摘要
平滑肌瘤(leiomyoma)是起源於平滑肌纖維細胞的良性軟組織腫瘤，好發於消化道、子宮、皮膚和皮下組織。頭頸部平滑肌瘤約占所有軟組織平滑肌瘤的1%，而發生在副鼻竇的平滑肌瘤相當罕見。本文報告1名24歲女性病人至本科求診，主訴左側顏面疼痛約10年之久，曾經被診斷爲齲齒而接受拔除手術，也曾被診斷爲三叉神經痛而接受治療，不過症狀並無改善。電腦斷層檢查發現位於左上頜竇有一平滑但不均勻的腫瘤，壓迫到眶下神經。經Caldwell-Luc副鼻竇手術切除腫瘤後，病理特殊染色証實爲平滑肌瘤。根據Murono等在1998年統計27個鼻腔內平滑肌瘤的病例，只有3個副鼻竇平滑肌瘤病例，國內則至今尚無病例報告。因屬罕見，特此提出此一病例報告並予討論。
並列摘要
Leiornyomas are benign smooth-muscle tumors that are commonly seen in the areas such as alimentary tract, uterus, skin, and subcutaneous tissue. Only approximately 1% of leiomyoma are found in the area of the head and neck areas and they are rarely seen in the paranasal sinuses. In this report, we describe a 24-year-old female patient who had had a medical history of persistent pain in the area of her left cheek for 10 years. She was initially diagnosed with dental caries, and as a result, her left upper first and second premolar teeth were extracted. In addition, she was treated for trigeminal neuralgia, but the symptoms persisted. Using a CT scan, a heterogeneous mass was located within her left maxillary sinus and this was found to have caused infraorbital nerve compression. After the tumor was excised totally via a Caidwell-Luc procedure, the tumor was verified to be leiomyma by histopathological examination. Based on the review of Murono et al., which was published in 1998, there were only three paranasal sinus leiomyoma cases among their twenty seven case studies. As this is the first reported case in Taiwan, we would like to put this case forward and discuss its causes, diagnosis and treatment.
延伸閱讀
- 邱盛璋、陳穆寬（2011）。上頜竇棕色腫瘤。台灣耳鼻喉頭頸外科雜誌，46(3)，176-178。https://doi.org/10.6286/2011.46.3.176
- 江郁翰、莊永勳、張正權（1998）。上頜骨高度分化不良之軟骨肉瘤－病例報告。中華民國耳鼻喉科醫學會雜誌，33(5)，532-535。https://doi.org/10.6286/1998.33.5.532
- 陳震宇、李明儒、陳錦國、陳世英、李勝煌（2003）。上頜竇之血管內乳突狀內皮增生。台灣耳鼻喉頭頸外科雜誌，38(3)，126-129。https://doi.org/10.6286/2003.38.3.126
- Yuan, W. H., Teng, M. M. H., Hsu, H. C., Chen, S. S., Lirng, J. F., Chang, F. C., Luo, C. B., Guo, W. Y., Chiang, J. H., & Chang, C. Y. (2001). 上顴骨咀嚼區病灶. The Kaohsiung Journal of Medical Sciences, 17(3), 139-149. https://doi.org/10.6452/KJMS.200103.0139
- 邱建鋐、郭葉璘、郭芳穎、簡志彥（2007）。Cavernous Hemangioma of the Maxillary Sinus。台灣耳鼻喉頭頸外科雜誌，42(2)，55-58。https://doi.org/10.6286/2007.42.2.55