Oncocytic Carcinoma of the Ectopic Parotid Gland-A Case Report

異位性腮腺嗜酸細胞惡性腫瘤－病例報告及文獻回顧

陳依凡(Yi-Fan Chen) ； 李永賢(Wing-Yin Li) ； 馬旭(Hsu Ma)

《臺灣整形外科醫學會雜誌》 27卷1期 (2018/03) Pp. 52-60

摘要

Background: Oncocytic carcinoma (OC) is characterized by the presence of oncocytes with marked cellular atypia, frequent occurrence of mitosis, invasion of adjacent structures, and metastasis to distant or regional lymph nodes. OC of the salivary gland is a rare tumor, and that of the ectopic salivary gland is even rare. Aim and Objective: The purpose of this study was to characterize the clinical presentation and prognosis of OC, and to review the literature about OC of salivary glands and carcinoma of the ectopic salivary gland. Case Presentation: A 51-year-old man noted a painless mass in his right malar region, which enlarged gradually for the past 6 months. Superficial parotidectomy with preservation of the buccal branch of the right facial nerve was performed. OC was diagnosed according to the pathology report. Wide excision of the tumor with suprahyoid lymph node dissection was then performed. No metastatic lymphadenopathy was noted, and postoperative radiotherapy was arranged. Twenty two months after the curative surgery, there was no evidence of locoregional recurrence or distant metastasis. Conclusion: The present case is an extremely rare case of OC derived from an ectopic salivary gland. OC is an aggressive malignant tumor and possesses a high rate of regional and distant metastases. Radical surgical excision with elective neck dissection is recommended as the treatment of choice, and careful long-term follow-up is necessary.

關鍵字

oncocytic carcinoma ； oncocytic adenocarcinomas ； salivary gland tumor ； ectopic salivary gland carcinoma

並列摘要

背景：嗜酸細胞惡性腫瘤的特色為帶有顯著細胞異型、頻繁的細胞有絲分裂、鄰近組織破壞及遠端或近端淋巴轉移之嗜酸細胞。唾液腺嗜酸細胞惡性腫瘤十分少見，更罕見於異位性唾液腺中。目的及目標：本文目標為描述嗜酸細胞惡性腫瘤的臨床表徵及治療預後，並回顧唾液腺嗜酸細胞惡性腫瘤以及異位性唾液腺惡性腫瘤之相關文獻。病例報告：一位51歲男性表示右側顴骨區域一無痛腫瘤，半年來持續增大。患者接受了淺表腮腺切除併顏面神經之頰神經支保留手術。病理報告顯示為嗜酸細胞癌，於是患者接受廣泛性切除併舌骨上頸部淋巴廓清手術。無淋巴結轉移，術後並安排放射治療。二十二個月後，無局部復發或遠端轉移。結論：本報告描述之異位性唾液腺嗜酸細胞惡性腫瘤病例極為罕見。嗜酸細胞惡性腫瘤為擁有高度局部及遠端轉移機率之高度惡性腫瘤。根除性切除併頸部淋巴廓清手術是目前最建議之治療選擇，且長期小心地追蹤是必要的。