- 期刊
原發腭血管肉瘤：病例報告及文獻回顧
Primary Angiosarcoma of the Palate: Report of a Case and Review of Literature
摘要
口腔血管肉瘤(angiosarcoma)是罕見卻相當惡性的腫瘤。33歲男性主訴右上顎腭側牙齦腫脹、潰瘍約一年多，觸診柔軟伴隨壓痛。X光檢查顯示上顎前牙區至右側犬齒齒槽骨已遭受破壞，而且無規則邊緣。兩側頸部動脈血管造影顯示無多血管性腫瘤、無不正常血管交通或動脈瘤，因此排除血管瘤的可能。隨即於門診安排切片檢查，於顯微鏡可見紡錘型細胞聚集有明顯細胞核及頻繁細胞分裂，並兼多處壞死，伴隨不成熟的血管新生。在免疫組織化學檢查下，腫瘤細胞對vimentin及CD31呈陽性反應，但對CK、S-100、HMB45、actin、desmin、LCA及CD34是陰性的，故診斷爲血管肉瘤(angiosarcoma)。診斷確立後建議病人接受手術治療，但病人因害怕手術，拒絕後往他院尋求化學治療。
並列摘要
Oral angiosarcoma is a rare malignant tumor with aggressive behavior. A 33-yearold man suffered from palatal ulcerative swelling over R't maxilla for more than 1 year. The tumor showed soft in consistency with tenderness. X-ray showed a radiolucent lesion over anterior maxilla alveolar ridge, without clear margin. The angiography showed no hypervascular tumor, vascular communication or aneurysm, and the suspicion of hemangioma was ruled out. The incisional biopsy was then performed in OPD. Microscopically, the sections showed picture of aggregates or sheets of epithelioid or spindle cells exhibiting prominent nuclei and frequent mitotic figures with multifocal necrosis. Foci of vague vascular channel formation were also seen. Immunohistochemically, the tumor cells were positive for vimentin and CD31, but negative for CK, S-100, HMB45, actin, desmin, LCA, and CD34. So angiosarcoma was confirmed. The surgical treatment was then suggested, but the patient refused and search for chemotherapy in other hospital.