多發性口腔癌併腮腺區淋巴結潛伏性轉移－病例報告

Metachronous Oral Carcinoma with Occult Metastasis to Parotid Node-A Case Report

張雅菁(Ya-Ching Chang) ； 于錫倩(Hsi-Chien Yu) ； 楊榮武(Jung-Wu Yang) ； 官文雄(Wen-Hsiung Guan) ； 廖國安(Kuo-An Liao) ； 吳泰清(Tai-Ching Wu) ； 盧納密(Na-Mi Lu) ； 曾慶誠(Ching-Cheng Tseng) ； 蔣維凡(Wei-Fan Chiang)

《臺灣口腔顎面外科學會雜誌》 23卷1期 (2012/03) Pp. 10-24

https://doi.org/10.7104/TJOMS.201203.0011

摘要

腮腺淋巴結是少見的口腔癌轉移部位。本文提出一位54歲男性患者，在2005年3月被診斷出同發性右頰黏膜鱗狀細胞癌及右嘴角乳突瘤，接受了右肩胛舌骨上區淋巴廓清術、腫瘤廣泛性切除術，並立即以足背動脈游離皮瓣修補。在2008年8月因異位原發性右軟腭鱗狀細胞癌再次接受于術，兩次手術前之影像學檢查皆未有頭頸部癌轉移性淋巴結之發現。然而，在2010年發現右腮腺淋巴結潛伏性轉移，因此接受了右腮腺全葉切除術。經過化學倂放射線治療，該患者目前仍在本院門診追蹤當中，迄今尚無再次頸部淋巴結轉移之跡象。本文除介紹該患者之多發性口腔腫瘤之病史外，並就腮腺淋巴結潛伏性轉移及足背動脈游離皮瓣做相關文獻回顧。

關鍵字

口腔鱗狀細胞癌 ； 多發性口腔腫瘤 ； 腮腺淋巴結轉移 ； 足背動脈游離皮瓣

並列摘要

The parotid node is an uncommon site of metastasis in oral cancer, We report a case of 54-year-old male patient who was diagnosed as synchronous squamous cell carcinoma of right buccal mucosa and papilloma of right mouth angle in March 2005, He undertook right supra-omohyoid neck dissection, tumor wide excision, and immediate dorsalis pedis free flap reconstruction Forty months later, second primary carcinoma of right soft palate was found and the patient undertook wide excision in Augnst 200S, However, there was occult metastasis to right parotid, the patient undertook total lobectomy in July 2010, After adjuvant radiotherapy, the patient is keeping regnlar follow up in our clinic, and there was no evidence of neck metastasis till now, We shared the treatment courses of this patient and review the associated literature on the aspect of multifocal oral carcinoma, parotid node metastasis, and the clinical application of dorsalis pedis free flap.

並列關鍵字

Oral squamous cell carcinoma ； multifocal oral carcinoma ； parotid nodal metastasis ； dorsalis pedis free flap