單側腮腺同時多發性華生氏瘤－病例報告

華生氏瘤是腮腺好發率第二高的良性腫瘤，約佔所有腮腺腫瘤的2%至10%。好發年紀在60至70歲，男性較女性發生率高，與吸煙有密切相關性。多發性腮腺腫瘤在臨床上較罕見，大多數是多發性華生氏瘤。我們提出了一個罕見病例的病例報告：單側腮腺同時多發性華生氏瘤。本病例爲一名51歲的男性病患，有長期吸煙的習慣，來院主訴爲在五年内，出現了無痛且緩慢變大的右側腮腺腫瘤，理學檢査結果，沒有顏面神經功能障礙，口内無異常腫塊。爲他安排頭頸部的磁振造影，影像顯示在右側腮腺出現兩個獨立的腫瘤。因此安排右側全腮腺切除手術，將整個腮腺合併腫瘤切除。病理組織切片報告結果顯示爲兩個華生氏瘤。顯微切片下顯示出乳頭狀，瘤狀细胞上皮和淋巴組分組成的良好的結節。兩個華生氏瘤大小分別爲2.9 × 2.8 × 2.1立方公分（淺葉）和4.6 × 2.8 × 1.9立方公分（深葉），與周邊的邊緣最近小於0.1公介。腫瘤之間的距離爲0.45公分。單側腮腺同時多發性華生氏瘤的發生是很罕見的，合併深葉的華生氏瘤侵犯更極爲罕見。對腮腺腫瘤手術前評估，如細針穿刺细胞檢查或電腦斷層掃描輔助的組織切片在術前檢查非常重要。然而，腮腺深葉的組織切片風險和困難度對於臨床醫師仍然是有爭議的。本病例考慮深葉的組織切片風險和困難度，採取全腮腺切除手術直接檢査的方式作爲斷及治療。

關鍵字

華生氏瘤；全腮腺切除術；同時性

並列摘要

Warthin tumor is the second most common benign tumor of the parotid gland, representing approximately 2 % to 10 % of all parotid tumors. It is more common in males between 60 and 70 years of age and is closely related to smoking. The occurrence of multiple tumors in the parotid glands is rare and the majority of these are multifocal Warthin tumons (adenolymphoma or papillary cystadenoma lymphomatosum). We report a rare case of multiple Warthin tumors in the parotid gland In this case, a 51-year-old male tobacco smoker presented with a painless, slowly enlarging right parotid gland for 5 years. He does not have tender and facial nerve dysfunction when he presents in our clinic. Magnetic resonance imaging of the head and neck demonstrate two separated solid masses in the superficial and deep lobe of the gland respectively. Base on dinical and imaging examinations, Warthin tumor of right parotid gland is highly suspected. Total parotidectomy is performed, and the resected gland is found to contain two separated masses. The histopathologic result shows two Warthin tumors. The microscopic view, shows well-delineated nodules composed of papillary, oncocytic epithelium and lymphoid components Two well-circumscribed tumor masses measuring 29 × 28 × 2.1 cm^3 and 4.6 × 28 × 19 cm^3, which are both less than 0.1 cm away from the nearest margin. Distance between two tumors is 0.45 cm. The occurrence synchronous ipsilateral Warthin tumor is rare, and the deep lobe involvement is extremely rare. The pre-surgical evaluations such as fine needle aspiration biopsy or guided tissue biopsy via computed tomography is very important. However, the risk and difficult for tissue biopsy of deep lobe of parotid gland is still controversial for clinician. Definite diagnosis can only be obtained through a histopathologic result. Total parotidectomy is the recommended treatment for the disease.

並列關鍵字

Warthin tumor ； Total parotidectomy ； Synchronous

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單側腮腺同時多發性華生氏瘤－病例報告

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