구강 편평세포암종 제거 후 발생한 경부 골육종에서의 상피간엽이행
Epithelial-mesenchymal transition in osteogenic sarcoma of the neck following oral squamous cell carcinoma
김현실, 김남희, 한선희, 차인호, 서동준, 박원서, 육종인, 김형준,
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김현실 ( Kim Hyun-Sil ) - 연세대학교 치과대학 구강병리학교실
김남희 ( Kim Nam-Hee ) - 연세대학교 치과대학 구강병리학교실
한선희 ( Han Seon-Hee ) - 연세대학교 치과대학 구강병리학교실
차인호 ( Cha In-Ho ) - 연세대학교 치과대학 구강악안면외과학교실
서동준 ( Seo Dong-Jun ) - 연세대학교 치과대학 구강악안면외과학교실
박원서 ( Park Won-Se ) - 연세대학교 치과대학 통합진료학과
육종인 ( Yook Jong-In ) - 연세대학교 치과대학 구강병리학교실
김형준 ( Kim Hyung-Jun ) - 연세대학교 치과대학 구강악안면외과학교실
KMID : 0355620100360030172
Abstract
Postirradiation extraosseous osteogenic sarcomas are uncommon in the head and neck, despite the extensive use of high-dose radiation. It has been described as de novo radiation-induced neoplasm. We present a 73-year-old male who had been treated by radiotherapy for gingival cancer 7 years earlier and later developed extraosseous osteogenic sarcomas (EOSs) of the neck. Microscopically, the neck mass was composed with mesenchymal malignant cells with cartilaginous and osteogenic differentiation. Immunohistochemical stain demonstrated strong positivity of tumor cells for Snail, the one of major epithelial-mesenchymal transition (EMT) inducer. The E-cadherin expression was scarce, showing inverse relationship to Snail expression. Compared with previous squamous cell carcinoma (SCC) of the gingiva, the present EOS sample revealed the remained epithelial cells on cytokeratin immunohistochemistry, suggesting the tumor arise from the cells of epithelial origin. We have also reviewed the previous 6 cases of head and neck EOSs carefully. The clinicopathologic features of the unusual lesion suggest that it is an incomplete EMT of precedent epithelial malignancy rather than de novo pathology.
키워드
Squamous cell carcinoma(SCC);Extraosseous osteogenic sarcoma(EOS);Epithelial-mesenchymal transition(EMT);Snail;E-cadherin;Mouth neoplasms
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