- 期刊
側頸部囊狀轉移性鱗狀細胞癌－病例報告
Metastatic Squamous-Cell Carcinoma Mimicking a Cervical Cyst - Case Report
摘要
本科於1999年5月經歷一例34歲男性病患，主訴左上側頸部有一無痛性腫塊約3、4個月。理學檢查及電腦斷層攝影顯示除左上側頸部胸鎖乳突肌前緣有一6 x 8 cm之柔軟固定性囊腫外，並無其他異常。細針穿刺（fine needle aspiration）切片結果為良性，在第二鰓裂囊腫之臆斷下，安排摘除手術，術後病理報告結果為鰓裂囊腫併惡性轉變。根據文獻報告，此類病灶多為原發於Waldeyer’s ring之轉移性鱗狀細胞癌。因此於全身麻醉之情況下，進行Waldeyer’s ring之全內視鏡切片檢查；術中發現左側腭扁桃有異常，故切取部份扁桃組織送病理化驗。結果顯示為原發於左側腭扁桃之鱗狀細胞癌。臨床上單一之頸部囊狀轉移性鱗狀細胞癌與良性之頸部囊腫甚難區別，術前經常被誤診為鰓裂囊腫或術後診斷為鰓裂起源之惡性囊腫。因此我們提出此病例並根據文獻報告加以討論。
並列摘要
A 34-year-old man revealed a large soft mass over the left upper lateral neck. Computed tomography revealed no evidence of any other lesion apart from this cystic mass. Preoper-atively, fine needle aspiration of this lesion revealed a benign content, although this. Result turned out to be a malignancy postoperatively. According to the literature, this kind of metastatic mass typically originated from Waldeyer’s ring. Therefore we performed an endoscopy-guided biopsy of Waldeyer’s ring. The primary site being noted to be the palatine tonsil. Since it is usually misdiagnosed as branchial cleft cyst preopera-tively and branchiogenic carcinoma postoperatively, we present this case and discuss its possible mechanism.
延伸閱讀
- 祁力行、林永和、劉定國、彭伯宇（2002）。口腔原發不明鱗狀細胞癌之頸部轉移－病例報告。中華民國口腔顎面外科學會雜誌，13(1)，26-39。https://doi.org/10.7104/CJOMS.200203.0026
- Chan, C. Y., Lim, K. E., Hsu, Y. Y., Tsai, Y. H., Chang, H. C., & Kuo, H. W. (2006). 囊狀異位性腦組織以單側頸部腫塊表現－病例報告. 慈濟醫學雜誌, 18(3), 217-219. https://doi.org/10.6440/TZUCMJ.200606.0217
- 林煥章、黃逸岳、印憶恒、洪堅銘、沈也雄、林正仲（1997）。起源於含齒性囊腫之鱗狀細胞癌－病例報告。中華民國口腔顎面外科學會雜誌，8(1)，26-34。https://doi.org/10.7104/CJOMS.199703.0026
- 陳志男、劉博仁、胡璟、韓鎮安、袁本治（1998）。以側頸囊腫表徵之轉移性乳頭狀甲狀腺癌－二例報告。中華民國耳鼻喉科醫學會雜誌，33(5)，540-545。https://doi.org/10.6286/1998.33.5.540
- Yang, Y. L., Lai, C. S., Lin, S. D., Wang, C. K., & Tsai, K. B. (2003). Intramuscular Metastasis of Cutaneous Squamous Cell Carcinoma: A Case Report. The Kaohsiung Journal of Medical Sciences, 19(4), 188-192. https://www.airitilibrary.com/Article/Detail?DocID=02575655-200304-19-4-188-192-a