin 40 mg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> for 6 cycles) “with resected high-risk salivary tumors of the large and minor salivary gland”. </span><b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Outcome</span></b> <b><span style="font-family:Verdana;">Measures:</span></b><span style="font-family:Verdana;"> Recurrent locoregional Free survival, distant free survival, and overall survival. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of the 48 participants in the study 31 patients had parotid gland tumors. 23 patients received solely adjuvant radiation while 25 patients received concurrent chemoradiotherapy. In the chemoradiation group, platinum-based regimens were employed in all. The mean age in both groups was 48 years. Adenoid cystic carcinoma was the primary pathogenic form of both arms 56% (28 cases). Stage II patients were 35% and 32%, stage III was 39% and 48% and stage VIa were 26% and 20% in the radiation arm and chemoradiotherapy arm respectively. 40 of 48 patients (83%) had close or positive surgical margins and 30 of 48 patients (62%) have a perineural invasion. Both risk variables are more or less well balanced in both arms with no statistical difference. The 2- and 4-year estimates of the locoregional recurrence-free survival rate in the chemoradiation group were 95% and 73%, compared to 77.4% and 43.6% in the radiation arm respectively (p = 007). In the two-and four-year-old chemoradiation arm distant free metastases were 100% and 59% compared to 68% and 39% respectively in the radiation arm (p = 0.08). The overall survival estimates for 2 and 4 years were 93% and 78% respectively in the Chemoradiation Group but in the radiation-alone group were 95% and 48% respectively. The statistically significant differences were p = 0.009 by log-rank testing. Treatment was generally tolerated, although, in the chemoradiation group adverse symptoms, mainly mucositis increased. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Adding weekly cisplatin as a radiosensitizer for locally advanced stage or high-grade salivary gland cancer with adjuvant conventional radiation looks to be helpful and justifies further exploration in selected patients.</span></span>展开更多
Secretory carcinoma(SC), previously described as mammary analogue secretory carcinoma(MASC), is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first descript...Secretory carcinoma(SC), previously described as mammary analogue secretory carcinoma(MASC), is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first description of SC/MASC, reported by Skálová et al. in 2010, was as a rare salivary carcinoma imitating secretory carcinoma of the breast. SC/MASC is a unique salivary gland tumor with morphological overlap with acinic cell carcinoma(Aci CC), mucoepidermoid carcinoma(MEC), and adenocarcinoma not otherwise specified(ADCNOS). SC/MASC shares similar clinicopathological features with Aci CC. As a critical difference between SC/MASC and Aci CC, SC/MASC characteristically has the chromosomal translocation t(12;15)(p13;q25) which leads to a fusion gene between the ETV6 gene on chromosome 12 and the NTRK3 gene on chromosome 15. This genetic background is an important differential diagnostic finding for excluding other salivary gland tumors and may be a critical factor determining the prognosis for patients with SC/MASC. Research in recent years has provided a large body of new data on SC/MASC and suggests the possibility that the ETV6-NTRK3 translocation could be a therapeutic target. Here, we review the morphological and clinicopathological features of SC/MASC and discuss new directions for therapy.展开更多
Background: Salivary gland tumours (SGTs) are rare, but recent reports suggest an increasing incidence. Although there are previous Nigerian studies on the patterns of SGTs, patterns and trends of disease may change o...Background: Salivary gland tumours (SGTs) are rare, but recent reports suggest an increasing incidence. Although there are previous Nigerian studies on the patterns of SGTs, patterns and trends of disease may change over time. The aim of this study was to describe the pattern of presentation of SGTs, and to determine the trends in occurrence of SGTs at Federal Teaching Hospital (FTH), Gombe over a period of 15 years. Method: This descriptive study included cases of histologically diagnosed SGTs from January 2008 to December 2022. Relevant information (age, gender, site, year of diagnosis, and histopathologic diagnosis) was extracted from the cancer registers and histopathologic records. The lesions were then categorized into benign and malignant SGTs and grouped into three groups spanning 5 years each based on the year of diagnosis. Data analysis was done using IBM SPSS version 23, and p ≤ 0.05 was considered statistically significant. Results: There were 93 (61.2%) benign and 59 (38.8%) malignant SGTs. Benign SGTs had a mean age of 36.4 ± 13.6 years, and were more common in females (57.0%), and in the parotid (41.9%). Pleomorphic adenoma (94.6%) was the most common benign SGT. Malignant SGTs had a mean age of 44.5 ± 18.4 years, with male predilection (54.2%) and occurrence mostly in the palate (27.6%) and parotid (22.4%). Mucoepidermoid carcinoma (39.0%) and adenoid cystic carcinoma (32.2%) were the most frequent malignant SGTs. The mean age of occurrence of malignant SGTs was significantly higher than that of benign SGTs (p = 0.005). The trend analysis showed that there has been a steady rise in the proportion of males presenting with malignant SGTs. Similarly, there has been a steady increase in the frequency of benign SGTs in the parotid. The palate was the predominant site for the malignant SGTs between 2008 and 2012, but in the last five years (2018 to 2022), the parotid has become the predominant site. Over the duration of the study, the ratio of benign to malignant SGTs has remained relatively constant. Conclusion: While the overall pattern of presentation of SGTs in Gombe is similar to reports in the literature, this study has identified some changes in trends over the years.展开更多
Transforming growth factor-β (TGF-β) and bone morphogenetic protein (BMP)were related to embryonic development and the differentiation of many types of cells. Recent studies showed that they might play an important ...Transforming growth factor-β (TGF-β) and bone morphogenetic protein (BMP)were related to embryonic development and the differentiation of many types of cells. Recent studies showed that they might play an important role in regulating the differentiation o展开更多
A 66-year-old woman presented with a 2-year history of asthma has progression of dyspnea within a week, and a computed tomography (CT) revealed an endotracheal tumor at level of aortic arch. The resected tumor, measur...A 66-year-old woman presented with a 2-year history of asthma has progression of dyspnea within a week, and a computed tomography (CT) revealed an endotracheal tumor at level of aortic arch. The resected tumor, measured by 18 × 12 × 10 mm, has histologically malignant features including frank invasion with desmoplastic stroma and foci of necrosis. Presence of glycogen and mucin was confirmed by periodic acid-Schiff (PAS) and diastase PAS staining. Immunohistochemically, the tumor cells were diffusely positive for cytokeratin (CK) 7 and AE1/3, focally positive for CK5/6 and CK14, but negative for CK20. Thyroid transcription factor-1 (TTF-1), Napsin A, and SP-A, indicating lung parenchymal origin were all negative. Other muscular markers, neuroendocrine markers, renal cell carcinoma markers, and markers related to perivascular epithelioid cell tumors were all negative. Postoperative systemic examination suggests no primary tumor outside the lung. The follow up was excellent being recurrence free for 14 months in spite of the positive surgical margin by the tumor cells. This is a first report ?of rare neoplasm, clear cell carcinoma of salivary gland type, presenting as an endotracheal mass.展开更多
BACKGROUND Salivary carcinosarcoma is an extremely rare tumor containing both malignant epithelial and mesenchymal constituents.This article reports a rare case of carcinosarcoma with salivary duct carcinoma and osteo...BACKGROUND Salivary carcinosarcoma is an extremely rare tumor containing both malignant epithelial and mesenchymal constituents.This article reports a rare case of carcinosarcoma with salivary duct carcinoma and osteosarcoma as the tumor components.The clinicopathological characteristics,treatment,and prognosis are discussed in conjunction with the literature.CASE SUMMARY A 48-year-old man presented with a complaint of a mass in the right parotid region.Osteosarcoma was first considered for assessment by fine-needle aspiration cytology.Physical examination revealed a mass measuring approximately 4 cm×3.5 cm×3 cm.The mass,the whole lobe of the right parotid gland,and the right mandible were completely removed during surgery.Postoperative histopathology confirmed carcinosarcoma of the salivary gland.CONCLUSION A definite diagnosis of salivary gland carcinosarcoma can only be obtained after complete surgical resection.展开更多
AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were col...AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.展开更多
The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour.For salivary gland tumours,conservative and functional salivary surger...The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour.For salivary gland tumours,conservative and functional salivary surgery,including partial sialoadenectomy as well as anatomical and functional preservation of the facial nerve,great auricular nerve,superficial musculoaponeurotic system (SMAS),and Stensen’s duct,has become increasingly popular.In the present review,we discuss the following aspects of conservative and functional surgery in the treatment of salivary gland tumours:(i) partial superficial parotidectomy (PP) to treat benign parotid gland tumours,(ii) modification of surgical incisions to improve cosmetic results,(iii) modification of the surgical approach to decrease complications,(iv) extracardial dissection to treat benign superficial parotid tumours,(v) partial sialoadenectomy to treat benign submandibular gland tumours,and (vi) 125I brachytherapy to preserve facial nerves.The majority of the operated parotid or submandibular glands are preserved,and surgical complications are also decreased.Conservative and functional surgery plays a significant role in maintaining normal salivary gland function and in improving patients’ quality of life during the treatment of salivary gland tumours and thus should be further promoted.展开更多
Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical ...Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical and pathologic features.A new and rare variant of gastric adenocarcinoma with chief cell differentiation(GA-CCD)has recently been recognized.Studies reporting the distinct clinicopathologic characteristics proposed the term oxyntic gland polyp/adenoma because of the benign nature of the GACCD.Typically,GA-CCD is a solitary mucosal lesion that develops either in the gastric cardia or fundus.Histologically,this lesion is characterized by tightly clustered glands and anastomosing cords of chief cells.Immunohistochemically,GA-CCD is diffusely positive for mucin(MUC)6 and negative for MUC2and MUC5AC.However,other gastric tumors such as a gastric neuroendocrine tumor or fundic gland polyp have been difficult to exclude.Because GA-CCD tends to be endoscopically misdiagnosed as a neuroendocrine tumor or fundic gland polyp,comprehensive assessment and observation by an endoscopist are strongly recommended.Herein,we report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection.展开更多
Ghrelin, a peptide hormone, newly identified in oral mucosal tissue, has emerged re-cently as a principal modulator of the in-flammatory responses to bacterial infection through the regulation of nitric oxide syn-thas...Ghrelin, a peptide hormone, newly identified in oral mucosal tissue, has emerged re-cently as a principal modulator of the in-flammatory responses to bacterial infection through the regulation of nitric oxide syn-thase system. In this study, using rat sub-lingual salivary gland acinar cells, we report that lipopolysaccharide (LPS) of periodon-topathic bacterium, P. gingivalis- induced enhancement in the activity of inducible ni-tric oxide synthase (iNOS) was associated with the suppression in Akt kinase activity and the impairment in constitutive (c) cNOS phosphorylation. Further, we show that the detrimental effect of the LPS on Akt activa-tion, manifested in the kinase protein S-nitrosylation and a decrease in its phos-phorylation at Ser473, was susceptible to suppression by iNOS inhibitor, 1400W. Moreover, we demonstrate that a peptide hormone, ghrelin, countered the LPS- induced changes in Akt activity and NOS system. This effect of ghrelin was reflected in the decreased in Akt S-nitrosylation and the increase in its phosphorylation at Ser473, as well as cNOS activation through phos-phorylation. Our findings suggest that P. gingivalis-induced up-regulation in iNOS leads to Akt kinase inactivation through S-nitrosylation that impacts cNOS activation through phosphorylation. We also show that the countering effect of ghrelin on P. gingivalis-induced disturbances in Akt ac-tivation are manifested in a decrease in the kinase S-nitrosylation and the increase in its phosphorylation.展开更多
AIM: To evaluate the clinical, radiological, and treatment features of lacrimal gland tumors.METHODS: Retrospective review of 99 eyes of 92 patients with lacrimal gland tumors diagnosed and managed in a single institu...AIM: To evaluate the clinical, radiological, and treatment features of lacrimal gland tumors.METHODS: Retrospective review of 99 eyes of 92 patients with lacrimal gland tumors diagnosed and managed in a single institution between January 1999 and March 2017. Clinical and radiological features, histopathology, treatment methods, and prognosis were evaluated.RESULTS: The mean patient age was 40.3(range: 7-80)y.The diagnosis was made histopathologically in 91(91.9%) tumors and on a clinical and radiological basis in 8(8.1%) tumors. Final diagnoses included idiopathic orbital inflammation(pseudotumor) in 46(46.5%) lesions, pleomorphic adenoma in 14(14.1%), adenoid cystic carcinoma in 12(12.1%), granulomatous inflammation in 10(10.1%), lymphoma in 5(5.0%), benign reactive lymphoid hyperplasia in 3(3.0%), dacryops in 3(3.0%), carcinoma ex pleomorphic adenoma in 2(2.0%), adenocarcinoma in 1(1.0%), dermoid cyst in 1(1.0%), cavernous hemangioma in 1(1.0%), and leukemic infiltration in 1(1.0%). Nonepithelial tumors comprised 64.6%(n=64) of all lacrimal gland tumors, epithelial tumors 32.3%(n=32), dermoid cyst 1%(n=1), cavernous hemangioma 1%(n=1), and leukemic infiltration 1%(n=1). There were in total 78(78.8%) benign and 21(21.2%) malignant tumors. CONCLUSION: Overall, 65% of lacrimal gland tumors were of non-epithelial origin and 32% of epithelial origin. By histopathology and clinical evaluation, 79% of lacrimal gland tumors were benign. The most common lacrimal gland tumors include idiopathic orbital inflammation(46.5%), epithelial(32.3%), and lymphoproliferative(8.1%) lesions.展开更多
AIM:To determine whether Chinese herbs (CHs) relieve xerostomia (dry mouth) by increasing salivary secretion.METHODS: The submandibular glands of Wistar rats were surgically isolated and perfused arterially with buffe...AIM:To determine whether Chinese herbs (CHs) relieve xerostomia (dry mouth) by increasing salivary secretion.METHODS: The submandibular glands of Wistar rats were surgically isolated and perfused arterially with buffered salt solution. After control perfusion, recording started 5 min prior to the start of stimulation. After fluid secretion was induced by 0.2 μmol/L carbamylcholine (CCh) in the perfusate for 10 min, Chinese herb (CH) was added in the perfusion for 5 min. CCh was then overloaded at 0.2 μmol/L in the perfusion for 20 min. The volume of salivary fluid secretion was recorded by a computer-controlled balance system.RESULTS: Saliva secretion formed an initial ephemeral peak at 30 s followed by a gradual increase to a sustained level. CH alone induced no or little saliva in all types of CH selected. During perfusion with CH,overloading of CCh promoted fluid secretion in 15 of 20 CHs. This promotion was classified into four patterns, which were eventually related to the categories of CH: Overall sustained phase was continuously raised (Yin-nourishing, fluid production-promoting and heat-clearing agents); The sustained secretion rose to reach a maximum then decreased (Qi-enhancing agent); Sustained secretion rose to reach the highest maximum and was then sustained with a slight decline (swelling-reducing, phlegm-resolving and pus-expelling agents); Stimulation of salivary secretion without any added stimulants. Addition of CCh raised the fluid secretion to reach the highest maximum then sharply decreased to a lower sustained level (blood activating agent).CONCLUSION: The present findings lead to the conclusion that various CHs have different promotional effects directly on the salivary gland.展开更多
Objective: Mucoepidermoid carcinoma(MEC) is the most common primary malignancy of the salivary glands. Insulin-like growth factor-II m RNA-binding protein-3(IMP3) is an important prognostic factor in some cancers and ...Objective: Mucoepidermoid carcinoma(MEC) is the most common primary malignancy of the salivary glands. Insulin-like growth factor-II m RNA-binding protein-3(IMP3) is an important prognostic factor in some cancers and a tool that differentiates between benign and malignant pancreatic lesions. This study aimed to identify a relationship between the expression of IMP3 and the outcome of salivary gland MEC, as well as to differentiate MEC from pleomorphic adenoma(PA).Methods: Tissue specimens from 70 cases of salivary gland MEC, 40 cases of PA, and 10 cases with normal salivary gland were examined immunohistochemically for IMP3. The association among the expression of IMP3, clinicopathological characteristics and patient's survival was assessed.Results: IMP3 was present in 51.4% of MEC but absent in PA and normal salivary gland tissues. IMP3 expression was associated with age > 60 years, submandibular gland tumors, tumor size > 4 cm, high-grade tumors, lymph node metastasis, involvement of surgical margins, perineural invasion, distant metastasis, advanced TNM stage, tumor relapse, and death(P<0.05). Increased expression of IMP3, tumors of the submandibular gland, and lymph node metastasis were independent prognostic factors of disease-free survival(DFS). In addition, IMP3 was a strong predictor of overall survival(OS) together with distant metastasis and intermediate and high-grade tumors.Conclusions: IMP3 expression is highly important in evaluating the outcome of MEC. IMP3 can be used to differentiate MEC from PA of salivary glands.展开更多
Salivary glands are complex in nature. They could be either tubulo acinar, merocrine or exocrine glands secreting mainly saliva. Salivary gland is one of the main soft tissue structures in the maxillofacial area. Sali...Salivary glands are complex in nature. They could be either tubulo acinar, merocrine or exocrine glands secreting mainly saliva. Salivary gland is one of the main soft tissue structures in the maxillofacial area. Saliva is a clear, slightly acidic muco serous fluid that coats the teeth, mucosa and thereby helps to create and maintain a healthy environment in the oral cavity. Salivary glands may be affected by a number of diseases: local and systemic and the prevalence of salivary gland diseases depend on various etiological factors. The glands may be infected byviral, bacterial, rarely fungal or its ductal obstruction which may cause painful swelling or obstruction, affecting their functions. The salivary gland may also be affected by a various benign and malignant tumours. This review article briefly describes about the various salivary gland disorders, diagnostic techniques and their management including the recent advances and the future perspective.展开更多
BACKGROUND Solitary fibrous tumor(SFT)is an uncommon mesenchymal neoplasm that arises from the pleura.A few SFTs have also been described in extrapleural sites.However,SFT of the thyroid gland is rare.Here,we report a...BACKGROUND Solitary fibrous tumor(SFT)is an uncommon mesenchymal neoplasm that arises from the pleura.A few SFTs have also been described in extrapleural sites.However,SFT of the thyroid gland is rare.Here,we report a case of extrapleural SFT on the thyroid gland,in addition to a literature review.CASE SUMMARY A 59-year-old man visited our hospital in July 2017 complaining of a large mass in his neck.His thyroid function test results,including antibody levels,were within the normal limits.Ultrasonography showed a 4.7 cm×4.0 cm×3.2 cm solitary mass of intermediate suspicion in the left thyroid lobe.A fine-needle aspiration biopsy was subsequently performed.The pathologist reported a benign follicular lesion.However,the size of this nodule increased to 5.5 cm×5.0 cm×3.4 cm by April 2018.After a multidisciplinary discussion,a left lobectomy was performed in May 2018.The specimen showed a well-demarcated,partly encapsulated,soft nodule of whitish and tan/brown color on the cut surface.Light microscopy revealed high cellularity with moderate cytologic atypia.The mitotic count was 5/10 high-power fields.There was no tumor necrosis or lymphovascular invasion.The tumor was CD34-positive and signal transducer and activator of transcription 6-positive.Neither thyroid transcription factor-1 nor cytokeratin expression was detected.The Ki-67 showed intermediate proliferative activity.The final diagnosis was extrapleural SFT of the thyroid gland with a clear resection margin.The patient was discharged without complication three days after the surgery.CONCLUSION In the literature,extrapleural SFT of the thyroid gland has been reported to behave indolently with the capacity for recurrence and rare metastasis,although surgical resection is the treatment of choice.Understanding this disease entity is important for accurate diagnosis and proper management.展开更多
文摘Salivary gland tumors(SGTs)make up a small portion(approximately 5%)of all head and neck tumors.Most of them are located in the parotid glands,while they are less frequently located in the submandibular glands,minor salivary glands or sublingual gland.The incidence of malignant or benign tumors(BTs)in the salivary glands varies according to the salivary gland from which they originate.While most of those detected in the parotid gland tend to be benign,the incidence of malignancy increases in other glands.The use of magnetic resonance imaging(MRI)in the diagnosis of SGTs is increasing every day.While conventional sequences provide sufficient data on the presence,localization,extent and number of the tumor,they are insufficient for tumor specification.With the widespread use of advanced techniques such as diffusion-weighted imaging,semiquantitative and quantitative perfusion MRI,studies and data have been published on the differentiation of malignant or BTs and the specificity of their subtypes.With diffusion MRI,differentiation can be made by utilizing the cellularity and microstructural properties of tumors.For example,SGTs such as high cellular Warthin’s tumor(WT)or lymphoma on diffusion MRI have been reported to have significantly lower apparent diffusion values than other tumors.Contrast agent uptake and wash-out levels of tumors can be detected with semiquantitative perfusion MRI.For example,it is reported that almost all of the pleomorphic adenomas show an increasing enhancement time intensity curve and do not wash-out.On quantitative perfusion MRI studies using perfusion parameters such as Ktrans,Kep,and Ve,it is reported that WTs can show higher Kep and lower Ve values than other tumors.In this study,the contribution of advanced MRI to the diagnosis and differential diagnosis of SGTs will be reviewed.
文摘Salivary gland tumors represent 2% - 6.5% of all head and neck tumors. Since salivary gland tumors have various clinical features and histological types, it is often difficult to diagnose and treat them. The aim of this study was to conduct a retrospective clinical-statistical analysis of 37 minor salivary gland tumors (MSGTs) treated in the Department of Oral Surgery at Nihon University School of Dentistry at Matsudo over a 16-year period. The frequencies and distributions of sex, age, occurrence site, preoperative examination (fine needle cytology and/or biopsy), treatment, and prognosis of the tumors were analyzed and compared with previous reports. The average age at diagnosis was 58.1 years (range 22 - 91 years). The peak occurrence of tumors was in the sixties (10 cases, 27.0%), followed by the forties (8 cases, 21.6%) and the seventies (7 cases, 18.9%). The average age of patients with benign tumors was 56.8 years (range 22 - 91 years). For malignant tumors, the average age was 61.7 years (range 42 - 81 years). The male-female ratio was 1:2.1 for all minor salivary gland tumors, 1:2.4 for benign tumors, and 1.5:1 for malignant tumors. There were 27 (73.0%) benign and 10 (27.0%) malignant tumors. Pleomorphic adenoma (PA) was the most common tumor (24 (64.9%) cases). Most salivary gland tumors originated from the palate (21 cases, 56.8%);the second most common site was the buccal mucosa (14 cases, 37.8%). For most patients, an intraoral mass was the primary presentation, and the second most common symptom was swelling. Surgical treatment was performed for all cases, both benign and malignant tumors. There was one case of local recurrence of PA, as well as one of multiple lung metastases after surgery for adenoid cystic carcinoma. Diagnosis and treatment of MSGTs are often delayed because the patients have few symptoms, and it is difficult to distinguish benign from malignant tumors. More cases need to be examined in the future, and the diagnostic accuracy of imaging and histopathological diagnosis needs to be improved.
文摘<strong>Objective:</strong><span style="font-family:""><span style="font-family:Verdana;"> Concurrent chemoradiation value of the resected salivary tumor adjuvant context against regular radiation therapy alone. </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> Prospective randomized clinical trial. </span><b><span style="font-family:Verdana;">Patients:</span></b><span style="font-family:Verdana;"> 48 patients were randomized to either adjuvant postoperative radiology alone versus concurrent chemoradiotherapy (weekly cisplatin 40 mg/m</span><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> for 6 cycles) “with resected high-risk salivary tumors of the large and minor salivary gland”. </span><b><span style="font-family:Verdana;">Main</span></b> <b><span style="font-family:Verdana;">Outcome</span></b> <b><span style="font-family:Verdana;">Measures:</span></b><span style="font-family:Verdana;"> Recurrent locoregional Free survival, distant free survival, and overall survival. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Out of the 48 participants in the study 31 patients had parotid gland tumors. 23 patients received solely adjuvant radiation while 25 patients received concurrent chemoradiotherapy. In the chemoradiation group, platinum-based regimens were employed in all. The mean age in both groups was 48 years. Adenoid cystic carcinoma was the primary pathogenic form of both arms 56% (28 cases). Stage II patients were 35% and 32%, stage III was 39% and 48% and stage VIa were 26% and 20% in the radiation arm and chemoradiotherapy arm respectively. 40 of 48 patients (83%) had close or positive surgical margins and 30 of 48 patients (62%) have a perineural invasion. Both risk variables are more or less well balanced in both arms with no statistical difference. The 2- and 4-year estimates of the locoregional recurrence-free survival rate in the chemoradiation group were 95% and 73%, compared to 77.4% and 43.6% in the radiation arm respectively (p = 007). In the two-and four-year-old chemoradiation arm distant free metastases were 100% and 59% compared to 68% and 39% respectively in the radiation arm (p = 0.08). The overall survival estimates for 2 and 4 years were 93% and 78% respectively in the Chemoradiation Group but in the radiation-alone group were 95% and 48% respectively. The statistically significant differences were p = 0.009 by log-rank testing. Treatment was generally tolerated, although, in the chemoradiation group adverse symptoms, mainly mucositis increased. </span><b><span style="font-family:Verdana;">Conclusions:</span></b><span style="font-family:Verdana;"> Adding weekly cisplatin as a radiosensitizer for locally advanced stage or high-grade salivary gland cancer with adjuvant conventional radiation looks to be helpful and justifies further exploration in selected patients.</span></span>
文摘Secretory carcinoma(SC), previously described as mammary analogue secretory carcinoma(MASC), is a recently described salivary gland tumor which morphologically resembles mammary secretory carcinoma. The first description of SC/MASC, reported by Skálová et al. in 2010, was as a rare salivary carcinoma imitating secretory carcinoma of the breast. SC/MASC is a unique salivary gland tumor with morphological overlap with acinic cell carcinoma(Aci CC), mucoepidermoid carcinoma(MEC), and adenocarcinoma not otherwise specified(ADCNOS). SC/MASC shares similar clinicopathological features with Aci CC. As a critical difference between SC/MASC and Aci CC, SC/MASC characteristically has the chromosomal translocation t(12;15)(p13;q25) which leads to a fusion gene between the ETV6 gene on chromosome 12 and the NTRK3 gene on chromosome 15. This genetic background is an important differential diagnostic finding for excluding other salivary gland tumors and may be a critical factor determining the prognosis for patients with SC/MASC. Research in recent years has provided a large body of new data on SC/MASC and suggests the possibility that the ETV6-NTRK3 translocation could be a therapeutic target. Here, we review the morphological and clinicopathological features of SC/MASC and discuss new directions for therapy.
文摘Background: Salivary gland tumours (SGTs) are rare, but recent reports suggest an increasing incidence. Although there are previous Nigerian studies on the patterns of SGTs, patterns and trends of disease may change over time. The aim of this study was to describe the pattern of presentation of SGTs, and to determine the trends in occurrence of SGTs at Federal Teaching Hospital (FTH), Gombe over a period of 15 years. Method: This descriptive study included cases of histologically diagnosed SGTs from January 2008 to December 2022. Relevant information (age, gender, site, year of diagnosis, and histopathologic diagnosis) was extracted from the cancer registers and histopathologic records. The lesions were then categorized into benign and malignant SGTs and grouped into three groups spanning 5 years each based on the year of diagnosis. Data analysis was done using IBM SPSS version 23, and p ≤ 0.05 was considered statistically significant. Results: There were 93 (61.2%) benign and 59 (38.8%) malignant SGTs. Benign SGTs had a mean age of 36.4 ± 13.6 years, and were more common in females (57.0%), and in the parotid (41.9%). Pleomorphic adenoma (94.6%) was the most common benign SGT. Malignant SGTs had a mean age of 44.5 ± 18.4 years, with male predilection (54.2%) and occurrence mostly in the palate (27.6%) and parotid (22.4%). Mucoepidermoid carcinoma (39.0%) and adenoid cystic carcinoma (32.2%) were the most frequent malignant SGTs. The mean age of occurrence of malignant SGTs was significantly higher than that of benign SGTs (p = 0.005). The trend analysis showed that there has been a steady rise in the proportion of males presenting with malignant SGTs. Similarly, there has been a steady increase in the frequency of benign SGTs in the parotid. The palate was the predominant site for the malignant SGTs between 2008 and 2012, but in the last five years (2018 to 2022), the parotid has become the predominant site. Over the duration of the study, the ratio of benign to malignant SGTs has remained relatively constant. Conclusion: While the overall pattern of presentation of SGTs in Gombe is similar to reports in the literature, this study has identified some changes in trends over the years.
文摘Transforming growth factor-β (TGF-β) and bone morphogenetic protein (BMP)were related to embryonic development and the differentiation of many types of cells. Recent studies showed that they might play an important role in regulating the differentiation o
文摘A 66-year-old woman presented with a 2-year history of asthma has progression of dyspnea within a week, and a computed tomography (CT) revealed an endotracheal tumor at level of aortic arch. The resected tumor, measured by 18 × 12 × 10 mm, has histologically malignant features including frank invasion with desmoplastic stroma and foci of necrosis. Presence of glycogen and mucin was confirmed by periodic acid-Schiff (PAS) and diastase PAS staining. Immunohistochemically, the tumor cells were diffusely positive for cytokeratin (CK) 7 and AE1/3, focally positive for CK5/6 and CK14, but negative for CK20. Thyroid transcription factor-1 (TTF-1), Napsin A, and SP-A, indicating lung parenchymal origin were all negative. Other muscular markers, neuroendocrine markers, renal cell carcinoma markers, and markers related to perivascular epithelioid cell tumors were all negative. Postoperative systemic examination suggests no primary tumor outside the lung. The follow up was excellent being recurrence free for 14 months in spite of the positive surgical margin by the tumor cells. This is a first report ?of rare neoplasm, clear cell carcinoma of salivary gland type, presenting as an endotracheal mass.
基金Science and Technology Program of Sichuan Province,China,No.2022YFS0289.
文摘BACKGROUND Salivary carcinosarcoma is an extremely rare tumor containing both malignant epithelial and mesenchymal constituents.This article reports a rare case of carcinosarcoma with salivary duct carcinoma and osteosarcoma as the tumor components.The clinicopathological characteristics,treatment,and prognosis are discussed in conjunction with the literature.CASE SUMMARY A 48-year-old man presented with a complaint of a mass in the right parotid region.Osteosarcoma was first considered for assessment by fine-needle aspiration cytology.Physical examination revealed a mass measuring approximately 4 cm×3.5 cm×3 cm.The mass,the whole lobe of the right parotid gland,and the right mandible were completely removed during surgery.Postoperative histopathology confirmed carcinosarcoma of the salivary gland.CONCLUSION A definite diagnosis of salivary gland carcinosarcoma can only be obtained after complete surgical resection.
文摘AIM:To present computed tomography(CT) findings of different histological subtypes of parotid gland masses in detail and to establish diagnostic strategy.METHODS:From January 2009 to November 2011,56 patients were collected through the histopathology and Picture Archiving and Communication Systems records,which revealed 5 basal cell adenoma(BCA),16 pleomorphic adenoma(PA),25 Warthin's tumor(War-T),3 Kimura's disease(KD) and 7 parotid carcinoma(PCa) cases.All the CT images were retrospectively analyzed by two radiologists in consensus,based on their description of morphology(location,number,size,margin and fibrous capsule) and enhancement patterns of masses.In addition,the diagnostic efficiency of diagnostic strategy is tested.RESULTS:War-T and BCA patients' mean age was 59.9 ± 12.6 years and 58.4 ± 18.2 years;the significant difference was seen in War-T vs PA and BCA vs PA.About 40% of War-Ts presented with bilateral multifocal lesions,a higher ratio than others.Seventy two percent of War-Ts were limited to the superficial lobe,followed by BCA 60% and PA 40%.Vessel facing sign and enlarged lymph nodes were both frequent in War-T,which respectively accounts for 84% and 76% of cases.Rapid contrast enhancement and decreases were unique for War-T.BCA and PA showed obvious delayed enhancement.The diagnostic strategy of parotid gland tumor had a good diagnostic efficiency,with high accuracy,sensitivity and specificity.CONCLUSION:Determination of the histological subtypes of parotid gland masses might be possible based on CT findings and clinical data.A diagnostic strategy with high diagnostic efficiency was established.
基金the financial support from the National Foundation of Natural and Science China (grant nos 81671005, 39270723, 39470753, 30572050, and 03031102)
文摘The principle of modern oncological surgery is to conserve the functional organs or tissues as much as possible based on eradication of the tumour.For salivary gland tumours,conservative and functional salivary surgery,including partial sialoadenectomy as well as anatomical and functional preservation of the facial nerve,great auricular nerve,superficial musculoaponeurotic system (SMAS),and Stensen’s duct,has become increasingly popular.In the present review,we discuss the following aspects of conservative and functional surgery in the treatment of salivary gland tumours:(i) partial superficial parotidectomy (PP) to treat benign parotid gland tumours,(ii) modification of surgical incisions to improve cosmetic results,(iii) modification of the surgical approach to decrease complications,(iv) extracardial dissection to treat benign superficial parotid tumours,(v) partial sialoadenectomy to treat benign submandibular gland tumours,and (vi) 125I brachytherapy to preserve facial nerves.The majority of the operated parotid or submandibular glands are preserved,and surgical complications are also decreased.Conservative and functional surgery plays a significant role in maintaining normal salivary gland function and in improving patients’ quality of life during the treatment of salivary gland tumours and thus should be further promoted.
文摘Gastric adenocarcinoma is one of the most common malignancies worldwide.Histochemical and immunohistologic analyses classify the phenotypes of gastric adenocarcinoma into several groups based on the variable clinical and pathologic features.A new and rare variant of gastric adenocarcinoma with chief cell differentiation(GA-CCD)has recently been recognized.Studies reporting the distinct clinicopathologic characteristics proposed the term oxyntic gland polyp/adenoma because of the benign nature of the GACCD.Typically,GA-CCD is a solitary mucosal lesion that develops either in the gastric cardia or fundus.Histologically,this lesion is characterized by tightly clustered glands and anastomosing cords of chief cells.Immunohistochemically,GA-CCD is diffusely positive for mucin(MUC)6 and negative for MUC2and MUC5AC.However,other gastric tumors such as a gastric neuroendocrine tumor or fundic gland polyp have been difficult to exclude.Because GA-CCD tends to be endoscopically misdiagnosed as a neuroendocrine tumor or fundic gland polyp,comprehensive assessment and observation by an endoscopist are strongly recommended.Herein,we report a rare case of oxyntic gland adenoma endoscopically mimicking a gastric neuroendocrine tumor that was successfully removed by endoscopic mucosal resection.
文摘Ghrelin, a peptide hormone, newly identified in oral mucosal tissue, has emerged re-cently as a principal modulator of the in-flammatory responses to bacterial infection through the regulation of nitric oxide syn-thase system. In this study, using rat sub-lingual salivary gland acinar cells, we report that lipopolysaccharide (LPS) of periodon-topathic bacterium, P. gingivalis- induced enhancement in the activity of inducible ni-tric oxide synthase (iNOS) was associated with the suppression in Akt kinase activity and the impairment in constitutive (c) cNOS phosphorylation. Further, we show that the detrimental effect of the LPS on Akt activa-tion, manifested in the kinase protein S-nitrosylation and a decrease in its phos-phorylation at Ser473, was susceptible to suppression by iNOS inhibitor, 1400W. Moreover, we demonstrate that a peptide hormone, ghrelin, countered the LPS- induced changes in Akt activity and NOS system. This effect of ghrelin was reflected in the decreased in Akt S-nitrosylation and the increase in its phosphorylation at Ser473, as well as cNOS activation through phos-phorylation. Our findings suggest that P. gingivalis-induced up-regulation in iNOS leads to Akt kinase inactivation through S-nitrosylation that impacts cNOS activation through phosphorylation. We also show that the countering effect of ghrelin on P. gingivalis-induced disturbances in Akt ac-tivation are manifested in a decrease in the kinase S-nitrosylation and the increase in its phosphorylation.
文摘AIM: To evaluate the clinical, radiological, and treatment features of lacrimal gland tumors.METHODS: Retrospective review of 99 eyes of 92 patients with lacrimal gland tumors diagnosed and managed in a single institution between January 1999 and March 2017. Clinical and radiological features, histopathology, treatment methods, and prognosis were evaluated.RESULTS: The mean patient age was 40.3(range: 7-80)y.The diagnosis was made histopathologically in 91(91.9%) tumors and on a clinical and radiological basis in 8(8.1%) tumors. Final diagnoses included idiopathic orbital inflammation(pseudotumor) in 46(46.5%) lesions, pleomorphic adenoma in 14(14.1%), adenoid cystic carcinoma in 12(12.1%), granulomatous inflammation in 10(10.1%), lymphoma in 5(5.0%), benign reactive lymphoid hyperplasia in 3(3.0%), dacryops in 3(3.0%), carcinoma ex pleomorphic adenoma in 2(2.0%), adenocarcinoma in 1(1.0%), dermoid cyst in 1(1.0%), cavernous hemangioma in 1(1.0%), and leukemic infiltration in 1(1.0%). Nonepithelial tumors comprised 64.6%(n=64) of all lacrimal gland tumors, epithelial tumors 32.3%(n=32), dermoid cyst 1%(n=1), cavernous hemangioma 1%(n=1), and leukemic infiltration 1%(n=1). There were in total 78(78.8%) benign and 21(21.2%) malignant tumors. CONCLUSION: Overall, 65% of lacrimal gland tumors were of non-epithelial origin and 32% of epithelial origin. By histopathology and clinical evaluation, 79% of lacrimal gland tumors were benign. The most common lacrimal gland tumors include idiopathic orbital inflammation(46.5%), epithelial(32.3%), and lymphoproliferative(8.1%) lesions.
基金Supported by Cooperation survey and research project of the Nippon Foundation of the Japan-China Medical Association (2006-12)the International cooperation project (BZ2006058) of Bureau of Science and Technology of Jiangsu Province,China
文摘AIM:To determine whether Chinese herbs (CHs) relieve xerostomia (dry mouth) by increasing salivary secretion.METHODS: The submandibular glands of Wistar rats were surgically isolated and perfused arterially with buffered salt solution. After control perfusion, recording started 5 min prior to the start of stimulation. After fluid secretion was induced by 0.2 μmol/L carbamylcholine (CCh) in the perfusate for 10 min, Chinese herb (CH) was added in the perfusion for 5 min. CCh was then overloaded at 0.2 μmol/L in the perfusion for 20 min. The volume of salivary fluid secretion was recorded by a computer-controlled balance system.RESULTS: Saliva secretion formed an initial ephemeral peak at 30 s followed by a gradual increase to a sustained level. CH alone induced no or little saliva in all types of CH selected. During perfusion with CH,overloading of CCh promoted fluid secretion in 15 of 20 CHs. This promotion was classified into four patterns, which were eventually related to the categories of CH: Overall sustained phase was continuously raised (Yin-nourishing, fluid production-promoting and heat-clearing agents); The sustained secretion rose to reach a maximum then decreased (Qi-enhancing agent); Sustained secretion rose to reach the highest maximum and was then sustained with a slight decline (swelling-reducing, phlegm-resolving and pus-expelling agents); Stimulation of salivary secretion without any added stimulants. Addition of CCh raised the fluid secretion to reach the highest maximum then sharply decreased to a lower sustained level (blood activating agent).CONCLUSION: The present findings lead to the conclusion that various CHs have different promotional effects directly on the salivary gland.
文摘Objective: Mucoepidermoid carcinoma(MEC) is the most common primary malignancy of the salivary glands. Insulin-like growth factor-II m RNA-binding protein-3(IMP3) is an important prognostic factor in some cancers and a tool that differentiates between benign and malignant pancreatic lesions. This study aimed to identify a relationship between the expression of IMP3 and the outcome of salivary gland MEC, as well as to differentiate MEC from pleomorphic adenoma(PA).Methods: Tissue specimens from 70 cases of salivary gland MEC, 40 cases of PA, and 10 cases with normal salivary gland were examined immunohistochemically for IMP3. The association among the expression of IMP3, clinicopathological characteristics and patient's survival was assessed.Results: IMP3 was present in 51.4% of MEC but absent in PA and normal salivary gland tissues. IMP3 expression was associated with age > 60 years, submandibular gland tumors, tumor size > 4 cm, high-grade tumors, lymph node metastasis, involvement of surgical margins, perineural invasion, distant metastasis, advanced TNM stage, tumor relapse, and death(P<0.05). Increased expression of IMP3, tumors of the submandibular gland, and lymph node metastasis were independent prognostic factors of disease-free survival(DFS). In addition, IMP3 was a strong predictor of overall survival(OS) together with distant metastasis and intermediate and high-grade tumors.Conclusions: IMP3 expression is highly important in evaluating the outcome of MEC. IMP3 can be used to differentiate MEC from PA of salivary glands.
文摘Salivary glands are complex in nature. They could be either tubulo acinar, merocrine or exocrine glands secreting mainly saliva. Salivary gland is one of the main soft tissue structures in the maxillofacial area. Saliva is a clear, slightly acidic muco serous fluid that coats the teeth, mucosa and thereby helps to create and maintain a healthy environment in the oral cavity. Salivary glands may be affected by a number of diseases: local and systemic and the prevalence of salivary gland diseases depend on various etiological factors. The glands may be infected byviral, bacterial, rarely fungal or its ductal obstruction which may cause painful swelling or obstruction, affecting their functions. The salivary gland may also be affected by a various benign and malignant tumours. This review article briefly describes about the various salivary gland disorders, diagnostic techniques and their management including the recent advances and the future perspective.
基金Supported by the National Research Foundation of Korea grant funded by the Korea government,No.2019R1G1A1004679
文摘BACKGROUND Solitary fibrous tumor(SFT)is an uncommon mesenchymal neoplasm that arises from the pleura.A few SFTs have also been described in extrapleural sites.However,SFT of the thyroid gland is rare.Here,we report a case of extrapleural SFT on the thyroid gland,in addition to a literature review.CASE SUMMARY A 59-year-old man visited our hospital in July 2017 complaining of a large mass in his neck.His thyroid function test results,including antibody levels,were within the normal limits.Ultrasonography showed a 4.7 cm×4.0 cm×3.2 cm solitary mass of intermediate suspicion in the left thyroid lobe.A fine-needle aspiration biopsy was subsequently performed.The pathologist reported a benign follicular lesion.However,the size of this nodule increased to 5.5 cm×5.0 cm×3.4 cm by April 2018.After a multidisciplinary discussion,a left lobectomy was performed in May 2018.The specimen showed a well-demarcated,partly encapsulated,soft nodule of whitish and tan/brown color on the cut surface.Light microscopy revealed high cellularity with moderate cytologic atypia.The mitotic count was 5/10 high-power fields.There was no tumor necrosis or lymphovascular invasion.The tumor was CD34-positive and signal transducer and activator of transcription 6-positive.Neither thyroid transcription factor-1 nor cytokeratin expression was detected.The Ki-67 showed intermediate proliferative activity.The final diagnosis was extrapleural SFT of the thyroid gland with a clear resection margin.The patient was discharged without complication three days after the surgery.CONCLUSION In the literature,extrapleural SFT of the thyroid gland has been reported to behave indolently with the capacity for recurrence and rare metastasis,although surgical resection is the treatment of choice.Understanding this disease entity is important for accurate diagnosis and proper management.
