鼻咽乳頭狀腺癌-病例報告

Nasopharyngeal Papillary Adenocarcinoma-Case Report

王俊杰(Chun-Chieh Wang) ； 鍾從得(Tsung-Te Chung) ； 郭健龍(Chien-Long Kuo)

《中華民國耳鼻喉科醫學雜誌》 36卷5期 (2001/06) Pp. 324-327

https://doi.org/10.6286/2001.36.5.324

摘要

鼻咽乳頭狀腺癌相當少見，回顧英文文獻中，只有3篇共11例被報導過。本科於1998年10月經歷1名20歲女性病患，主訴鼻塞及鼻部異物感等症狀，有半年之久。理學檢查發現鼻咽部腫塊，經病理組織切片證實為乳頭狀腺癌；術中發現腫塊有完整被膜，呈莖狀突起附著於鼻咽部前壁近鼻中隔末端。甲狀腺超音波檢查，鼻咽部及頸部電腦斷層描，均無發現甲狀腺腫瘤及相關頸部淋巴結腫瘤轉移。同年11月，再以鼻竇內視鏡進行腫瘤周圍廣泛切除手術。術後追蹤2年，無復發情形。鼻咽乳頭狀腺癌為罕見疾病，臨床表現上，無頸部淋巴結腫大，治療是以手術廣泛性的切除為主，此與鼻咽部上皮細胞癌易有頸部淋巴結轉移及以放射線為主要治療，有所差異。其預後也有所不同，乳頭狀腺癌經手術切除預後良好。

關鍵字

乳頭狀腺癌 ； 鼻咽

並列摘要

Nasopharyngeal carcinoma (NPC) is prevalent in Chinese populations. The common histopathological features of NPC are non-keratinizing squamous and undifferentiated carcinomas. In contrast, nasopharyngeal papillary adenocarcinoma is rare and only 11cases have been previously reported in the English literature. In October 1998, a 20-year-old woman presented with a six month history of nasal obstruction and the sensation of a foreign body. A nasopharyngeal mass was found on physical examination and a diagnosis of papillary adenocarcinoma was made after a biopsy. The mass was well encapsulated and had a pedicle at the junction of the anterior wall of the nasopharynx and nasal septum. Thyroid ultrasound no thyroid tumors and computed tomographic scanning demonstrated no evidence of cervical lymphadenopaty. In November, wide excision around the tumor site was performed with a sinoscope and no local pathological changes were found. There has been no evidence of recurrence in the two years following the tumor’s removal. In summary, nasopharyngeal papillary adenocarcinoma presents as an exophytic mass without metastatic cervical lymph node involvement and an excellent prognosis following appropriate surgical management. This is in contrast to ordinary NPC, typically accompanied by metastatic neck masses, and for which radiotherapy is the mainstay of treatment.

並列關鍵字

papillary adenocarcinoma ； nasopharynx