中耳惡性腫瘤－兩例報告

中耳的原發性腺癌或纖維肉瘤相當少見。本文報告兩個病例。病例1為腺癌，以右側耳悶以及長在完整鼓膜內側的腫塊來表現，病人根治乳突鑿開術，但並未接受術後放射療法。病例2為纖維肉瘤，則以右側的耳痛、耳漏和突出於外耳道的肉芽狀腫瘤來表現，病人拒絕手術，只接受全程的放射療法和3次的化學療法。回顧英文文獻，顯示腺癌的治療以積極的手術切除為主，而術後放射療法則依病人健康情況、腫瘤組織病理和腫瘤侵犯程度來決定，預後主要依據腫瘤的組織分類，對於惡性度低的腺癌，預後良好。而纖維肉瘤的治療則以廣泛的整體手術切除加上術後放射療法，預後主要依據腫瘤的組織分類、腫瘤大小、年齡和手術切除邊緣是否乾淨，5年存活率約為60%。病例1已追蹤4個月，而病例2也已追蹤8個月，兩例至今情況良好。

關鍵字

腺癌；纖維肉瘤；中耳

並列摘要

Primary adenocarcinoma or fibrosar-coma of the middle ear is a rare disease. Here two cases were presented. Case 1 of adenocarcinomal in a 39-year-old woman presented with right side ear fullness and a mass behind the intact tympanic membrane. She received right radical mastoidectomy with facial nerve dissection. The postopera-tive irradiation was not given. Case 2 of fibrosarcoma in a 27-year-old man presented with right side otalgia, otorrhea and a reddish mass protruded from the right external auditory canal. He refused to receive operation. Only complete course of irradiation and adjuvant chemotherapy for 3 times were given. Review of the literature shows adenocarci-nomas must be differentiated from other adenomatous tumors and are best managed by aggressive surgical resection. The post-operative irradiation is only used in cases of incomplete resection or high-grade tumors. The literature also advocated fibrosarcomas are best managed by radical en bloc resection with post-operative irradi-ation. Prognosis depends on the tumor grade, tumor size, patient age and surgical margin status. Five-year survival rate is about 60%. There is no evidence of recurrence 4 months after treatment for case 1 and 8 months after treatment for case 2.

並列關鍵字

adenocarcinoma ； fibrosarcoma ； middle ear

被引用紀錄

駱月娥（2009）。(-)-vitisin B 誘導人類血癌細胞凋亡分子機轉之探討〔碩士論文，臺北醫學大學〕。華藝線上圖書館。https://doi.org/10.6831/TMU.2009.00099

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中耳惡性腫瘤－兩例報告

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