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Soft Palatal Tumor with Intracranial Spreading

軟顎腫瘤往顱內散佈

摘要


本文報告一例原生長於右側軟顎的類腺體癌,侵犯顯下窩及翼顎窩,再經由卵圓孔及圓形孔散佈進入中顱窩及海綿竇。原來的腫瘤為粘膜下,且缺乏症狀,因此病人本身及醫師檢查時都忽略了,病患反而表現出激烈頭痛,右側第五對顱神經之第二枝第三枝麻痺,並且因為顯下窩的翼狀肌被侵犯引起右側顯頷關節運動不良。CT及MRI都可清楚的看到原發腫瘤在右側軟顎,冠狀切面並可清楚看到腫瘤經由卵圓孔及圓形孔進入中顱窩。由於位於顱底的顱內腫瘤也有機會往下侵犯,因此對於顱底腫瘤,冠狀切面非常重要。

並列摘要


A 39-year-old male patient had adenoid cystic carcinoma arising from the minor salivary gland at the right side of the soft palate. The tumor caused a local bony destruction of the pterygoid plate, invaded the pterygopalatine fossa and infratemporal fossa, and then spread upward into the middle cranial fossa via the foramen ovale and foramen rotundum. The primary tumor was silent and located at submucosa. The patient instead presented symptoms of intracranial tumor, such as severe headache and impairment of the 2nd and 3rd divisions of the trigeminal nerve. The anatomy of the skull base and the spreading routes of the oral tumor are discussed.

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