手术切除带骨性包壳的咽旁间隙多形性腺瘤一例

Analysis of One Parapharyngeal Space Pleomorphic Adenoma Patient with Ossified Capsule

目的探讨带骨性包壳的咽旁间隙多形性腺瘤的临床特征和影像学特点,提高诊治水平。方法对收治的带骨性包壳的咽旁间隙多形性腺瘤1例的临床资料进行回顾性分析。结果本例因头晕2月余,发现右侧咽旁间隙肿物1个月入院。查体:咽腔相对狭窄,右侧扁桃体Ⅲ度肿大,左侧扁桃体Ⅱ度肿大。行头颅CT扫描示:右侧咽旁间隙见一2.4 cm×3.6 cm×3.8 cm大小的类圆形团块,病变呈混杂软组织稍高密度影,边缘为蛋壳样包壳,内见少许低密度区,考虑涎腺混合瘤可能。头颅MRI示:右侧咽旁间隙见一团状混杂信号影,界线清晰,可见类包膜样影。行手术切除,术后病理报告:多形性腺瘤伴钙化。后痊愈出院。结论带骨性包壳的咽旁间隙肿物临床少见,及时行相关检查,可减少误诊误治。

Objective To investigate clinical and imaging characteristics of parapharyngeal space pleomorphic adenoma with ossified capsule in order to improve diagnostic level. Methods Clinical data of one parapharyngeal space pleomorphie adenoma patient with ossified capsule was retrospectively analyzed. Results The patient was admitted for dizziness more than 2 months and discovering parapharyngeal space mass for Ⅰmonth. Relative pharyngeal cavity stenosis, grade Ⅲ right tonsil and grade Ⅱ left tonsil were found. Head CT scan showed that the 2.4 cm × 3.6 cm× 3.8 cm eggshell-like mass was found in right parapharyngeal space, lesion was mixed soft tissue with slightly high density image, and border was surrounded by eggshell-like ossified capsule with a little low density area in it, and then mixed salivary gland tumor was considered. Head MRI showed that tuft-like mixed image was found in right parapharyngeal space and visible envelope-like image. Exsection was performed, and pleomorphic adenoma with calcification was diagnosed by postoperative pathological result. The patient was cured and discharged. Conclusion The parapharyngeal space pleomorphic adenoma with ossified capsule is rare, and there- fore relevant examination should be performed in time to reduce incidence rate of misdiagnosis and mistreatment.