摘要
平滑肌肉瘤(Leiomyosarcoma)是由平滑肌分化衍生而來，是一種非常稀少的間葉性腫瘤，其中約只有3%~10%發生在頭頸部。在口腔組織當中，主要侵犯的是上顎竇和上、下顎骨，至於如本例發生在舌頭的病患是非常少見。在臨床上，平滑肌肉瘤是一無痛性，緩慢增長的皮下或黏膜下腫瘤，好發於50~70歲女性，腫瘤的顏色以灰白色和粉紅色為主，通常會與鄰近組織緊密結合在一起。在顯微鏡下，此肉瘤是由多種不同的梭行細胞所構成，此細胞並含有雪茄狀的細胞核與嗜伊紅性的細胞質。本病例為54歲女性患者，因舌右側有一紅色病變而到某醫院耳鼻喉科求診，經診斷為黏液囊腫。病患又至另一醫院接受切片檢查，病理報告為纖維肉瘤；並於2002年8月10日至本院求診。口內發現在舌頭右側有一3×2.5cm的外突性腫賬，於是在同年8月30日接受廣泛腫瘤切除術及右側舌骨上頸部清除術，並於同年9月9日出院，術後病理報告為平滑肌肉瘤，並無頸部淋巴轉移，目前患者定期回診，觀察3年尚無復發現象。
並列摘要
Leiomyosarcoma (LMS) is a relatively uncommon mesenchymal tumor that exhibits smooth muscle differentiation. Only 3% to 10% of LMS arise in the head and neck. Most LMS involving the oral tissues primarily affect the maxillary sinus, the maxilla or mandible. LMS of the tongue, like the present case, is a rare lesion. Clinically, they generally appear as a painless, occasionally ulcerated, slowly enlarging, subcutaneous or submucosal mass. The tumors are usually firmly fixed to surrounding tissues. Histologically, the tumor was composed of spindle-shaped cells with elongated, ”cigar-shaped” nuclei and eosinophilic cytoplasm. We report a case of LMS involving the tongue of a 57-year-old female. Tracing hack to her history, she visited an ENT Department of a local hospital due to a reddish, nodular lesion on the right lateral border of tongue, and the diagnosis was mucocele. Then she came to another hospital for an incisional biopsy, and the pathological report was fibrosarcoma. Finally, she was referred to our department for help. Intra-oral examination showed a 3×2.5 cm exophytic, indurated lesion of the right lateral border of tongue. Therefore, she received right supraomohyoid neck dissection and right partial glossectomy on 2002-08-30. The surgical margins were tumor free and no lymph node metastasis was observed. Now the patient was kept on follow-up and no signs of local recurrence could he detected.
延伸閱讀
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