腮腺深叶基底细胞腺瘤的诊断与治疗(附2例报告)

Diagnosis and treatment of basal cell adenoma from deep leaf of parotid (Report of two cases and literature review)

目的探讨腮腺基底细胞腺瘤的临床特点、生物学行为、组织病理分型和治疗方案。方法报道2例发生于腮腺深叶的基底细胞腺瘤患者的临床资料,结合文献复习进行分析。结果 2例患者通过手术切除肿块及同侧腮腺腺体,保留面神经,病理证实为腮腺基底细胞腺瘤,术后患者恢复良好,随访至今无复发。结论腮腺基底细胞腺瘤是一种罕见的良性肿瘤,发生于腮腺深叶的更为少见,影像学检查是其主要的诊断方法,组织病理学是其确诊并分型的主要依据。需要与咽旁肿瘤及腮腺来源的其他肿瘤类型相鉴别。腮腺基底细胞腺瘤有四种病理亚型,其中膜性型具有多灶侵袭性,并可伴发其他皮肤肿瘤,同时具有较高复发率和恶变率。腮腺基底细胞腺瘤的治疗主要采取腮腺部分或浅叶及其全腮腺切除术,膜性型应行全腮腺切除,及时随访。

Objective To discuss the clinical characteristics,biological behaviour,histopathological grouping and treatment of basal cell adenoma of parotid.Methods Clinical and pathological data of two patients suffering from basal cell adenoma from deep leaf of parotid were analyzed retrospectively with a review of related literature.Results The masses combined with ipsilateral parotid gland were surgically removed with reservation of the facial nerve.The postoperative diagnosis was confirmed to be basal cell adenoma histopathologically.The patients recovered well postoperatively and were alive without recurrence after following up for 6 months.Conclusion Basal cell adenoma of parotid is an extremely rare benign tumor.It can be diagnosed mainly by imaging and fine needle aspiration,and the final diagnosis depends on histopathology.This tumor should be differentially diagnosed from other tumors originated from parapharyngeal space and parotid.Basal cell adenoma of parotid has four pathological subtypes.The membranous basal cell adenoma is special due to its multifocal invasion,accompanying skin tumors,high recurrence rate and malignancy.Partial or total parotidectomy is proper treatment strategy for basal cell adenomas of parotid.Total parotidectomy should be adopted to membranous basal cell adenoma,and the postoperative follow-up period should be shortened.