口腔黏膜之腺細胞癌 — 病例報告
Acinic cell carcinoma of the buccal mucosa-
case report
方嘉郎
Ue-Chen Kao;Fei-Peng Lee;Wei-Jing Wu;Chia-Lang
Fang
摘要 腺細胞癌是較不常見之唾液腺腫瘤，大多發生在腮腺，少數發生在下頜腺及舌下 腺，發生於小唾液腺則相當罕見。此腫瘤發生率約佔所有唾液腺腫瘤的 1-4%， 腮腺所有腫瘤的 3-5%，大唾液腺惡性腫瘤之 7-15。此腫瘤之臨床表現一般而言 為一緩慢成長，直徑小於 3cm，疼痛程度不一之腫塊。由於此病發生率不高，臨 床醫師往往難以在初次就診時，即能給予正確的診斷。本例為 46 歲女性，主訴 左側上臉頰口角處有一腫塊約 3 年，經手術切除後證實為一腺細胞瘤，追蹤 31 個月迄今無復發現象。Abstract
Acinic cell carcinoma is a rare salivary gland tumor, occurring almost exclusively in the parotid gland. Submandibular and sublingual gland involvement is rare and minor salivary gland origin is exceptional. Clinically, most acinic cell carcinomas present as a
slow-growing mass, fixed or mobile, hard or cystic, and with variable degrees of pain. Given its rarity, it is difficult to diagnose at a patient＇s initial visit. The usual clinical diagnosis is one of a mixed tumor. The rate of recurrence is high. Metastasis, if it occurs, has a predilection for the lung, but regional lymph nodes are rarely affected. After careful excision of the acinic cell carcinoma, frozen sections should be made to confirm the adequacy of the surgical margins in an effort to minimize recurrence and metastasis. We present the case of a 46-year-old woman whose chief complaint was swelling of the left buccal mucosa, which had grown slowly over three years. After surgical excision, tissue pathology revealed it to be an acinic cell carcinoma of a minor salivary gland. No evidence of recurrence was found over 31 months of follow-up. Acinic cell carcinoma should be included in the differential diagnosis of buccal squamous cell carcinoma.
