A rare case of undifferentiated adenocarcinoma in the submandibular gland
1987 Volume 33 Issue 8 Pages 1670-1676
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1987 Volume 33 Issue 8 Pages 1670-1676
Adenocarcinoma in the submandibular gland is rarely encountered. Recently, the authors experienced a rare case of submandibular gland tumor which showed undifferentiated adenocarcinoma.
Patient: S.T. 71-year-old male.
Chief complaint: Swelling in the left submandibular region.
History of the present illness: The patient consulted a dentist due to the poor fitting of full dentures on January, 1985. Though the patient was told of swelling in the submandibular region by the dentist, he had no therapy because of no pain. When he reconsulted the dentist January, 1986, the dentist recommended a detailed examination. So he visited our hospital on February, 7th.
Present condition: In general condition, the patient was of small stature and good nutrition. In local findings, the pigeon's egg-sized tumor, which had elastic hardness immobility, tenderness, was palpated in the left submandibular region. The regional lymph nodes had a moveable, pea-sized swelling without tenderness. Salivary secretion from the left Wharton's duct was not obtained. Roentgenographically, the mandible and the submandibular gland had almost normal findings. General blood tests showed no abnormality other than slight increase of ESR to 11mm/1h.
Treatment: On March 13th, the tumor was resected enblock with the submandibular gland under general anesthesia. Radiation was done to prevent recurrence after operation. The patient was discharged on April, 24th, and postoperative course is well.
Histopathological diagnosis: Undifferentiated adenocarcinoma. The tumor consisted of round and pleomorphic cell arranged compactly in bands, and proliferated infiltratively in the surrounding tissue. In addition to a part of tumor masses, pseudoglandular formation that the tumor cells are arranged circumferentially around the central destritus, near the duct basement membrane, was observed.
This histopathological finding resembled Comedo carcinoma of mammary gland, so that it considered to be a rare type in the adenocarcinoma of the submandibular gland.
