單純以轉移性淋巴腮腺腫瘤為表現的默克爾細胞癌

Metastatic Merkel Cell Carcinoma in the Parotid Gland with Unknown Primary Site

張紘䪸(Hung-Min Chang) ； 蔡青劭(Stella Chin-Shaw Tsai) ； 曹唐義(Tang-Yi Tsao) ； 李佳茹(Chia-Ru Li) ； 葉啟源(Chi-Yuan Yeh) ； 黎瓊柱(Chiung-Chon Li)

《童綜合醫學雜誌》 7卷1期 (2013/06) Pp. 31-35

摘要

默克爾細胞癌是一種極少見的皮膚未分化癌，它來自於表皮中一種神經內分泌細胞默克爾細胞演變而來，伴有高度侵略性，多發生在長時間接受日照的白年老男性，常發現在頭頸部，但仍有少數人，單以淋巴轉移而找不出原發性部位，因數據與案例不多，還沒有一個明確的確切治療定論。本篇報告一位79歲男性病患因直徑約三公分的輕微壓痛腮腺腫塊來就診，於耳鼻喉科行淺表腮腺切除術送病理化驗後診斷出是轉移性默克爾細胞癌，在經過一連串腫瘤勘查甚至接受全身正子掃描後，仍找不出原發部位。術後繼續於本院接受頸部淋巴區域的放射線治療。現追蹤長達半年，無任何術後併發症與復發現象。現持續於本院門診追蹤。本文討論少見的原發部位不明之轉移性默克爾細胞癌，並單以唾液腺淋巴腫塊來表現，此案例希望提供醫師參考。

關鍵字

默克爾細胞癌 ； 唾液腺腫瘤

並列摘要

Merkel cell carcinoma is a rare undifferentiated skin carcinoma originating from neuroendocrine cells in the epidermis. Merkel cell is a highly aggressive form of cancer, often occurring in the head and neck area of white elderly men with a history of prolonged sun exposure. Lymph node metastasis is common. However, the primary site of Merkel cell carcinoma is not always identifiable. The management of Merkel cell carcinoma has not been clearly defined because of limited data and only few case reports.Here, we report the case of a 79-year-old male patient with a mildly tender parotid mass about 3 cm in diameter. Superficial parotidectomy was performed. Pathological analysis indicated metastatic Merkel cell carcinoma. After a series of tumor surveys and whole-body positron emission tomography, the original cancer site remained unknown. Postoperative irradiation of the neck area was performed. During 6-month followup, no postoperative complications or recurrence were observed. In this article, we discuss a rare metastatic Merkel cell carcinoma presenting as a parotid mass with unknown primary site.

並列關鍵字

Merkel cell carcinoma ； parotid tumor