摘要
肉瘤是源自於中胚層的惡性腫瘤，軟組織肉瘤的發生率佔所有惡性腫瘤的1%，且在診斷上較複雜與困難，故在此提一未分化肉瘤討論，並對相關文獻作一回顧。病患爲一29歲孕婦，主訴自民國94年6月其左側臉頰迅速腫脹。臨床檢查發現左側臉頰具壓痛感腫脹，約8×6公分大小，觸診時發現腫塊佔據整個左側頰部；在左側頰黏膜有一2×2公分大小的潰瘍。電腦斷層婦描發現一巨大壞死性腫塊，上至左側顳下窩，下至頰部下區域，並侵犯左側髁關節、冠狀突及下顎骨技，並有頸部林巴結增大情況。於94年7月於全身麻醉下接受更深層的切片檢查，病理報告證實爲肉瘤；隨後於94年8月轉診至某醫院接受放射線合併化學藥物治療，於94年9月病故。此病例由於病理組織切片分化極差，藉由免疫組織化學染色方式，鑑別診斷包括滑液肉瘤或骨骼肌肉瘤；因其在診斷上相當困難，且病患爲孕婦的關係，而造成確定診斷及後續治療之延誤，故針對此病例所做的理學、影像學、細胞學、組織切片、免疫組織化學分析等檢查、及孕婦和放射線劑量之關係提出討論。
並列摘要
Sarcomas are malignancies that originate from the mesoderm. The prevalence of soft tissue sarcomas accounts for one percent of all malignancies. Due to the complexity and difficulties in diagnosis, we show a case report and reviewed a series of papers. A twenty-nine-year-old pregnant woman noticed rapid facial swelling and numbness of the left face since June 2005. Physical examination revealed a tender mass measuring about 8×6 cm in size occupying almost the entire left cheek and a 2×2 cm ulceration over the left buccal mucosa. CT scan revealed a large necrotic mass occupying a region superior to the left infratemporal fossa and inferior to the lower border of mandible, bony destruction of the left condylar process, coronoid process, and mandibular ramus, and multiple enlarged lymph nodes in the neck region. Debulking surgery was arranged on July 2005, and the biopsy report revealed sarcoma. She then visited another hospital for concomitant chemoradiation therapy that was to start on August 2005. Unfortunately, she expired on September 2005. Due to the poor differentiation of the disease, the differential diagnosis included-other than sarcoma-synovial sarcoma and rhambdomyosarcoma by immunohistochemistry stain method. The confirmed diagnosis and treatment plans were delayed due to difficulties in pathologic examinations and the pregnant condition. We show this case for the discussion of physical examinations, image studies, cytology, histology, and immunohistochemistry stains, and the risks associated with diagnostic radiography during pregnancy.