- 期刊
Axillary Cystic Hygroma-A Rare Lesion in Adult
腋窩囊狀水囊腫一個罕見位置及年齡分布的良性腫瘤－案例報告
摘要
背景：囊狀水囊腫是個主要發生在新生兒的淋巴管瘤，而在成人中發生的個案通常跟留有胚胎生長活性的淋巴組織再生有關。在之前的文獻，成人發生在腋窩的囊狀水囊腫則只有兩例。目的及目標：透過完整的報告一個極為罕見的囊狀水囊腫，重新檢視針對這良性腫瘤的診斷工具及適合的處置方式，來增加外科醫師對這疾病的認知及診斷的準確性。材料及方法：一個六十九歲的婦女最近兩個多月抱怨左腋下有一腫瘤，相關的檢查顯現一從腋下延伸到側胸壁，大小約12×7.5×12公分的囊狀腫瘤，術中發現和肋間神經分支沾黏，在小心剝離神經後移除腫瘤，周遭重要組織被保留而不需犧牲。病理報告證實為成人極少見的囊狀水囊腫。結果：手術後病人症狀獲得解除且無任何神經學上的後遺症。結論：不像小兒的囊狀水囊腫，成人的囊狀水囊腫通常不會消失。術前的影像檢查可確定診斷及判斷跟周遭重要組織的連結。而處置主要以外科切除同時盡量保留周遭重要組織，輔以術後密切追蹤以確定再發之可能。
關鍵字
無資料並列摘要
Background: A cystic hygroma (CH) is a form of lymphangioma that usually occurs in childhood. The development of CH in adulthood is proposed to be related to delayed proliferation of lymphatic cell rests that retain their embryonic growth potential. Axillary CH is extremely rare in adults and, to our knowledge, only 2 cases have been reported.Aim and Objectives: To present a rare case of adult axillary CH and to review its diagnosis modalities and management options. Materials and Methods: The patient was a 69-year-old woman complaining of a left axillary mass that had developed over the last 2 months. Serial examination revealed a large cystic tumor, measuring 12×7.5×12cm, extending from the left axillary fossa to the lateral thoracic wall. Intraoperatively, we observed that the tumor adhered to the branches of the intercostal nerve. We removed the tumor while preserving nearby structures. The tumor pathology confirmed the diagnosis of CH.Results: This patient recovered without any sequelae, and there was no evidence of recurrence at 12-months follow-up. Conclusion: Unlike pediatric CH, a CH in adulthood rarely regresses spontaneously. Appropriate imaging is essential to confirm the diagnosis and to identify nearby critical structures. Surgical excision while preserving the critical structures represents the principal therapeutic goal. (J Taiwan Soc of Plast Surg 2012;21:257~264)