同侧腮腺原发2种不同肿瘤1例及文献回顾

谢宏亮， 汤剑明， 张国权南方科技大学第一附属医院，暨南大学第二临床医学院，深圳市人民医院，口腔医学中心口腔颌面外科，深圳（518020）

广东

【摘要】 目的 探讨同侧腮腺内同时原发不同病理类型肿瘤的临床表现、组织病理学特点、诊断治疗及预

1

后。方法 报道 例同侧腮腺内腺淋巴瘤和基底细胞腺瘤同时发生的病例，并结合文献对腮腺多原发肿瘤的

1个月,术前扪及右腮腺浅叶肿物，结合核磁共振检查诊诊疗进行回顾分析。结果 患者发现右腮腺区包块断为右侧腮腺浅叶及深叶肿瘤。全麻下行右侧腮腺深叶及浅叶肿物和部分腺体切除术+面神经解剖术，术后

1

病理报告右侧腮腺浅叶为腺淋巴瘤，深叶为基底细胞腺瘤伴囊变。手术效果良好，无并发症，术后随访 年未

2

见复发。复习文献结果表明，腮腺多原发性肿瘤是指双侧或者单侧同时存在 种或以上的肿瘤。该疾病以手术治疗为主。结论 同侧腮腺内同时原发不同病理类型的肿瘤病例罕见，需完善影像学检查防止漏诊，手术为首选治疗方案，良性肿瘤预后良好。

【关键词】 腮腺； 多原发性肿瘤； 腺淋巴瘤； 基底细胞腺瘤； 细针穿刺活检； 磁共振成像；术中冰冻病理； 手术入路； 包膜外切除

R78 A 2096⁃1456（2024）04⁃0296⁃06

【中图分类号】 【文献标志码】 【文章编号】

微信公众号

. 2 1 [J]. 口腔疾病防治,

【引用著录格式】 谢宏亮，汤剑明，张国权 同侧腮腺原发 种不同肿瘤 例及文献回顾

2024, 32(4): 296⁃301. doi:10.12016/j.issn.2096⁃1456.2024.04.008.

Unilateral parotid gland Simultaneously primary two different pathological tumors: a case report and litera⁃

XIE Hongliang, TANG Jianming, ZHANG Guoquan. Department of Oral and Maxillofacial Surgery,

ture review

Stomatological Medical Center Shenzhen People's Hospital the First Affiliated Hospital of South University of Sci⁃

＆ ＆

ence and Technology＆the Second Clinical Medical College of Ji’Nan University, Shenzhen 518020, China Corresponding author: XIE Hongliang，Email: 83207882@qq.com, Tel: 86⁃755⁃22943590

To explore the clinical manifestations, histopathological characteristics, diagnosis, treatment,

【Abstract】 Objective

and prognosis of simultaneous unilateral primary tumors of different pathological types in the parotid gland.

Methods

A case of simultaneous unilateral primary parotid gland tumors, i.e., adenolymphoma and basal cell adenoma, was re⁃ viewed and analyzed in combination with the literature. The patient discovered a lump in the right parotid

Results

gland area one month prior to presentation, and a tumor was palpated in the shallow lobe of the right parotid gland before surgery. According to MR images, the initial diagnoses were tumors of the shallow and deep lobes of the right pa⁃ rotid gland. The tumors of the deep and shallow lobes were excised with part of the gland, and the facial nerves were dis⁃ sected under general anesthesia. Postoperative pathology revealed an adenolymphoma in the shallow lobe of the right pa⁃ rotid gland and a basal cell adenoma with cystic transformation in the deep lobe. The surgical effect was good, with no complications, and there was no recurrence after 1 year of follow⁃up. A review of the relevant literature showed that mul⁃ tiple primary tumors of the parotid gland can manifest as the simultaneous presence of two or more types of tumors on both sides or on one side, and the disease is mainly treated with surgery. Multiple unilateral primary pa⁃

Conclusion

rotid gland tumors are rare. Imaging examinations need to be combined with clinical evaluations to prevent missed diag⁃ noses. Surgery is the first treatment option, and patients with benign tumors have a good prognosis. parotid gland; multiple primary tumors; adenolymphoma; basal cell adenoma;

【Key words】

【收稿日期】2023⁃08⁃06；【修回日期】2023⁃12⁃10【基金项目】深圳市科技计划项目（JCYJ20220530152406015）【通信作者】谢宏亮，主治医师，硕士研究生，Email：83207882@qq.com，Tel：86⁃755⁃22943590 fine needle aspira⁃

tion biopsy; tion

J Prev Treat Stomatol Dis, 2024, 32(4): 296⁃301.

The authors declare no competing interests.

【Competing interests】

This study was supported by the grants from Shenzhen Science JCYJ20220530152406015). magnetic resonance imaging; intraoperative frozen pathology; and surgical approach;

Technology

Plan extracapsular resec⁃

Project

Foundation(No.

术禁忌证，于全麻下行“右侧腮腺深叶及浅叶肿物和部分腺体切除术+面神经解剖术”，手术入路为经典耳屏前绕耳垂至颌后下颌角下“S”形切口，翻开腮腺咬肌筋膜，解剖并保护面神经分支及主干后切除部分腮腺浅叶及肿物，然后在面神经下方暴露腮腺深叶肿物并完整切除。2

治疗结果

手术过程顺利，术中面神经保存完好，完整切

2 4.5 cm × 2 cm ×

除 个肿瘤，见腮腺浅叶肿瘤大小

2 cm，肉眼可见包膜完整，剖面灰红实性质软；深2.8 cm × 2 cm × 1 cm，

叶肿瘤包膜完整，囊性，大小

0.2 cm，内含清亮稀薄液体（图2）。

壁厚术中冰冻病理提示：右腮腺浅叶肿物：腺淋巴

瘤（Warthin 1

瘤），周围触及淋巴结 枚，呈反应性增生。右腮腺深叶肿物：基底细胞腺瘤。术后患者无面瘫、无涎瘘等并发症。术后石蜡病理报告：右

侧腮腺浅叶肿瘤考虑为腺淋巴瘤（Warthin

瘤），肿

1

瘤由腺管及淋巴间质构成，周围触及淋巴结 枚，呈反应性增生，深叶肿瘤考虑为基底细胞腺瘤伴囊性变，囊壁由基底膜和基底样上皮细胞组成，囊壁部分形成小管状结构，包含两层细胞，内层为柱状细胞和鳞状细胞，外层为肌上皮细胞，细胞体积较小，细胞质较少，染色较深，小管内包含嗜伊红

3）。

物质（图

1 B

术后随访 年，复查腮腺 超，未见肿瘤复发。