Case Report: A Rare Primary Neuroendocrine Tumor (Typical Carcinoid) of the Sublingual Gland

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口腔病理科 On-Line KMU Student Bulletin

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原文題目(出處)：

Case Report: A Rare Primary Neuroendocrine Tumor (Typical Carcinoid) of the Sublingual Gland

原文作者姓名：

Kenji Yamagata, Kousuke Ohki, Fumihiko Uchida, Naomi Kanno, Shogo Hasegawa, Toru Yanagawa, and Hiroki Bukawa

通訊作者學校： Department of Oral and Maxillofacial Surgery, Institute of Clinical Medicine, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan

Department of Oral and Maxillofacial Surgery, Ishioka Daiichi Hospital, Ishioka, Japan

報告者姓名(組別)： 陳牧心(D 組) 報告日期：

105/11/03

內文：

1. Introduction

1) heterogeneous, ranging from benign to malignant.

2) Typical carcinoid is a well-differentiated neuroendocrine carcinoma.

3) Most carcinoids occurring in the head and neck area are found in the larynx.

4) First case of a typical carcinoid in the oral cavity was reported in 2011, and 2 cases so far.

2. Case report

1) 62-year-old woman had swelling in the sublingual gland for 9 months, with no pain.

2) PMH: hypertension, hyperlipidemia, and cerebral infarction.

3) Regional lymph nodes were normal, and the submandibular gland was hard and swollen.

4) Elastic mass measuring 28 × 13mm on the left side of the floor of her mouth, mucosal surface was normal, with no ulceration.

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5) MRI showed a well-defined tumor of the sublingual gland measuring 28 × 25 × 12mm.

6) FDG-PET depicted a mass measuring 28 × 13mm.

7) The carcinoid was removed by primary excision performed extraorally under GA.

8) One year f/u, there was no tumor recurrence or neck metastasis.

9) The resected tumor was 26 × 24 × 12 mm, whitish in color and solid in consistency.

10) HE staining: nuclei were round and varied in size, highly vascularized, hyalinized stroma.

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11) Immunohistochemical staining: CD56 (+), chromogranin A (+), and synaptophysin (−).

12) A pathological diagnosis of typical carcinoid of the sublingual gland was made based on above exam.

3. Discussion

1) Carcinoid tumors are usually found in the gastrointestinal tract or the bronchopulmonary tract.

2) Typical carcinoid tumor: a tumor with a neuroendocrine/carcinoid morphology, mitotic rate of less than 2/10HPF, and absence of necrosis.

3) Typical carcinoids are rare, it is still difficult to describe their clinical behavior or prognosis.

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5) 2005 WHO classification: atypical carcinoid tumors more mitotic than the typical carcinoids.

6) Immunohistochemically, NETs are positively(>1) stained by chromogranin A, synaptophysin, CD57, or CD56. (In this case, CD56 and chromogranin A are positive)

7) Radiation and chemotherapy are ineffective against typical carcinoids.

8) Carcinoid of the larynx: metastases 33%, 5-year survival rate is 48%. In all 3 reported cases of oral typical carcinoid, they did not recur during the follow-up period (1-2 years).

題號題目

1 以下對於 multiple endocrine neoplasia (MEN) type 2B 之敘述，何者錯誤?

(A) 比起其他種類的 MEN 有更多的口腔表徵

(B) 可在嘴角或舌頭前端看到些許神經瘤(neuroma) (C) 患者的四肢、臉型通常較寬

(D) 組織切片下可見增厚的神經束膜(perineurium) 答案

(C)

出處：Oral and Maxillofacial Pathology

題號題目

2 有關 Merkel cell carcinoma (neuroendocrine carcinoma of skin)之敘述，

何者正確?

(A) 紫外線(UV)的暴露是主要的危險因子 (B) 出現在黑人族群的比例較高

(C) 發生在口腔黏膜的機會高

(D) 在免疫組織化學染色中，對嗜鉻粒蛋白(chromogranin A)，突觸素 (synaptophysin)多呈陰性

答案 (A)

出處：Oral and Maxillofacial Pathology