摘要
背景：肌類上皮瘤（myoepithelioma）是少見但已被確實區分出來的腫瘤，至今僅有少數案例報告。方法：回溯性病歷查閱從2006年5月至2011年1月童綜合醫院耳鼻喉科病患中，共診斷有7個病患。針對病人疾病之臨床症狀、病理診斷、治療選擇及結果予以討論。結果：7名病人中有6名良性肌類上皮瘤及1名惡性肌類上皮瘤，免疫染色大部份病人呈現上皮免疫染色S-100、EMA、vimentin、KI-67及cytokeratin （AE1/AE3）陽性反應，並且所有良性腫瘤切除後均無復發之跡象。討論：要建立良性肌類上皮瘤或惡性肌類上皮瘤之診斷需要病理免疫染色，而要建立惡性肌類上皮瘤之診斷除要有肌上皮組織分化外，腫瘤細胞還需表現出惡性表徵。治療上，良性肌類上皮瘤主要是完整切除，惡性肌類上皮瘤則需廣範圍切除，甚至需作頸部淋巴廓清手術或是術後放射治療，腫瘤切緣是否乾淨是很重要的預後因子。
並列摘要
BACKGROUND: Myoepithelioma is a rare but well-characterized group of tumors with very few cases reported to date.METHODS: Retrospective chart review were performed on all patients who were treated at the Department of Otolaryngology, Tungs' Taichung MetroHarbor Hospital from May 2006 to January 2011, and were pathologically diagnosed with myoepithelioma, both benign and malignant. We analyzed clinical data including clinical presentation, pathological diagnoses, treatment options and outcome.RESULTS: A total of 7 patients were collected. There were 6 myoepitheliomas and 1 myoepithelial carcinoma. While no recurrence was noted in all benign myoepitheliomas, one malignant myoepithelioma developed lung metastasis due to involvement of the surgical margins. Applying immunohistochemical studies, all cases were reactive for epithelial markers.CONCLUSION: To establish the diagnosis of benign or malignant myoepithelioma, immunohistochemical staining and tumor biological presentation were important. Treatment of choice for benign lesions is wide excision. The malignant tumors require broad tumor-free margins, neck-dissection and radiotherapy. Margin status is an important predictive indicator.
延伸閱讀
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