以硬质肿块为表现的耳鼻咽喉小涎腺来源腺样囊性癌(附9例报告)

Adenoid cystic carcinoma of ENT associated with hard lump: a report of 9 cases

目的：探讨以硬质肿块为表现的耳鼻咽喉小涎腺来源腺样囊性癌的临床特征，病理特点及预后。方法：回顾性分析9例以硬质肿块为表现的发生于耳鼻咽喉各部位的小涎腺来源腺样囊性癌患者的临床资料。结果：本组患者从出现症状到确诊时间平均为4．3年，随访6个月～15年；9例均复发，死亡5例，其中肺转移3例，骨转移1例，颅内扩散1例；存活4例。带瘤生存时间最长为6年3个月。结论：本组9例病理类型均为实心型小涎腺来源腺样囊性癌，均有以硬质肿块生长为主要表现的特点，应及早诊断，第1次行扩大手术，术后辅以放疗，其预后远较其他类型差。

Objective：To assess the clinical and pathological features of the patients with ENT adenoid cystic carcinoma（ENTACC） who presented with hard lump, and to detect its prognosis. Method： A retrospective analysis was performed on 9 patients with ENTACC by their clinical data. Result：The period from the occurrence of primary symptoms to definite diagnosis was 4 years and 3 months on average. All patients were followed up from 6 months to 15 years. All of the cases relapsed after operation and radiotherapy. Five patients died, among which 3 died with lung metastases, 2 with local lymphatic metastases, 1 with bonemetastases and 1 with encephalic diffusion. The other 4 cases still survive. The longest survival period with tumor was 6 years and 3 months. Conclusion： The pathological result of these 9 cases were all salivary gland derived adenoid cystic carcinoma of solid type. It was mainly characterized by the development of ENT hard lump. All of the patients should be diagnosed in time. Extensive excision and postoperative radiotherapy are needed at the first time. The tumor of solid histological pattern appears with much poorer prognosis compared with that of other histological pattern.