摘要
類澱粉沉積症(amyloidosis)是一種蛋白質代謝異常的疾病，有典型且具嗜伊紅性物質沉積在身體各個器官，發生原因及致病機轉目前仍無定論。可分爲全身性(systemic)和局限性(localized)，而全身性又可分類成原發型(primary)及續發型(secondary)。至於在頭頸部，類澱粉沉積症的發生則爲少見，且大多數爲局部侵犯的型態，而其中又以喉部爲好發位置。發生於頭頸部位僅有零星案例報告，但發生在腮腺則更爲罕見。本部於2006年2月間經歷一60歲的女性病患，主訴左耳下方發現一硬塊兩年，因最近3個月硬塊快速增長，轉至本院就診。理學檢查於左耳下發現一個約3×3 cm不可移動之腫塊，無壓痛感且觸感具彈性。術前頭頸部電腦斷層攝影顯現一約3×3 cm邊界不清晰之腫塊於左側腮腺。病人接受全身麻醉手術切除左側全葉腮腺並保留顏面神經。病理報告顯示爲類澱粉沉積症。術後病患耳下腫塊消失，且無其他任何不適之症狀。於門診追蹤至今將近2年，理學檢查並無復發跡象且身體其他並無新發現之病灶。腮腺類澱粉沉積症實屬少見，特此提出此一病例報告並予討論。
並列摘要
Amyloidosis is a kind of disease with abnormal protein metabolism characterized by the accumulation of eosinophilic material in various organ. Amyloidosis may be either systemic or localized, and the former can be further divided into primary and secondary. Amyloidosis affecting the head and neck region is uncommon and is mostly in the form of localized amyloidosis. Larynx is the most common site of involvement. In February 2006, we encountered a 60-year-old female patient who had history of left infraauricular mass for 2 years, but it was progressive in recent months. Then she was referred to our department for further evaluation. Physical examination showed a 3×3 cm ma which was fixed, nontender and elastic over left infraauricular area. Preoperation CT scan of the head and neck revealed a tumor mass about 3×3 cm within left parotid gland without clear border. The patient accepted left total lobectomy of parotid gland under general anesthesia. The histopathologic examination confirmed the diagnosis of amyloidosis. There was no more mass over left infraauricular area after operation and patient did not feel any discomfort. Patient was regularly followed up for 2 years without recurrence.
延伸閱讀
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