巨大頸部蛤蟆腫

頸部蛤蟆腫為臨床上不常見的疾病，其成因是由於舌下腺黏液外滲入頸部間隙中，造成無上皮內襯的假性囊腫。典型的表現為頸部柔軟、無痛性、非可動性腫塊，且部分病人曾有口底手術或外傷的病史。本病例為一罕見之巨大頸部蛤蟆腫以廣泛頸部賬痛、頭痛及牙關緊閉表現。病人曾於一年半前曾接受過口底蛤蟆腫切除手術，但並未完整的摘除舌下腺。電腦斷層顯示許多低密度囊腫佔滿了整個下頜間隙及舌下間隙，並延著側咽間隙向上延伸至顱底，造成對周圍組織的腫塊效應。之後病人接受經頸部方式摘除頸部蛤蟆腫、舌下線及下頜腺，病理報告顯示分別為假性囊腫及慢性發炎。術後因囊腫造成的壓迫症狀立即得到緩解。雖然術後有短暫舌頭麻木感，但在一個月內即恢復。患者術後恢復良好，並無複發跡象。因病例罕見，故提出報告。

關鍵字

巨大蛤蟆腫；舌下線；側咽間隙

並列摘要

A plunging ranula is a relatively uncommon phenomenon, presenting as mucous extravasation from a sublingual gland into the cervical tissue spaces, with a pseudocyst that lacks an epithelial lining. It typically manifests as a soft, painless, non-mobile swelling in the neck, with some patients having had previous mouth-floor surgery or trauma. We present a rare case of giant plunging ranula with headache and trismus, associated with an extensive right-sided tender swelling of the neck. The patient had undergone surgery for an oral ranula 15 months previously, without complete excision of the sublingual gland. A computed tomography scan of the neck revealed variously sized low attenuation cystic lesions involving the sublingual and submandibular space, with extension into the parapharyngeal space up to the base of the skull, causing a mass effect on the surrounding structures. The patient underwent surgical removal of the cervical cyst and sublingual gland via a cervical approach. The histopathologic examination confirmed the pseudocystic wall and chronic inflammation of the gland. Symptoms caused by cyst compression were relieved immediately after surgery. Temporary numbness of the tongue was noted postoperatively but resolved within 1 month. No recurrence of the ranula was observed during the subsequent follow up.

並列關鍵字

giant ranula ； sublingual gland ； parapharyngeal space

國際替代計量

巨大頸部蛤蟆腫

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