顎下腺唾石症として経過観察されていた石灰化と骨形成を伴う顎下腺悪性腫瘍の1例

• Published in: 日本口腔外科学会雑誌 Vol. 65; no. 7; pp. 461 - 466
• Main Authors: 藤田, 祐生, 墨, 哲郎, 奥長, 秀介, 若林, 健, 太田, 嘉幸, 大前, 政利
• Format: Journal Article
• Language: Japanese
• Published: 社団法人 日本口腔外科学会 20.07.2019
• Subjects: 唾石症; 石灰化; 腺癌 NOS; 顎下腺悪性腫瘍; 骨形成
• ISSN: 0021-5163; 2186-1579
• DOI: 10.5794/jjoms.65.461

Salivary gland adenocarcinoma, not otherwise specified (NOS), is an epithelial carcinoma forming ductal or glandular structures that lack sufficient histologic features of the currently recognized categories of salivary gland carcinoma. We report an extremely rare case of adenocarcinoma, NOS, with calcification and bone formation in the submandibular gland.　A 44-year-old man who was referred to our department had been given a diagnosis of sialolithiasis of the right submandibular gland at a referral hospital a few years ago. CT and MR images revealed a 15-mm calcified substance in the right submandibular gland, and FDG-PET images revealed multiple abnormal uptakes in the cervical lymph nodes. We diagnosed a malignant submandibular gland tumor with multiple lymph node metastases of the neck and performed radical surgery with the patient under general anesthesia. Histological analysis of the surgical specimen revealed that the tumor was a high-grade adenocarcinoma, NOS, with dystrophic calcification and bone formation; moreover, multiple cervical metastatic nodes were detected with extracapsular invasion. Therefore, he underwent cetuximab-based bioradiotherapy as an adjuvant therapy. He has been followed up closely, and no recurrence has been noted.