Angiosarcoma Presenting as a Left Parotid Mass-Case Report

以腮腺腫塊為表現的血管肉瘤－病例報告

王恩盈(En-Ying Wang) ； 溫永頌(Yung-Sung Wen)

《台灣耳鼻喉頭頸外科雜誌》 57卷2期 (2022/06) Pp. 123-128

https://doi.org/10.6286/jtohns.202206_57(2).123

摘要

Parotid masses are common in our clinical practice, with three-fourths of the cases being benign lesions and pleomorphic adenomas having the highest incidence. In contrast, angiosarcoma is a rare malignant neoplasm that accounts for ＜0.1% of all head and neck cancers. Cutaneous angiosarcoma is the most common subtype that involves the head and neck region and presents initially as bruise-like patches. Angiosarcoma progresses rapidly, with a mortality of 50% within 3 years from diagnosis even after surgical resection. We report a case of parotid angiosarcoma in a 69-year-old woman that initially presented as left preauricular and postauricular tumors for 1 month. Definitive diagnosis was made using immunohistochemical staining of the excised tissue. Disease severity was assessed using chest computed tomography and a whole-body gallium scan, which suggested an inactive disease. The patient responded to surgical excision and postoperative radiotherapy extremely well. She is under regular follow-up postoperatively, with no evidence of recurrence. This case helps improve our understanding of the diagnosis and treatment of angiosarcoma, given its nonspecific presentation and poor prognosis owing to consequent late diagnosis.

關鍵字

angiosarcoma ； head and neck cancer ； parotid mass

並列摘要

腮腺腫塊在臨床上十分常見，其中四分之三的病例為良性病變，以多形性腺瘤的佔比最高。相較之下，血管肉瘤（angiosarcoma）為一種罕見的惡性腫瘤，僅佔所有頭頸癌的＜ 0.1%。皮膚血管肉瘤是最常見於頭頸部的亞型，最初表現為瘀傷樣的斑塊。血管肉瘤進展迅速，即使在手術切除後，診斷後3年內的死亡率仍為50%。我們報告了1例69歲女性的腮腺血管肉瘤，最初表現為左側耳前及耳後腫塊。我們使用切除組織的免疫組織化學染色確診為血管肉瘤。而後，利用胸部電腦斷層掃描、核醫鎵-67發炎掃描並評估疾病嚴重程度，從而確定疾病目前處於非活性狀態。患者對手術切除和術後放射線治療反應極好，療程結束後規律於門診追蹤治療，治療的效果非常理想，截至目前為止並沒有復發的跡象。此病例有助於提高我們對血管肉瘤診斷和治療的理解，避免因為其非特異性的表現而造成延後診斷，進而導致預後不良。

並列關鍵字

angiosarcoma ； head and neck cancer ； parotid mass（血管肉瘤 ； 頭頸癌 ； 腮腺腫瘤）