會厭海綿狀血管瘤

Cavernous Hemangioma of the Epiglottis

陳建志(Jiann-Jy Chen) ； 王興萬(Hsing-Won Wang) ； 鄭明芳(Ming-Fang Cheng)

《台灣耳鼻喉頭頸外科雜誌》 40卷2期 (2005/04) Pp. 78-81

https://doi.org/10.6286/2005.40.2.78

摘要

血管瘤是人類孩童時期最常見的良性腫瘤，超過一半的是發生於頭頸部，但是發生於下咽的實屬罕見，其中恰巧位於會厭的更爲罕見。會厭血管瘤必須與會厭囊腫或是其他的會厭良性腫瘤做鑑別診斷，包括甲狀線舌骨囊腫、皮樣囊腫、畸胎瘤、淋巴管瘤、軟骨瘤、舌部甲狀或是乳突狀瘤等。本院報告1例45歲女性，以咽喉異物感爲主訴，經間接喉鏡檢查初步臆斷爲會厭囊腫，經直接喉鏡下手術切除時難以止血，只好以鉀鈦磷雷射(KTP laser)燒灼殘存的腫瘤組織後方止血，最後病理確定診斷爲會厭海綿狀血管瘤之罕見案例。因此，當我們發現會厭部位的腫塊時，縱然它有一般的外表，還是要想到血管瘤的可能性，貿然的麻醉插管、切片檢查及手術切除頗具風險，唯有術前詳盡的檢查，包括核磁共振和血管造影，方可給予正確的評估及選擇適切的治療方式。

關鍵字

海綿狀血管瘤 ； 會厭囊腫

並列摘要

Hemangioma is the commonest benign tumor in infant and child. Although over half hemangioma occurs in the head and neck region, epiglottic hemangioma is a rare curiosity. The differential diagnosis is epiglottic cyst or other benign tumors, including thyroglossal duct, dermoid cyst, teratoma, lymphangioma, chondroma, lingual thyroid, or papillomatosis. A 45-year-old female patient presented with foreign body sensation in the throat for half a year. An epiglottic cyst was highly suspected by indirect laryngoscopy. However, high bleeding tendency was encountered during surgical excision under direct laryngoscopy. KTP laser was used to vaporize the residual tumor and to terminate bleeding. The pathology revealed cavernous hemangioma. In conclusion, we should keep in mind the possibility of epiglottic hemangioma when confronted with a common epiglottic mass. A hasty intubation, biopsy, and excision can be dangerous. To arrive at an accurate diagnosis and the appropriate treatment, detailed pre-operative evaluations, including magnetic resonance images and angiography, may be needed for differential diagnosis in selected cases.

並列關鍵字

cavernous hemangioma ； epiglottic cyst