儿童腮腺肿瘤的临床分析

Clinical analysis of parotid gland tumor in children

目的总结儿童腮腺肿瘤的临床、病理及诊断治疗特点。方法回顾性分析天津医科大学附属肿瘤医院1985年12月～2007年12月收治的77例住院治疗的18岁以下儿童腮腺肿瘤患者的临床、病理和随访资料,并将其与同期收治的1303例成人腮腺肿瘤的发病率和组织病理类型加以比较。结果77例儿童腮腺肿瘤中,良性肿瘤51例,占66.2%,恶性肿瘤26例,占33.8%。良性肿瘤中脉管瘤最多19例,占37.3%,恶性肿瘤中黏液表皮样癌最多9例,占恶性肿瘤的34.6%。67例经手术治疗,上皮性恶性肿瘤中,7例术后辅以放疗。随访1～17年不等,3例局部复发,包括多形性腺瘤1例,恶性肌上皮瘤1例,黏液表皮样癌1例。结论儿童腮腺肿瘤的瘤谱与成人有很大不同,其中脉管瘤和畸胎瘤常发生于儿童,但少见于成人。儿童腮腺实体肿瘤中恶性肿瘤所占比例为50%(18/36),但在成人仅占23.7%(249/1050)。首次手术治疗的彻底性关系到儿童腮腺肿瘤的预后。虽然术后放疗可以降低腮腺癌的复发率,但是放射线对儿童甲状腺的潜在致癌性及对口腔颌面部生长发育的影响还有待于临床上进一步的研究。

OBJECTIVE To investigate the clinical and pathological characteristics and its diagnosis and treatment of the parotid gland tumor in children.METHODS The clinical data of 77 children with parotid gland tumor treated in Department of Head and Neck,Tianjin Cancer Hospital affiliated Tianjin Medical University from Dec.1985 to Dec.2007 were retrospectively studied.RESULTS Among the 77 cases,51 cases were benign tumor（66.2%）,26 cases were malignant tumor（33.8%）.Among the benign cases,hemangioma and lymphangioma were the most common diseases,which accounted for 37.3%（19/51）.Mucoepidermoid carcinoma（34.6%, 9/26） was the most common malignancy.Sixty seven cases were treated surgically.Among 18 cases of the epithelial malignant tumors,7 cases treated combined with postoperative radiotherapy.During the period of following-up from 1 to 17 years,1 case of pleomorphic adenoma,1 case of malignant myoepithelioma and 1 case of mucoepidermoid carcinoma recurred. CONCLUSION The clinical and pathological features of parotid gland tumors in children were different from those in adults.The hemangioma,lymphangioma and teratoma are rare in adults but common in children.Half of the solid tumors of parotid gland in children are malignant,but only 23.7%in adults. The primary radical operation has great value to the prognosis of children parotid tumor.Although postoperative radiotherapy can reduce the risk of recurrence,oncogenesis in thyroid gland and the adverse effect on the orofacial development of radiotherapy in children need investigated clinically in future.