左側腮腺之腺泡腺癌－病例報告

腺泡腺癌是唾液腺中很罕見的腫瘤，好發於中年女性且以腮腺最常見。臨床上，除理學及放射線學檢查外，通常需術後組織病理切片確定診斷。安排後續的輔助治療計畫，以便提高治療的成功率。傳統治療惡性腫瘤原則爲廣泛性切除合併頸部淋巴廓清術。而腺泡腺癌屬低度惡性腫瘤，可採取保守性切除手術而通常不需施予頸部淋巴廓清術。本病例左臉頰有一4×4×2公分隆起之腫塊，質地稍硬且深壓時會痛，核磁共振顯示邊緣完整且有被膜，雙側頸部可發現許多小於1公分的反應性淋巴結。手術切除腫瘤，邊緣完整且有被膜，外觀及質地類似唾液腺之多形性腺瘤，病理報告爲低度惡性腺泡腺癌（混合型）。術後追蹤，傷口癒合良好，無顏面神經受損等併發症，由於手術安全距離不足，於術後1個月施予輔助性放射線治療，共48格雷的劑量。目前追蹤9個月，並沒有腫瘤復發之跡象。

關鍵字

腺泡腺癌；腮腺；輔助性放射線治療

並列摘要

Acinic cell carcinoma is a rare tumor of salivary gland. It is most common in middle-aged women and is found predominantly in the parotid gland. Besides physical and radiographic examinations, a post-operative pathology report is also required for a final diagnosis. The rate of success will be enhanced if appropriate adjuvant treatment plan is carried out. Traditionally, the principle treatment for malignancy is wide excision with neck lymphatic dissection. However, acinic cell carcinoma is regarded as low-grade malignant tumor. Therefore, conservative excisional treatment is enough and neck lymphatic dissection is not necessary. In this patient, there is a lump present on the left cheek about 4×4×2 cm in size. It is indurated and tender to palpation. From the MRI, it appears that the lesion is surrounded by a capsule and the margin is well defined. Bilaterally in the neck area, there are many reactive nodes, which the sizes are less than 1 cm. After the tumor was excised, it shows clear margin with capsule. The outlook resembles pleomorphic adenoma, but the pathological report confirmed it as a low-grade acinic cell carcinoma (mixed type). Postoperative follow-up reveals good healing and no other complications such as facial nerve damage. We referred him to receive the adjuvant radiotherapy, 48 gray in total dose, postoperative 1 month due to the insufficient safe margin. So far the patient has been followed for 9 months, and no sign of recurrence is found.

並列關鍵字

Acinic cell carcinoma ； Parotid gland ； Adjunctive radiotherapy

國際替代計量

左側腮腺之腺泡腺癌－病例報告

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