mucoepidermoid carcinoma
Introduction
Introduction to mucoepidermoid carcinoma Mucoepidermoid carcinoma (mucoepidermoid carcinoma) is also called mucoepidermoid tumor, accounting for 5% to 10% of parotid tumors. Stewart et al. refer to it as a mucoepidermoid tumor based on its clinical features and histological features, and it is divided into benign and malignant types. WHO has also used the name of mucoepidermoid tumor, but many scholars believe that this classification is Inappropriately, this tumor is considered to be malignant and should be called mucoepidermoid carcinoma. According to the degree of differentiation and biological behavior of cancer cells, it is divided into low-grade malignant and highly malignant mucoepidermoid carcinoma. basic knowledge Sickness ratio: 0.001%-0.002% Susceptible people: no specific population Mode of infection: non-infectious Complications: idiopathic facial nerve spasm
Cause
Mucin epidermoid carcinoma etiology
The main components of the tumor are mucin-like cells and epidermal-like cells, and the mucoepidermoid carcinoma is derived from epithelial cells of the glandular duct. Mucin epidermoid carcinoma occurs in the parotid gland, accounting for more than 70%. The small parotid gland is common in the ankle. Other parts, such as the posterior molar region, the cheek, the upper lip, the lower lip, etc., rarely occur, which can occur in Any age, more common in 30 to 50 years old, more women than men, about 1.5:1, highly differentiated people often have painless masses, slow growth, tumor size, borders can be clear or unclear, moderately moderate Hard, the surface can be nodular.
Prevention
Mucus epidermoid cancer prevention
There is no effective prevention method for this disease. Early detection and early treatment are the key to prevention. It is very important to do these above-mentioned dietary health care at ordinary times, and it can help the optimal inhalation of patients with mucous epidermoid cancer optimal nutrition inhalation. Therefore, we must pay attention to assisting patients to maintain a healthy amount of calcium supplement diet, improve the patient's physical fitness and increase the chance of recovery.
Complication
Mucin epidermoid carcinoma complications Complications idiopathic facial nerve facial muscle twitching
In the case of the parotid gland, facial nerve spasm symptoms and facial muscle twitching symptoms may occur when the facial nerve is involved. It may occur in the ankle and may damage the hard palate.
Symptom
Mucus epidermoid cancer symptoms common symptoms twitching growth slow molars
When the parotid gland tumor invades the facial nerve, facial paralysis may occur, and recurrence may occur after surgery. However, the rate of cervical lymph node metastasis is low, and blood to metastasis is more rare. Contrary to highly differentiated, poorly differentiated mucoepidermoid carcinoma grows faster and may have pain. The boundary is unclear and adheres to the surrounding tissues. The parotid gland tumor often involves the facial nerve. The cervical lymph node metastasis rate is high, and blood to metastasis can occur. Postoperative recurrence is easy. Therefore, highly differentiated mucoepidermoid carcinoma is low-grade malignant tumor, and poorly differentiated. Mucin epidermoid carcinoma is a highly malignant tumor, the former is more common, the latter is rare.
The clinical manifestations of mucoepidermoid carcinoma are closely related to the degree of clinical differentiation. They are highly differentiated, accounting for the majority. They are generally painless masses, slower in growth, longer in disease duration, different in tumor size, clear in boundary, and harder in quality. Activity, smooth surface or nodular shape, can be cystic, or solid, occurs in the ankle or after the molar area, the mass is light blue or dark purple under the mucosa, smooth mucosa, soft texture, puncture A small amount of bloody purple-black liquid can be extracted.
Low-differentiated tumors grow faster, often accompanied by pain, the boundary is unclear, diffuse, and adheres to surrounding tissues, can be broken and secondary infection, forming a long-lasting ulceration surface, and has a pale yellow sticky secretion. Sometimes it can form sputum, which occurs in the parotid gland. When the facial nerve is involved, facial nerve spasm symptoms and facial muscle twitching symptoms may occur. Those who occur in the ankle may destroy the hard palate.
Examine
Examination of mucoepidermoid carcinoma
Generally, it is necessary to confirm the diagnosis after frozen section examination. In the case of the parotid gland, the parotid gland can be seen as erosive destruction, the catheter defect or interruption, the distal catheter may be partially or completely unfilled, the tube wall is not smooth, and branch catheter destruction may occur. Malignant tumors such as lipiodol leakage, CT findings showed a bump with unclear boundaries, and the glandular glands were destroyed or squeezed.
(1) General form
Mucinous epidermoid carcinoma is highly differentiated from mixed tumors. It is round and has a small tumor. The diameter is 2 to 3 cm, a few are more than 5 cm, and some have a capsule, but most of them are incomplete or even completely without a membrane. The profile is grayish white or Light pink, occasionally lobulated, there may be many different sacs, containing mucus, poorly differentiated people completely lacking the envelope, unclear boundaries, invading adjacent tissues, the cut surface is grayish white, no leaves, uniform texture, may have Scattered small pouches and translucent small stoves.
(two) microscopic examination
Mucin epidermoid carcinoma consists of mucoid-like cells, epidermoid cells and intermediate cells. Mucus-like cells are cupped or columnar when differentiated and mature, cytoplasm is transparent, and the nucleus is at the basal part. When the differentiation is immature, it resembles adenocarcinoma cells, cytoplasm. Containing mucus, carmine red staining positive, epidermoid cells resemble the stratified squamous epithelium of the oral mucosa, showing intercellular bridges, occasionally keratinized, intermediate cells are cuboidal, small in size, uniform in size, less cytoplasm, similar Epithelial basal cells, intermediate cells can evolve to mucin-like cells and epidermal-like cells, highly differentiated, mucin-like cells and epidermal-like cells, fewer intermediate cells, tumor cells can form irregular flaky, but often formed Different sizes of cysts, common mucus cells in the lining of the wall, mucus-like cells can be covered on epidermal-like cells, or mixed between epidermal-like cells, larger cysts can have nipples protruding, red stains in the cavity Mucus, poorly differentiated, mainly epidermal-like cells and intermediate cells, while mucin-like cells are less, tumor cells become distinct, nuclear division is seen, substantial epithelial masses, less cysts, and It can be seen that the tumor invades the surrounding tissue.
(3) Biological characteristics
Mucin epidermoid carcinoma often shows invasive growth, high recurrence rate, lymph node metastasis, metastasis to bone, brain, lung, but high differentiation can have a complete capsule, less recurrence after complete resection.
Diagnosis
Diagnosis and identification of mucoepidermoid carcinoma
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
In the case of the parotid gland, it should be differentiated from cancer of the salivary gland, mumps, and parotid gland.
Parotid tumor accounts for 80% of salivary gland cancer, and 75% of them are benign, while more than half of submental gland tumors are malignant. According to clinical examination images (ct, mri, pet), malignant symptoms occur more rapidly, lumps Pain, tenderness, nerve compression symptoms, hard, fixed, etc., cancer can be locally spread, or even distant metastasis, the treatment is surgery, plus radiation therapy, depending on the type or occurrence of the malignant, sometimes have to use chemotherapy, About 70% can get good results (highly deteriorated by 30%, low by 80%) and may reappear after 10-15 years.
