腮腺区第一鳃裂囊肿癌变1例

Cancerization of first branchial cleft cyst in the parotid gland: one case report

1病例报告患者,男,84岁,因"右侧腮腺区肿物伴红肿疼痛5d"于2019年11月14日来院。患者述入院5d前发现右侧腮腺区一肿物,约鸡蛋大小,红肿明显,伴间歇性剧烈疼痛,无畏寒发热、面颈部麻木不适、鼓腮漏气、口角歪斜和外耳道溢液等症状。当地医院涎腺彩超提示右侧腮腺可见等、低回声混杂团块。腮腺颌下腺增强CT示右侧颈部胸锁乳突肌上缘深面占位,右侧颈部淋巴结显示,考虑鳃裂囊肿伴感染可能(图1、2)。

A rare case of branchiogenic carcinoma from first cleft branchial cyst in the parotid gland is reported. An elderly male patient was admitted to the hospital presented with a mass accompanying with swelling and pain in the right parotid area for 5 days. Total right parotidectomy including the tumor resection and selective neck dissection were performed under general anesthesia. A thick-walled cyst containing necrotic tissue in the parotid gland was found. Postoperative histopathology showed that the tumor contained squamous epithelium and pseudostratified columnar epithelium. The cyst epithelium had atypical hyperplasia with necrosis. Some areas were cancerous with the formation of well-differentiated squamous cell carcinoma and cancer infiltration. No metastasis was found in the cervical lymph nodes. This case was in accordance with the diagnostic criteria of cancerization of the first branchial cleft cyst.