A rare case of mucinous adenocarcinoma with neuroendocrine differentiation of the mandibular ramus is presented. The patient, an 80-year-old man, was referred to our hospital with chief complaint of swelling and pain in the left buccal mucosa. CT and MRI examination showed an osteolytic tumor mass occupying the upper region of the left mandibular ramus. Macroscopically, the excised tumor was a relatively well-defined, solid mass with diffuse bone resorption, measuring 3 cm x 3.2 cm x 3 cm. Microscopical examination showed that the tumor forming glandular structures with abundant mucous production and high cellular atypia. Immunohistochemical studies demonstrated the positive reactivities for pan-keratin, cytokeratin 7, vimentin,alpha-amylase, alpha-smooth muscle actin, neuron-specific enolase, glial fibrillary acid protein, calcitonin, and somatostatin in tumor cells. These findings suggested that the tumor was originated from heterotopic or misplaced salivary gland in the mandible.
Lymphoepithelial cysts are usually found on the lateral region of the neck. Rarely, however, lymphoepithelial cysts can be found in the oral cavity. Here, we report a case of lymphoepithelial cyst located in the floor of the mouth, in a 57-year-old man. The patient complained of a painless swelling of the floor of the mouth. During the course of the first medical examination, a circumscribed oval mass was found in the floor of the mouth just at the right side of the lingual frenum, measuring approximately 9 x 8 mm. The clinical diagnosis was a cystic lesion. Under local anesthesia, the lesion was totally excised. Histologically, the cyst was lined with stratified squamous epithelium, and the surrounding area revealed large amounts of lymphoid tissue showing a various germinal center. The histopathological diagnosis was d lymphoepithelial cyst. There was no evidence of recurrence in the patient for 10 months after the operation.
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