Sclerosing Mucoepidermoid Carcinoma of the Parotid Gland with Neuralgia-A Case Report

腮腺硬化性黏液上皮樣癌合併臉部神經痛－病例報告

李立慈(Li-Tzu Lee) ； 關寶祥(Po-Cheung Kwan) ； 程稚盛(Chi-Sheng Cheng) ； 蕭應良(Ying-Lyung Hisao)

《中華民國口腔顎面外科學會雜誌》 17卷2期 (2006/09) Pp. 101-108

https://doi.org/10.7104/CJOMS.200609.0101

摘要

硬化性黏液上皮樣癌(sclerosing mucoepidermoid carcinoma)是黏液上皮樣癌之一種，文獻不多。其臨床表現比較不如高度黏液上皮樣癌惡性。其形成的原因可能為腫瘤壞死或黏液外漏而產生硬化性反應。
本報告為一左側腮腺黏液上皮樣癌病例，術後病人並無接受化學治療及放射線治療。四年後，因左側頭面那神經痛，經Tegretol藥物及神經外科以顯微腦神經減壓手術治療均無效。電腦斷層證實有一腫塊位於左側腮腺內，疑似黏液上皮樣癌複發。經手術切除腮腺及耳顳神經後，病人的臉部神經痛得到緩解。病理組織切片發現其少有黏液分泌細胞且上皮樣細胞異型亦不明顯。但間質中有膠原性沈積(collagen deposition)和纖維組織發生改變(desmoplasia change)之特殊表現，根據文獻記載，此病患的組織表徵類似硬化性黏液上皮樣癌，因此被診斷為硬化性黏液上皮樣癌。

關鍵字

硬化性黏液上皮樣癌 ； 腮腺 ； 神經痛

並列摘要

In several recently reported cases, sclerosing mucoepidermoid carcinoma has been proposed as a new subtype variant because of its specific histological pattern and low-malignancy potential, when compared with high-grade mucoepidermoid carcinoma in clinical observation. It is believed that tumor infarction and extravasation of mucus are the two mechanisms which cause the sclerosing pattern. Herein, we report a case of sclerosing mucoepidermoid carcinoma. The patient did not receive chemotherapy or radiotherapy after the first operation. Four years later, the patient presented with electric-shock pain over the left facial region. Neuralgia attack was suspected. An anticonvulsant agent (Tegretol) was prescribed and microvascular decompression was performed by a neurosurgeon, but symptoms persisted. CT scan showed a recurrent mass over the left parotid gland. After tumor ablation and sacrifice of the auriculotemporal nerve, the neuralgia symptom subsided. Histology showed rare mucus-secreting cells and no obvious epidermoid cell atypia. Collagen deposition and desmoplastic change were found in stroma. After reviewing the literature, we determined that the characteristic was similar to that of sclerosing mucoepidermoid carcinoma.

並列關鍵字

Mucoepidermoid carcinoma ； Sclerosing ； Neuralgia