臉頰隆突性皮膚纖維肉瘤－病例報告

隆突性皮膚纖維肉瘤(dermatofibrosarcoma protuberans)在臨床上為一種罕見的腫瘤，一般相信它源自於纖維細胞增生，其腫瘤大部份發生在體幹和四肢(約89%)，僅11%發生在頭頸部，腫瘤表現常是生長緩慢，且易局部復發，但卻較少轉移，男女發生率相當，年齡分佈由20歲到50歲。腫瘤由於不適當的切除和週邊的侵犯，常導致高的復發率，本科經歷1例左頰部隆突性皮膚纖維肉瘤之病例，病人為53歲男性，主訴左臉頰有一約2.5cm逐漸長大且無痛性的腫塊，經開業醫師施以病理切片證實為隆突性皮膚纖維肉瘤，乃進一步於本院接受廣泛腫瘤切除術，在術中發現腫瘤已侵犯局部腮腺和顏面視經，因此進一步廣泛皮膚和軟組織切除包括腮腺和顏面神經，並立即進行顏面神經接合術以及頸頰皮瓣轉移動建術，病人追蹤至今，未有復發的跡象。(中耳醫誌 1997;32:314-319)

關鍵字

隆突性皮膚纖維肉瘤；轉移重建皮瓣；臉頰

並列摘要

Dermatofibrosarcoma protuberans is an uncommon tumor. It is believed to be of fibroblastic origin. The tumor more frequently occurs on the trunk and extremities (about 89% of all cases), and less on the head and neck (about 11%). The tumor grows slowly and it’s clinical course is marked by locally aggressive invasion with rare metastasis. It occurs with approximately equal frequencies among the sexes. Most cases occur between the ages of 20 and 50 years. The high recurrence rate has been attributed to peripheral extension of the tumor and inadequate excision. This report presents a 53-year-old man who had developed a progressively growing painless mass, 2*2.5 cm in size, on the left cheek area for about 6 months. He received an excisional biopsy of the lesion by a local doctor and the histologic examination revaled dermatofibrosarcoma protuberans. Intraoperatively, the parotid gland and the frontal and zygomatic branches of facial nerve were found to be invaded. Therefore wide resection of the cheek skin and parotid gland were performed and the facial nerve branches were sacrificed. Then, the facial nerve and cheek defect were reconstructed by nerve grafting and cheek rotation-advancement skin flap respectively. The patient has been free of tumor recurrence till now.

並列關鍵字

dermatofibrosarcoma protuberans ； rotation-advancement skin flap ； cheek

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臉頰隆突性皮膚纖維肉瘤－病例報告

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