腮腺之嗜酸細胞瘤－罕見病例報告

嗜酸細胞瘤為唾液腺罕見的良性腫瘤，惡性轉變率低，生長速度也很慢，治療以手術切除為主，放射線治療的效果並不理想。當發現唾液腺腫塊時，影像檢查可使用電腦斷層，核磁共振及鎝-99m顯影；電腦斷層為第一線使用的影像工具，但核磁共振對於唾液腺腫瘤的鑑別診斷則較精確。臨床上唾液腺腫瘤診斷先以細針抽吸細胞學檢查初步排除惡性變化，精確度高達90%。確切診斷須經由手術大標本判定，因其腫瘤細胞之型態與華生氏瘤的組成類似，且某些惡性唾液腺瘤也會有嗜酸性變化，在病理診斷時需加做特殊染色（mucin，P63及PAX-8），以完全排除惡性腫瘤及非原發腫瘤之可能。本病例報告為一腮腺的嗜酸細胞瘤，本文簡介嗜酸細胞瘤之好發年齡、盛行率、發病部位、組織型態，並對病理鑑別診斷及治療方式做討論。

關鍵字

嗜酸細胞瘤；嗜酸性變化；華生氏瘤；腮腺

並列摘要

Oncocytoma is a rare benign tumor occurs in salivary gland of the oral cavity. This tumor presents indolent slow growing and low malignant transformation rate. Surgical excision is known as the curative treatment option rather than other modalities such as radiotherapy. Initially, radiographic imaging examination is playing important role in differential diagnosis and treatment planning for suspicious of tumor formation in parotid gland. For example, computerized tomographic scan (CT) may be the first line image tool to assess tumor status accurately, as well as, magnetic resonance imaging (MRI) could be showing better and specific ability to diagnosis of soft tissue tumor. Using fine needle aspiration (FNA) cytology examination commonly, the accurate rate is around 90% in detection of malignancy of salivary gland. However, FNA cytology examination is limited to identify cell types between oncocytoma and Warthin' s tumor, owing to the similarities of microscopic presentations. Also, it would be needed to preform additional special immunohistochemistry staining (such as mucin, P63 and PAX-8) for rule out the possibility of malignancy and metastasis tumor from kidney and thyroid gland. We present a case of 78-year old female with a low-grade growing mass on right side retromandibular region and subsequent treated by surgical excision at our department smoothly. This case report will attempt to discuss the disease natures, differential diagnosis, and prognosis of oncocytoma.

並列關鍵字

Oncocytoma ； Oncocytic change ； Warthin's tumor ； Parotid gland

國際替代計量

腮腺之嗜酸細胞瘤－罕見病例報告

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