Adenocarcinoma Not Otherwise Specified in the Maxilla Mimicking a Benign Sinonasal Cystic Lesion-A Case Report

形似上顎竇良性囊腫之腺癌－病例報告

陳怡伶(I-Ling Chen) ； 陳雅薇(Ya-Wei Chen) ； 吳政憲(Cheng-Hsien Wu) ； 高壽延(Shou-Yen Kao) ； 雷天文(Man-Tin Lui)

《臺灣口腔顎面外科學會雜誌》 24卷1期 (2013/03) Pp. 50-57

摘要

無特殊性腺癌是一種唾液腺惡性腫瘤，在組織學上無法歸類於任何一種唾液腺癌。細胞分化程度歧異度大，從低度到高度分化都可能存在。如同其他唾液腺腫瘤，無特殊性腺癌好發於大唾液腺，特別是腮腺。但是，當這種腫瘤發生在上顎區域，很容易被誤診為上顎良性齒源性腫瘤。我們在此提出一個最初被臆斷為齒源性囊腫而手術剜除的上顎左側無特殊性腺癌病例。在診斷確診後，又進行了全面性的腫瘤手術。藉此病例報告，我們呈現此病例的病程及治療計畫決策流程。在擬定手術計畫之前，如果先進行切開性組織切片檢查或細針抽吸式切片檢查可以避免錯誤發生。

關鍵字

上顎無特殊性腺癌 ； 鼻竇囊腫性病灶

並列摘要

Adenocarcinoma, not otherwise specified (adenocarcinoma NOS) is a malignant neoplasm of the salivary glands with ductal and glandular or secretory differentiation that cannot be attributed to any other currently recognized types of salivary gland carcinoma. These tumors exhibit great diversity in the cytoarchitecture which may range from low-grade to highgrade differentiation. Like most salivary gland tumors, adenocarcinoma NOS appears to be more common in the major salivary gland, especially the parotid gland. However, when the tumors develop in the maxillary region, they may bemisdiagnosed as a benign odontogenic or sinonasallesions. Here in we present a case of adenocarcinoma NOS over the left maxillary region that was initially presumed to be an odontogenic cyst and treated by surgical enucleation. An ablative tumor surgery was administered subsequently after the pathology disclosed adenocarcinoma. In this case report we intend to present the clinicalcourse of the disease and discuss the associated decision flow. Pathology diagnosis either by incisional biopsy or fine needle aspiration before definitive surgical treatment is indicated to avoid detention in treatment.

並列關鍵字

Adenocarcinoma Not Otherwise Specified ； Sinonasal Cystic Lesion