副腮腺病变32例临床分析

Clinical analysis of masses arising from the accessory parotid gland: report of 32 cases

目的：副腮腺病变在临床上并不多见,本研究旨在探讨副腮腺病变的临床表现、治疗和预后。方法：回顾性分析1999年4月—2008年11月收治的32例副腮腺病变患者的临床资料,包括性别、年龄、病程、症状、体格检查、影像学检查、治疗方案、术后病理检查和随访结果。结果：32例患者中,男8例,女24例,就诊年龄19~69岁,平均45岁。患者通常无明显的症状和体征,病变质地中等或偏硬,活动度良好,界限清楚。所有患者均接受手术治疗,术后病理诊断24例为良性病变（多形性腺瘤19例,良性淋巴上皮瘤3例,基底细胞腺瘤和慢性炎症各1例）,8例为恶性病变（腺泡细胞癌和淋巴上皮癌各2例,乳头状囊腺癌、基底细胞癌、上皮-肌上皮癌和黏液表皮样癌各1例）,恶性肿瘤患者术后追加放疗。随访12~128个月,平均36个月,预后良好,未见肿瘤复发。结论：副腮腺病变临床少见,其临床表现与良性肿瘤类似,治疗以手术为主,恶性肿瘤可追加术后放疗,预后较好。

PURPOSE： To analyze accessory parotid lesions in terms of clinical appearance,clinical differential diagnosis,treatment and prognosis.METHODS： From April 1999 to November 2008,32 patients with accessory parotid lesions was treated.The patients＇ general condition,clinical symptoms and signs,preoperative examinations,surgical treatment,and prognosis were recorded and analyzed.RESULTS： Among the 32 patients,there were 8 males and 24 females with an average age of 45 years.The patients always presented without obvious symptoms,and the masses were moderate to hard in hardness without tenderness,mobile with clear boundary.The pathological diagnosis was 24 benign lesions and 8 malignant lesions,including 19 pleomorphic adenomas,3 benign lymphoepithelial lesions,1 basal cell adenoma,and 1 chronic inflammation among benign lesions,while 2 acinic cell carcinomas,2 lymphoepithelial carcinomas,1 papillary cystadenocarcinoma,1 basal cell adenocarcinoma,1 myoepithelial carcinoma,and 1 mucoepidermoid carcinoma among malignant lesions.Surgery and surgery plus radiotherapy were performed in patients with benign and malignant lesions respectively with good prognosis.CONCLUSIONS： Accessory parotid lesions are rare and the clinical manifestations are similar to benign tumors.Surgical resection and surgical resection plus radiotherapy are the primary treatment for benign and malignant lesions,respectively.The prognosis is always good.