外耳道腺样囊性癌8例临床分析

Clinical analysis of 8 cases with adenoid cystic carcinoma of external auditory canal

目的探讨外耳道腺样囊性癌的临床病理特点,总结疗效。方法回顾性分析1985～2001年收治的8例外耳道腺样囊性癌患者的临床资料。结果8例患者中行局部肿瘤切除2例;行外耳道袖状切除加腮腺浅叶切除2例;行肿瘤切除加扩大乳突根治3例(1例手术5次,最后1次行颞骨次全切除术);行耳廓全切除加颞骨次全切除术1例。后4例术后辅以放疗。随访5～15年,2例健在,2例6年后肺转移带瘤生存,2例8年后死于肺转移,2例失访。结论外耳道腺样囊性癌早期确诊和彻底手术是延长患者生命的关键。肿瘤易发生肺转移,远期预后不佳,提倡综合治疗。

Objective To investigate the clinical and pathological features with adenoid cystic carcinoma of the external auditory canal, and evaluate the therapeutic effect. Methods The clinical data of 8 cases with adenoid cystic carcinoma of the external auditory canal were analyzed retrospectively. Results Of all 8 cases, simple tumor resection was performed in 2 cases, combined resection of external auditory canal and superficial leaf of parotid gland in 2 cases, tumor resection and radical mastoidectomy in 3 cases （subtotal resection of temporal bone was performed eventually in 1 case）, and total resection of auricle and subtotal resection of temporal bone in 1 case. All patients were followed up for 5 to 15 years. Two of them were cured, 2 were alive but with pulmonary metastases after operation, and 2 died of pulmonary metastases. Conclusion Early diagnosis and thorough resection of the tumor are crucial to prolong patient＇s life. The long-term prognosis is poor due to recurrence. Combined therapy is recommended.