中耳原發性腺癌－病例報告

Primary Adenocarcinoma of the Middle Ear - Case Report

溫凰全(Huang-Chuan Wen) ； 田輝勣(Hui-Chi Tien) ； 許振益(Chen-Yi Hsu)

《中華民國耳鼻喉科醫學雜誌》 34卷4期 (1999/07) Pp. 311-314

https://doi.org/10.6286/1999.34.4.311

摘要

中耳原發性腺癌是一種起源自中耳腺體極為罕見之疾病，一般對於是否起源於製造耳垢或是耳蠟的腺體所產生的外耳道惡性腫瘤局部轉移而來仍多有爭議。在診斷原發性腺癌時，必須排除來自其他部位轉移而來之腫瘤的可能性。此外，良性腺瘤也可能出現在中耳，在組織學上有時難以和腺癌完全加以區分，本科於1998年3月間經驗1例51歲女性，因左耳長期耳漏及耳鳴至本科求診。理學檢查發現於左側耳膜前上方有一凹陷袋；聽力檢查為左側輕度至中度傳導性聽力障礙；　電腦斷層顯示於左側乳突腔、乳突竇、以及上、中、下鼓室腔皆有軟組織病變。經乳突鑿開術發現外觀良好的軟組織腫瘤位於乳突竇，予以剝除及鼓室重建。術後因病理學檢查為分化良好的腺癌，故予追加放射線治療。

關鍵字

原發性腺癌 ； 中耳

並列摘要

Primary adenocarcinoma of the middle ear is very rare and its origin is still controversial. Before making a confirmative diagnosis, metastatic tumor should be ruled out. Moreover, it is difficult to differentiate adenoma from adenocarcinoma in pathological studies. In March 1998, we experienced the case of a 51-year-old patient who had suffered from persistent left ear discharge and tinnitus for several years. A retraction pocket at the antero-puperior part of the left ear drum was found. Audiometry revealed a mild to moderated conductive hearing loss of the left ear. Computed tomographic scanning of the temporal bone disclosed soft tissue density within the mastoid air cells, mastoid antrum, epitympanum, mesotympanum and hypo-tympanum. Under the impression of cholesteatoma, a modified radical mastoidectomy was performed. A yellowish soft tissue mass was removed from the tympanomastoid cavity and the tympanum was reconstructed. However, because the pathological study revealed adenocarcinoma, salvage radiotherapy was performed. The patient has been doing well for more than one year after these treatments.

並列關鍵字

primary adenocarcinoma ； middle ear