原文題目

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口腔病理科 On-Line KMU Student Bulletin

原文題目(出處)： Sialolipoma in Minor Salivary Gland: Case Report and Review of the Literature. Head and Neck Pathol 2010;4:249-252

原文作者姓名： Maiara de Moraes, Felipe Rodrigues de Matos, Cyntia Pereira de Carvalho, Ana Miryam Costa de Medeiros, Le´lia Batista de Souza

通訊作者學校： Departamento de Odontologia, Universidade Federal do Rio Grande do Norte, Av. Senador Salgado Filho, 1787, Lagoa Nova, Natal, RN CEP 59056-000, Brasil

報告者姓名(組別)： Intern C 組陳盈文

報告日期： 99.10.11

1. Introduction

 Lipomas

(1) In oral cavity are uncommon with a reported incidence of 1~4.4%

(2) Located at any oral site : buccal mucasa, tonque, palate, lip, salivary gland

 Sialolipoma

(1) A rare benign neoplasm

(2) Well-circumscribed and encapsulated by thin fibrous tissue

(3) Characterized by islands of epithelial salivary gland elements enclosed in mature adipose tissue

(4) Share similar clinical features with conventional lipomas of salivary gland : age, gender, sloe-growing symptom-free

(5) Most reported cases occur in parotid gland followed by palate

(6) In parotid gland, epithelial elements are sparsely distributed throughout the tumor

(7) In palatal region, the epithelial components are clustered.

(8) The amount of adipose tissue : from 50% in minor salivary glands to 90% in major salivary glands

2. Case report

 Patient’s data (1) Age : 72

(2) Gender : black female

(3) Smoke for more than 20 years (recently quit) (4) No specific medical history

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 Lesion

(1) Located: hard palate (2) Painless swelling (3) Identified 15 days ago (4) Size: 2 cm

(5) Clinical examination: asymptomatic mass (6) Palpation: palpable, movable, soft

(7) Color: normal color with purple points

 Clinical impression : a minor salivary gland tumor, such as pleomorphic adenoma

 Intraoperative impression: lipoma

 Excisional biopsy was performed and the specimen floated in the formalin solution

 Gross examination (1) Size: 1.7×1.3×0.6 cm

(2) A soft, yellow, well-delineated mass

(3) Consistency: lobular proliferation of the lipomatous tissue with thin fibrous tissue septa containing clustered salivary gland elements

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(4) Both glandular and adipose components were found in almost equal proportion

(5) The acinar cells were mucous and showed acinar atrophy & fibrosis (6) Duct ectasia and basophilic amorphous material compatible with mucin (7) No atypia in the adipose tissue

 No clinical sign of recurrence for 8 months after surgical excision

3. Review of literature

 35^th reported sialolipoma and 16^th case in the minor salivary gland in the English literature

 Through the 16 case in the minor salivary gland (1) Age: 27~84 years (mean: 61.6)

(2) Gender: 4 male (28.5%) 10 female (71.5%)

(3) Tumor size: 0.9~4 cm (mean : 1.7 cm)

(4) Clinical presentation: most frequently a painless swelling (56.3%) (5) Site: no preference (soft & hard palate, tongue, buccal mucosa, floor of

mouth, buccal sulcus, retromolar pad, lower lip) (6) Palate is the most common site with 6 cases (37.5%)

 Buccal mucosa is the site most commonly affected by oral lipomas (30.5~45.7%)

 4 to 6 reported sialolipoma of minor salivary gland have similar clinical impression of a benign salivary gland tumor such as pleomorphic adenoma

4. Discussion

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 Lipoma is a common soft tissue tumor, but it rarely occurs in salivary gland

 Sialolipoma is a lipoma with normal salivary gland elements

 Sialolipoma is considered as a distinct variant of salivary gland lipoma

 Some authors have reported an intense lymphoid infiltrate, marked ductal dilatation, fibrosis and myxoid change in adipose tissue

 Differential diagnosis with lipomatosis and pleomorphic adenoma with extensive adipose content

 The treatment of sialolipoma is surgical excision

 Neither local recurrence nor malignant transformation has been reported

題號題目

1

以下對於 lipoma 的敘述何者錯誤？

(A) 長在 salivary gland 的 lipoma 含有 salivary gland elements (B) 當攝取的卡洛里減少時，lipoma 並不會縮小

(C) 通常 lipoma 不會有症狀產生，在確診前常常已存在很久 (D) 一般來說，lipoma 的大小不會超過 3 cm

答案

(A)

出處：Oral & Maxillofacial Pathology/2^nd edition/Brad W. Neville, Douglas D. Damm, Carl M. Allen, Jerry E. Bouquot/P.452,453

題號題目

2

以下對於 lipoma 的敘述何者正確？

(A) 好發在口內任何地方 (B) 好發在兒童與青少年身上

(C) 好發在女性身上，男女比約略為 1:2 (D) 很容易復發

答案

(C)

出處：Oral & Maxillofacial Pathology/2^nd edition/Brad W. Neville, Douglas D. Damm, Carl M. Allen, Jerry E. Bouquot/P.452,453