Zeebregts Clark J, Mastboom Walter J B, van Noort Gerard, van Det Rob J
Department of Surgery, Medisch Spectrum Twente, The Netherlands.
J Craniomaxillofac Surg. 2003 Feb;31(1):62-6. doi: 10.1016/s1010-5182(02)00165-8.
Multiple tumours of the parotid gland with the same histological appearance may occur as synchronous unilateral tumours, but bilaterality has also been reported. Synchronous multiple unilateral parotid tumours with different histology remain rare.
Between January 1988 and May 2002, a total of 341 patients underwent parotidectomy in our department. Medical charts were reviewed retrospectively for synchronous multiple unilateral tumours.
Fourteen patients had two or more tumours within the same specimen. The combinations encountered were two to four adenolymphomas (n=9), adenolymphoma plus pleomorphic adenoma (n=3), adenolymphoma plus MALT lymphoma (n=1), and pleomorphic adenoma plus acinic cell carcinoma (n=1). The outcome was clinical freedom from signs of tumour recurrence in any patient (mean follow-up = 51 months).
Synchronous multiple unilateral parotid tumours usually include two or more adenolymphomas and might occur more often than previously realized. The possibility of a concomitant carcinoma, and the prevention of recurrent tumours, may warrant a more radical surgical excision of the parotid gland, accurate intraoperative examination of the resected specimen, and routine histological evaluation of the entire specimen. Preoperative radiological investigation may further increase the chances of finding multiple parotid tumours.
具有相同组织学表现的腮腺多发肿瘤可能表现为单侧同时性肿瘤,但双侧发病也有报道。具有不同组织学类型的单侧同时性多发腮腺肿瘤仍然罕见。
1988年1月至2002年5月期间,共有341例患者在我科接受了腮腺切除术。对病历进行回顾性分析,以查找单侧同时性多发肿瘤。
14例患者在同一标本中有两个或更多肿瘤。所遇到的组合为2至4个腺淋巴瘤(n = 9)、腺淋巴瘤加多形性腺瘤(n = 3)、腺淋巴瘤加黏膜相关淋巴组织淋巴瘤(n = 1)以及多形性腺瘤加腺泡细胞癌(n = 1)。所有患者均无肿瘤复发迹象(平均随访时间 = 51个月)。
单侧同时性多发腮腺肿瘤通常包括两个或更多腺淋巴瘤,其发生率可能比之前认为的更高。合并癌的可能性以及预防肿瘤复发,可能需要对腮腺进行更彻底的手术切除、术中对切除标本进行准确检查以及对整个标本进行常规组织学评估。术前影像学检查可能会进一步增加发现多发腮腺肿瘤的几率。