以中耳及外耳道腫塊爲表現之罕見鼻咽癌病例

Nasopharyngeal Carcinoma Presenting with a Middle Ear and External Ear Canal Mass

侯士欽(Shih-Chin Hou) ； 葉文堯(Wen-Yao Yeh) ； 榮蘊智(Yun-Chih Jung)

《台灣耳鼻喉頭頸外科雜誌》 43卷5期 (2008/10) Pp. 149-153

https://doi.org/10.6286/2008.43.5.149

摘要

鼻咽癌長久以來好發於中國人，其直接侵犯途徑通常是經由顱底孔洞或副鼻竇，但本院經歷一極爲罕見由耳咽管延伸至中耳及外耳之鼻咽癌病例。病患爲30歲男性，早期以右耳痛、流膿之中耳炎症狀爲表現，之後漸漸才有鼻水及痰液中帶血絲，右側頭痛及右頸快速生長之腫塊等之臨床症狀。耳鏡檢查發現右耳道有似肉芽組織及息肉樣腫塊，而內視鏡發現鼻咽部也有異常腫塊。經中耳、外耳道、鼻咽部腫塊之病理切片證實含有近乎相同之組織型態－未分化癌（WHO分類第三型），影像學檢查可見鼻咽部腫塊經耳咽管至鼓室之連續腫塊顯影，證實此病例之侵犯途徑乃經由耳咽管直接延伸至中耳腔甚至外耳道。

關鍵字

鼻咽癌 ； 耳咽管 ； 延伸 ； 中耳 ； 外耳道

並列摘要

Nasopharyngeal carcinoma (NPC) has been prevalent among the Chinese for a long time. The most common spread routes are the foramina at the base of skull or the paranasal sinuses. However, we encountered an NPC patient with an extremely rare presentation. He was a 30 year-old male who complained of right otalgia with purulent discharge as his initial symptoms. Gradually, he began to suffer from blood-tinged rhinorrhea and sputum, a right headache, and a fast-growing mass of right neck. A physical examination revealed granulation-like tissue and a polypoid mass in the right external ear canal and a bulging mass in the nasopharynx. The pathology of the middle ear, the external ear canal, and the nasopharynx were almost identical, namely an undifferentiated carcinoma (WHO classification type III). In addition, imaging showed that the nasopharyngeal mass was continuous with the tumor in Eustachian tube and that it had extended further to the tympanic cavity. So, from the pathological and imaging evidence, it was confirmed that the nasopharyngeal cancer had spread along the Eustachian tube to middle ear cavity and then further to the external ear canal.

並列關鍵字

nasopharyngeal carcinoma ； Eustachian tube ； extension ； middle ear ； external ear canal