摘要
瘤細胞瘤(onococytoma)為一種相當少見的唾液腺腫瘤，絕大多數為良性，約占所有唾液腺腫瘤的1%，常發生在腮腺淺葉，臨床以逐漸增之無痛性腫塊來表現。本科在1998年5月間經歷1名66歲女性病患，臨床上卻是以疼痛性腫塊來表現，且腫瘤生長於腮腺淺葉及深葉之間，經腮腺切除術後，病理報告證實為瘤細胞瘤，術後追蹤一牛半並無復發跡象。良性瘤細胞瘤之臨床症狀多以單一性腫塊表現，觸診時腫瘤堅硬，且為無痛性。本病例之症狀表現卻為疼性腫塊，且存在於腮腺淺葉及深葉之間，與一般瘤細胞瘤常見症狀殊異，因此臨床上不易與惡性唾液腺腫瘤作鑑別診斷。良性的瘤胞瘤只需手術切除完全即可治愈，復發率相當低。若為惡性的瘤細胞瘤，則預後相當差，治療必須以廣泛性切除唾液腺，再加以頸部廓清術後放射線治療。
並列摘要
Oncocytoma, a type of salivary gland tumor, is a rare neoplastic disease that comprises approximately 1% of all salivary gland tumors. Almost all oncocytomas are benign and, typically occur in the superficial lobe of the salivary gland. Clinically, most patients present with a slowly growing, painless mass. In May of 1998, a 66-year-old woman presented with a painful parotid mass. A tumor was found which occupied the superficial and deep lobes of the parotid gland. Histopathological examination after parotidectomy identified it as an oncocytoma. No relapse has been noted in the eighteen months following the surgical resection. In general, benign oncocytomas present as a single, painless mass. In this case, however, the patient presented with a hard, palpable and painful mass that located in the right parotid gland. The tumor was difficult to distinguish from a malignant salivary gland tumor, since the symptoms were not in keeping with a typical oncocytoma. Complete surgical excision can cure patients with benign oncocytoma, and patients have a very low relapse rate. In cases of malignant oncocytoma, the neoplasm often lacks a surrounding capsule or penetrates it, invade locally, destroys surrounding tissue, replaces normal salivary gland tissue, infiltrates perineurally, and exhibits vascular and lymphatic extension, with a correspondingly poor prognosis. Wide excision of the salivary gland and additional neck dissection or post-operative radiotherapy is necessary in such cases. The report concludes with a detailed discussion regarding the treatment of benign and malignant oncocytoma, offering guidance in the areas of differential diagnosis and treatment.
延伸閱讀
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