腮腺分泌性癌的临床表现及影像学特点

Clinical Manifestations and Imaging Characteristics of Parotid Secretory Carcinoma

目的:探讨腮腺分泌性癌的临床表现及影像学特点。方法:回顾性研究2017年1月~2020年10月就诊于郑州大学第一附属医院,接受手术经且病理诊断为腮腺分泌性癌的患者的临床资料,统计并分析患者的临床表现及影像学特点。结果:研究共纳入10例患者,男5例,女5例;发病年龄2~68岁,其中儿童2例,青少年1例,平均年龄38.5岁;肿物最大径在2.5~4.8 cm,病变多数累及腮腺浅叶及深叶、质地中等偏硬、边界清晰、活动度差,临床表现为渐进性生长的无痛性肿物。B超表现为边界清晰的囊实性病变,且囊性为主,未见明显的血流信号(5/7);5例CT显示病变呈浅分叶状,增强后呈不均匀强化,可见囊性低密度区及结节状影像,边界清晰(5/6);MRI示:圆形或结节状等T1长T2信号,压脂像高信号,ADC呈低信号,囊性成分在T1加权成像和T2加权成像时,显示为高信号,实性成分在T2加权成像时显示低信号(4/4)。结论:腮腺分泌性癌为比较罕见的低度恶性唾液腺肿瘤,其临床表现及影像学特点为腮腺分泌性癌的术前诊断提供了依据。

Objective:To investigate the clinical manifestations and imaging characteristics of parotid secretory carcinoma.Methods:The clinical data of patients with parotid secretory carcinoma who were treated in the First Affiliated Hospital of Zhengzhou University from January 2017 to October 2020 were retrospectively analyzed.The clinical manifestations and imaging characteristics of the patients were analyzed.Results:Ten patients,5 males and 5 females,were included in the study.The onset age was 2-68 years old,including 2 children and 1 adolescent,with an average age of 38.5 years old.The maximum diameter of the tumor was 2.5-4.8 cm.Most of the lesions accumulated in the superficial and deep lobe of the parotid gland,with medium to hard texture,clear boundary,and poor activity.The clinical manifestations were gradual growth of pailess tumor.B-ultrasound showed clear boundary cystic solid lesions,mainly cystic lesions.There was no obvious blood flow signal(5/7).CT showed that the lesions were shallow lobulated,and were heterogeneous enhanced after enhancement.Cystic low-density areas and nodular images were visible with clear boundary(6/7).MRI showed round or nodular,long T1 and T2 signal,high signal on fat pressure image,low signal on ADC.The cystic components showed high signal on T1 weighted imaging and T2 weighted imaging.The solid component showed low signal intensity(4/4).Conclusion:Secretory carcinoma of parotid gland is a rare low-grade malignant salivary gland tumor.Its clinical manifestations and imaging characteristics provide a basis for the preoperative diagnosis of parotid secretory carcinoma.