核醫掃描偽陰性之Warthin氏腮腺腫瘤－病例報告

Parotid Warthin's Tumor with False-negative Radionuclide Scanning – Case Report

林明毅(Ming-Yee Lin) ； 趙文元(Wen-Yuan Chao)

《中華民國耳鼻喉科醫學會雜誌》 33卷3期 (1998/06) Pp. 267-271

https://doi.org/10.6286/1998.33.3.267

摘要

Warthin氏腫瘤為一境界明顯，生長緩慢，具被膜之唾液腺腫瘤。其因胚胎發育過程之特性。幾乎均發生在腮腺，屬腮腺最常見之良性腫瘤之一，發生率僅次顧混合瘤，約腮腺腫瘤的2至10%。Warthin氏腫瘤之細胞（oncocyte）對放射性物質”鎝”（technetium）的吸收率很高，且極具專一性，故臨床上常被用來作為手術前的診斷與評估工具。其掃描結果之判讀，依腫瘤細胞對放射性物質之吸收程度，與其周圍正常組織相較應呈現熱區（hot area）。我們經驗1名35歲男性，因左耳下方腫塊發生約3年，且最近有變大的趨勢而來求診。局部檢查發現係左側腮腺尾端腫瘤，具輕微壓痛，無發炎徵狀，亦無面神經麻痺現象。核醫檢查結果顯示腫瘤部位為冷區（cold area）。但是經手術切除後，病理報告卻為一Warthin氏腫瘤。特依其腫瘤特性、診斷及治療過程分別討論之。

關鍵字

Warthin氏腫瘤 ； 核醫掃描 ； 囊狀退化

並列摘要

Warthin’s tumor, a slow-growing, wellcepsulated discrete salivary tumor, occurs most often in parotid gland because of its unique pathogenesis during embryogenetic period. It occurrence is less than that of mixed tumor only and accounts for about 2-10% of benign neoplasm in parotid gland. Technetium, a radionuclide material, is well up-took by this tumor with high spectificity and showing hot area. Thus, the radionuclide scanning is useful as a preoperative evaluating tool. In January 1997, we experienced a 35-year-old man with left infra-auricular mass for 3 years. He came to us because of its rapid growing. Local examination revealed a parotid tail tumor with mild tenderness. There was no infection sign or facial palsy. Radionuclide scanning showed a “cold pattern” over the tumor area. Superficial parotidectomy including the tumor was performed. However, the histopathology revealed Warthin’s tumor. Due to the unusually negative radionuclide scanning, the specialty, diagnosis and treatment of this patient were discussed.

並列關鍵字

Warthin's tumor ； radionuclide scan ； cystic degeneration