摘要
副神經節瘤（paraganglioma）源自遍佈於全身各處的副神經節，可見於心臟、肺臟、縱膈腔、消化道、腹膜後壁及膀胱等處。源自頭頸部的副神經節瘤相當罕見，其中源於鼻腔及鼻竇者更加稀少，至西元1995年前，文獻報告僅有23例，其中4例為惡性腫瘤。本院在2000年11月經驗一例，患者為17歲女性，主訴1年多來經常有鼻塞感並有鼻漏，而近8個多月來經常流鼻血，經檢查發現右側鼻腔腫塊佔滿鼻咽腔及鼻腔後部。手術切除腫瘤後所得病理切片診斷為典型的副神經節瘤。術後病人恢復良好，門診追蹤至今半年無復發的跡象。鼻腔的副神經節瘤雖罕見，但應列入鼻腔良性腫瘤的鑑別診斷之一。如果病灶有侵襲性的傾向，或是病理切片有細胞異常增生的證據，就應該仔細追蹤病患是否有復發的可能。
並列摘要
Paragangliomas can occur in heart, lung, mediastinum, gastrointestinal tract, retroperi-toneum and urinary bladder where paraganglia exist. Paraganglioma originating from the head and neck region are rare; there were only 23 cases reported in the past. Symptoms of recurrent epistaxis, rhinorrhea, nasal obstruction and facial swelling are common clini-cally but not specific to this tumor. Adequate surgical excision with clear margins is the standard treatment. Radiotherapy was used in recurrent tumors but the result was contro-versial. We report a 17-year-old female with histology-proved paraganglioma involiving nasal cavity with initial symptoms of nasal obstruction, rhinorrhea and recurrent epistaxis; a mass occupying mainly right nasal cavity and nasaopharynx was noted by physical exam-ination and nasopharyngeal fibroscopy. Surgical excision was done and pathological report was paraganglioma. There has been no recurrence 6 months after the operation. Nasal paraganglioma should be differentiated with other benign nasal tumors; its symp-toms are not specific and final diagnosis depends on histological exam. Surgical excision is the principal of treatment, and radiotherapy has been used for recurrence. Long-term follow-up is recommended because of easy recurrence.
延伸閱讀
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- 林家祥、李國林、張克昌（2001）。鼻中隔神經纖維瘤-病例報告。中華民國耳鼻喉科醫學雜誌，36(5)，300-303。https://doi.org/10.6286/2001.36.5.300
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- 蘇聖博、羅承裕、王拔群（2022）。Pleomorphic Adenoma of Nasal Septum-Case Report。台灣耳鼻喉頭頸外科雜誌，57(4)，304-308。https://doi.org/10.6286/jtohns.202212_57(4).304